FULMINATING MENINGOCOCCEMIA TREATED WITH CORTISONE; USE OF BLOOD EOSINOPHIL COUNT AS A GUIDE TO PROGNOSIS AND TREATMENT

[摘要] The total blood eosinophil count has been studied as an indicator of the adequacy of the adrenocortical response to the stress of acute infection. Marked eosinopenia was found in seven children on the first or second day of acute meningococcal infection of mild or moderate severity and in 18 other patients with rubeola, pneumonia or diphtheria. During convalescence the number of eosinophils in the blood became normal. An eighth patient, who was admitted during the recovery stage of mild meningococcal infection, exhibited a normal count which decreased sharply after the administration of ACTH.In three patients admitted with fulminating meningococcal infection, an initial eosinophil count of 75/cmm. was found in one and 130/cmm. in the other two. The eosinophil count response to the administration of ACTH did not return to normal until the third week in Case 2. These findings lend support to the belief that adrenal cortical function may be impaired in patients with overwhelming meningococcal infection.Cortisone was employed in addition to usual forms of therapy in the treatment of three children with fulminating meningococcemia. One patient died shortly after admission and the other two patients survived. It is believed that cortisone was of value in these latter two cases and that one of these patients would have certainly succumbed without its use. Cortisone may prove to be of value in the treatment of fulminating meningococcal infection because it is much more potent in overcoming stress than previously employed adrenal extracts. It is suggested that the circulating eosinophil count may be of value as a guide in the prognosis and treatment of meningococcal infections.

[学科分类] 儿科学