Abstract

ABSTRACTBacterial meningitis is a medical emergency that is ordinarily rapidly progressive. We present three patients who had meningococcal meningitis with an indolent course. Symptoms were present from two days to four weeks before hospitalization. Cerebrospinal fluid cultures grew Neisseria meningitidis one to eight days before antibiotic therapy, yet all patients remained fully alert and clinically stable during this interval. All recovered after penicillin therapy. In the future earlier diagnosis should be facilitated by an awareness of differing manifestations of meningococcal meningitis, including benign CSF findings, intact sensorium, and an indolent progression. Immunologic studies will be required to clarify the pathogenesis of this syndrome.