Clinical data in children with meningococcal meningitis in a Spanish hospital.

Neisseria meningitidis is the main cause of bacterial meningitis in Spain. Of the 213 children included in this study with meningococcal meningitis, 7 died. Mortality was linked to a shorter time from the first symptom to diagnosis (mean time for fatal cases was 9.5 h, mean time for survivors was 19 h, p = 0.034), to deteriorated consciousness (DC) (mortality rate (MR) with DC = 6/87, MR without DC = 1/124, p = 0.02) and to shock (MR with shock = 5/7, MR without shock = 2/206, p < 0.0001). Previous treatment reduced the yield from blood culture (36/54 versus 45/137, p < 0.0001). Positivity in both Gram stain (GS) and cerebrospinal fluid (CSF) culture increased with longer duration of symptoms (mean GS+ = 25 h, GS- = 16 h, p = 0.004; CSF+ = 20 h, CSF- = 12 h, p = 0.001), and blood culture (BC) gave more positive results when carried out earlier (mean BC- = 14 h, BC- = 24 h, p < 0.001). Reduced susceptibility to penicillin was seen in 34% of the strains, and rapidly evolving forms were responsible for most of the deaths; reduced susceptibility was more frequent among strains responsible for death or sequelae (9/15 = 60%) as compared with the more harmless strains (69/ 215 = 32%) (p = 0.04). The progressive reduction of susceptibility to penicillin indicates that it should be replaced by a third-generation cephalosporine.

[Scurvey, presentation of six cases (author's transl)]. / Escorbuto. A propósito de seis casos.

Authors present six cases of scurvy admitted in their hospital from September 1977 to July 1978. Symptoms were similar in the majority of them: irritability, skin haemorrhages, swollen gums, scorbutic rosary, swelling and tenderness lower limbs. Radiographic findings more common were: Fraenkels' line "ground glass" appearance, corner sign, Wymberger sign, and in some cases subperiosteal haemorrhages with calcification. Ascorbic acid levels were below normal values in all cases, and overload test showed typical pattern found on patients with scurvy. Special mention is made on the low incidence of this disease in the last few years and also the causes that have motived the existence of this six cases in such a short period of time are analyzed.

[Infantile cortical hyperostosis. A case report (author's transl)]. / Hiperostósis cortical infantil. A propósito de un caso con manifestaciones clínicas poco frecuentes.

Authors present a case of infantile cortical hyperostosis with several clinical and radiologic unusual aspects they principally stand out the observation of hypotonia and widely split sutures, possibly never published before.