During the 10-year period ending July, 1960, 43 patients with pneumococcal meningitis were encountered on our service. The majority were over 50 years of age. Meningitis was secondary to pneumonia in 16 patients and to otitis in eight. The spinal fluid smear was very reliable for early diagnosis, revealing the etiologic organism in 33 of 34 instances.
Factors having a bearing on prognosis were evaluated. The presence of associated pneumococcal infections, illness of over three days' duration, and coma were associated with a mortality of 75% or greater. Bacteremia, old age, blood count, spinal fluid cell count, or sugar concentration