PROLONGED SURVIVAL FOLLOWING STREPTOMYCIN THERAPY OF TUBERCULOUS MENINGITIS

Since the initial report of treatment of tuberculous meningitis with streptomycin by Cooke, Dunphy and Blake,1the efficacy of this therapy has been confirmed by numerous authors, particularly Hinshaw, Feldman and Pfuetze2and Bunn.3However, it appears that the longer such patients are followed, the less impressive are the results. Probably the ultimate survival rate following streptomycin therapy is 5 to 10 per cent, and many of these patients have incapacitating neurologic residua.4 We have had the opportunity of following a patient with tuberculous meningitis treated with streptomycin over a twenty-seven month period. He ultimately died of complications and reactivation of his infection. The case is of interest in that this patient was among the first to receive streptomycin therapy for tuberculous meningitis. Furthermore, the patient's prolonged survival and temporary clinical recovery illustrate the fallacy of attributing cures of this condition to streptomycin therapy when follow-up