Chapter 28: a history of bacterial meningitis

Abstract

Thomas Willis (1621-1675) described patients with, "inflammation of the meninges with a continual fever" as well as an early (1661) epidemic of meningitis. Robert Whytt (1714-1766) provided a classic depiction of tuberculous meningitis and its stages, later extended by John Cheyne (1777-1836). Gaspard Vieusseux (1746-1814) and Andre Matthey (1778-1842) in Geneva, and Elisa North (1771-1843) in Massachusetts, described epidemic (meningococcal) meningitis. Heinrich Quincke (1842-1922) utilized his new technique of lumbar puncture (1891) to provide an early analysis of cerebrospinal fluid (CSF). William Mestrezat (1883-1929), and H. Houston Merritt (1902-1979) later compiled large series of CSF profiles in meningitis. Organisms causing meningitis were identified in the late 19th century including Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae. Vladimir Kernig (1840-1917) and Josef Brudzinski (1874-1917) described their eponymous signs in 1882 and 1909. Successful treatment of meningitis began with the introduction of serum therapy for meningococcal meningitis by Georg Joachmann (1874-1915) in Germany and Simon Flexner (1863-1946) in America. Antibiotic therapy began in the 20th century with the use of sulfonamides by Francois Schwentker (1904-1954) and penicillin by Chester Keefer (1897-1972). Vaccination against meningitis debuted in the early 20th century, and progressed to the development of vaccines against Neisseria meningitidis and Haemophilus influenzae, which remain mainstays of modern medicine.