Os autores apresentam um caso grave de meningoencefalite, por Escherichia coli, em septuagenário tratado e curado por injeções intraraqueanas e intramusculares de succinato de cloranfenicol. Trata-se de paciente com 76 anos de idade e que após uma toxinfecção gastrintestinal aguda, apresentou um quadro de meningoencefalite, tendo o exame do líqüido cefalor-raqueano mostrado um processo meningítico por E. coli. Foi instituída a terapêutica antibiótica pelo cloranfenicol, por via intratecal, na dose diária de 3 mg por kg de pêso corporal, correspondendo a 2,5 ml de solução de succinato de cloranfenicol a 10%, ou seja 250 mg do sal. Por via intramuscular foi utilizada a dose diária de 1 g de succinato de cloranfenicol dividida em 4 doses. Em 23 dias de tratamento houve cura clínica total, acompanhada de melhora nítida do quadro inflamatório do LCR e de negativação do exame bacterioscópico. O exame clínico do paciente um ano após revelou ausência de qualquer seqüela neuropsíquica.

Report of a severe case of meningoencephalitis on a seventy six year old patient, who was treated and cured by intra-thecal and intra-muscular injections of chloramphenicol. The clinical process of meningoencephalitis started after a gastro-intestinal toxic infection. The cerebrospinal fluid examination showed a meningitic process by E. coli. It was prescribed chloramphenicol therapy by intra-thecal way, in daily doses of 3 mg/kg, corresponding to 2.5 ml of chloramphenicol succinate solution at 10% or 250 mg of the salt. At the same time, chloramphenicol succinate was administered by muscle in the daily dose of 1 g divided in four doses. After 23 days of treatment it was obtained clinical cure followed by improvement of the spinal fluid, which showed a decrease from 5,172 to 8 cells and complete negative bacterioscopic findings. After a one year follow-up the patient is quite well and is without neuro-psychiatric sequelae.

Foram estudadas amostras de liqüido cefalorraqueano de 55 pacientes que apresentaram poliomielite anterior aguda. Os autores fizeram um estudo das alterações encontradas no primeiro exame do LCR, analisando particularizadamente os dados fornecidos pelos exames físico, citológico, químico e sorológico. Êsses elementos são discutidos em correlação com os encontrados na literatura.

The study of the cerebrospinal fluid (CSF) abnormalities in 55 patients with acute anterior poliomyelitis is made. The lumbar puncture was performed in the preparalytic stage or, at least, in the first week after onset of paralysis. The findings were much alike that one of the literature, but the authors emphasize some peculiarities. All 55 samples of CSF showed some abnormalities, generally pleocitosis of lymphocytic type and moderately increased protein content. The fibrin clot was a very common finding (60%), and in many cases (22%) it appeared in absence of increased protein content. In a case the only abnormality was a delicate fibrin clot. In two cases the only abnormality found in CSF was: in one, neutrophil granulocyte and in the other, eosinophil granulocyte in spite of normal cell count.