ABSTRACT
Meningococcal antigen was measured by countercurrent immunoelectrophoresis in the blood and cerebrospinal fluid of 200 patients with group A meningococcal meningitis. Antigen was detected in the blood of 27 (13.5 per cent) patients. These patients had a worse prognosis and a higher incidence of allergic complications, such as arthritis and vasculitis, about 5 days after the start of antibiotic treatment. Antigen was found in the CSF of 129 (67.5 per cent) patients); antigen often persisted in the cerebrospinal fluid despite antibiotic treatment before admission. A combination of immunoelectrophoresis and routine bacteriologic study was used in the diagnosis of 162 (84.8 per cent) patients with meningococcal meningitis. High levels of antigen and a slow antigen disappearance were associated with neurologic damage. The antigen is stable and may be detected from specimens of cerebrospinal fluid dried on filter paper.
Subject(s)
Antigens, Bacterial , Meningococcal Infections/immunology , Antigens, Bacterial/analysis , Antigens, Bacterial/cerebrospinal fluid , Chloramphenicol/therapeutic use , Clinical Trials as Topic , Humans , Immunoelectrophoresis , Length of Stay , Meningococcal Infections/diagnosis , Meningococcal Infections/drug therapy , Penicillins/therapeutic use , Prognosis , Sulfonamides/therapeutic useSubject(s)
Nephritis/epidemiology , Pyoderma/epidemiology , Scabies/epidemiology , Adolescent , Bacteriological Techniques , Child , Child, Preschool , Complement System Proteins/analysis , Female , Fever , Hematuria , Hemoglobins/analysis , Humans , Leukocyte Count , Male , Nephritis/pathology , Nigeria , Parasite Egg Count , Proteinuria , Pyoderma/pathology , Scabies/pathology , Schistosoma haematobium , Seasons , Streptococcus/isolation & purification , Urea/blood , WeatherABSTRACT
In a controlled trial chloramphenicol proved as effective and much cheaper than penicillin for the treatment of group A meningococcal meningitis in Zaria, Nigeria. A short course of five days cured most patients. Adults and older children were soon able to take chloramphenicol by mouth, which reduced the cost and simplified treatment.It is suggested that chloramphenicol is a suitable alternative to sulphonamides for the treatment of meningococcal meningitis in those parts of Africa where the organism is sulphonamide-resistant.