Bacterial Meningitis in Spina Bifida Cystica: A Review of 37 Cases

Abstract

Out of a consecutive series of 262 infants with spina bifida cystica, 37 developed bacterial meningitis. The cerebrospinal fluid changes were typical of pyogenic meningitis. The positive cultures obtained produced Gram-negative bacilli in 22 in Group I, the commonest organism being Escherichia coli (12 cases). Pseudomonas pyocyanea was responsible for 7 cases. Gram-positive cocci were detected in 11, out of which 6 were Staphylococcus aureus. P. pyocyanea and staphylococcal infections were responsible for 7 out of 8 cases which were the result of procedures for the investigation and treatment of the associated hydrocephalus. Antibiotic treatment appropriate to the nature and sensivity of the organism was given by the systemic and intraventricular routes. Intraventricular hydrocortisone was used in each case. There were 8 survivors in Group I, of whom only one shows a normal mental development. There were 3 survivors in Group II (2 cases of pneumococcal and one of meningococcal meningitis).