Acute purulent meningitis complicating fracture of the skull and caused by pyogenic cocci is well known, but meningococcic meningitis occurring under similar conditions has been infrequently reported. Four such cases have recently been observed at the Bellevue Hospital and are being reported because of their therapeutic indications and forensic importance.
A study of the relationship of trauma and fracture of the skull to meningococcic meningitis was reported by Seligmann and Pieper.1 Of 674 cases of meningococcic meningitis, a history of trauma was recorded in 55, but fracture of the skull was demonstrated in only 2. In 21 of their cases, including the 2 in which there was fracture of the skull, meningitis appeared from one to three days after trauma. In 17 cases trauma preceded the onset of meningitis by from eight days to three months, and in 17 others a period of from four months to two years