Prognostic factors in pneumococcal meningitis

Abstract

The incidence of pneumococcal meningitis at the Philadelphia General Hospital was constant at 4.2 to 5 cases per 10,000 admissions per year for 23 years. The case fatality rate for the years 1952 to 1964 was 37%, compared to 79% in the previous decade. This remarkable improvement in prognosis is probably attributable to the use of large doses of penicillin and has unmasked the influence of certain host factors. The major determinants of prognosis are age, the severity of the meningitis and the presence or absence of associated disease. The adverse effect of increasing age can be explained by the increasing prevalence of associated disease. The response of survivors to treatment was described.