94 WILLIAM T. LAMPE, II Annals of Internal Medicine Gonococcal Meningitis Complicating Treated

GONOCOCCAL MENINGITIS is a rare disease, only 26 proved cases having been reported in the world literature (1). Most of these oc-curred before the advent of antibiotics. This report deals with the first known case of men-ingitis appearing in an acute treated gonococcal urethritis that was otherwise uncomplicated. T w o points are of interest: First, an accurately diagnosed gonococcal urethritis failed to re-spond to penicillin in doses usually considered to be "adequate, " despite the demonstration of the organism's sensitivity to penicillin in vitro. Second, septicemia and meningitis occurred with the same organism that did respond to treatment with penicillin in larger doses. C A S E REPORT A 27-year-old white male was admitted to York Hospital on April 2, 1962. His chief complaint was a penile discharge associated with dysuria of 2 weeks ' duration. He admitted to sexual intercourse 3 weeks prior to admission and stated that he had received intramuscular injections of penicillin (later found to be procaine penicillin G, 600,00