Meningitis due to combined infections. Association of Haemophilus influenzae type B and Clostridium perfringens

R. C. Gehrz, R. M. Ward, R. H. Lien, R. Thompson and C. W. Jarvis

Haemophilus influenzae type B and Clostridium perfringens were recovered simultaneously from the cerebrospinal fluid of a patient with purulent meningitis. No antecedent history of head trauma was present to explain the coexistence of the anaerobe with Haemophilus organisms. A review of the literature on mixed meningitis indicates that no previous cases of anaerobes have been reported in uncomplicated meningitis due to multiple organisms. In addition, the recovery of clostridia is extremely unusual in the absence of an identifiable portal of entry. We have identified two additional cases of clostridia infection in the central nervous system and recommend that anaerobic organisms be considered in selected cases of meningitis.