Treatment of Tuberculous Meningitis with Streptomycin

¹ Chief, Medical Division II, and Assistant to the Medical Director, B. S. Pollak Hospital for Chest Diseases, Jersey City, New Jersey.

1) The results of an experiment to determine the effects of intrathecally administered streptomycin in a small group of non-meningitic patients are recorded.

2) Particular emphasis is placed on the evaluation of cerebrospinal fluid findings during and after cessation of therapy.

3) A group of 10 cases of tuberculous meningitis treated with streptomycin is reported in which one patient (10 per cent) was still alive and well 33.5 months after onset of therapy.

4) Some important factors which influence length of survival are:

(a) duration of meningitis prior to onset of therapy.

(b) presence or absence of associated intracranial tubercles or tuberculomata.

(c) presence or absence of associated acute generalized miliary tuberculosis.

(d) age of patient (child or adult).

(e) adequacy of treatment.

5) A plan of treatment is outlined arid criteria for an apparent "cure" are suggested.