Recurrent and Persistent Fever in Bacterial Meningitis with Adequate Response to Antimicrobial Therapy

Abstract

106 children with bacterial meningitis and with adequate response to antimicrobial therapy were studied to determine the incidence, etiology and significance of recurrent and persistent fevers. 68 had meningococcal meningitis, 3 Hemophilus influenzae meningitis, 3 pneumococcal meningitis, and 32 meningitis of unknown etiology. 22% developed recurrent fever and 10% had prolonged fever. In more than half of the patients the etiology of these fevers was not determined. Phlebitis, drug fever and intercurrent infections accounted for the remaining cases. Three patients with H. influenzae meningitis had a prolonged febrile course accompanied with a slow restoration of the cerebrospinal fluid cell count. The persistence of fever in H. influenzae meningitis treated with ampicillin seems to be relatively frequent and should not be an indication for the replacement of ampicillin as long as other clinical and laboratory findings show evidence of a favorable response to therapy.