ACUTE PURULENT MENINGITIS IN CHILDREN: EXPERIENCE AT THE HOSPITAL FOR SICK CHILDREN, TORONTO.

Sixty-eight children with acute purulent meningitis were treated at The Hospital for Sick Children, Toronto, in 1962; nine deaths occurred. Hemophilus influenzae type B and meningitis in which no organism was cultured accounted for 35 and 17 cases, respectively. A number of other etiological agents caused six or fewer cases each.The principal presenting complaints were fever and vomiting, the more familiar symptoms of meningeal irritation occurring in 20% or less. A short duration of onset suggested a more severe illness and graver prognosis. Seven of the nine fatal cases had a presenting history of less than 24 hours' duration. Persisting high fever, convulsions, cyanosis and abdominal distension were also associated more specifically with the fatal cases.The laboratory examination of the initial spinal fluid sample, while of value in the identification of the causative organism, was not of prognostic value.The value of general treatment measures, as well as specific therapy, was evident in all cases.