[Early diagnosis, early therapy and prognosis of epidemic cerebrospinal meningitis]. / Ranniaia diagnostika, ranniaia terapiia i prognoz épidemicheskogo tserebrospinal'nogo meningita

The authors convened a special study for purposes of determining early signs of epidemic cerebrospinal meningitis and for the dependence of the prognosis from early etiotropic and pathogenetic therapy. On the basis of a study of 93 cases criteria of early diagnosis are being given. Unlike the data in literature, in 60.2% of the cases it was possible to initiate treatment during the first hours of the disease and in 94.6% -- not later than 48 hours. In most of the cases the disease had a grave course. Changed consciousness was observed in 55.9%, an increased amount of protein in the CSF -- in 58%. In 8 cases there was a syndrome of acute renal insufficiency. Despite these facts all the patients recovered. The authors come to the conclusion that prognosis may be significantly improved in cases of early diagnosis (during the first hours), intensive penicillin therapy (both intravenously and kanamicin into the carotid artery). The authors suggest that during reconvalescence it is feasible to prescribe resolving (pyrogenal lydase) and general therapy.