THE ACUTE PURULENT MENINGOENCEPHALITIS

The course of acute purulent meningitis and meningoencephalitis was in vestigated in 101 patients using records and a questionnaire directed to all patients. Patients who survived meningoencephalitis were asked to come to a neurological examination. Neuropsychological status, EEG and Tc-HMPAO-Spect were also performed in these patients. The patients were treated with a combination of three antimicrobial agents which w as commonly used at our hospital during the investigation time consist ing of penicillin, a cephalosporine of the third generation and an ami noglycoside. 40% of the patients suffered from more or less severe neu rologic sequelae; remaining cognitive deficits were also frequent. On the whole there was a tendency towards improvement in patients who suf fered from less severe deficits at the time of discharge from hospital , patients with more severe deficits also showed slight improvement bu t generally did not reach a restitutio ad integrum. Regarding this, in our opinion a broad initial antimicrobial therapy should be used, alt hough a statistically significant improvement of the patient's outcome by this could not be shown. Lethality as well as the frequency of com plications do not seem to differ over many years although antimicrobia l and intensive care treatment were improved. Thus, the outcome seems to depend largely on the occurrence of secondary focal complications o r brain oedema.