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Updated: Aug 11, 2026

Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 9, 2011
Clinical study of 44 cases of Staphylococcus aureus meningitis
V Pintado1, M A Meseguer, J Fortún
1Department of Infectious Diseases, Hospital Ramón y Cajal, Universidad de Alcalá de Henares, Carretera de Colmenar km 9.1, 28034 Madrid, Spain. vpintado@hrc.salud-madrid.org
Abstract:
In order to describe the clinical features and outcome of Staphylococcus aureus meningitis, the charts of 44 cases seen at one teaching hospital during a 20-year period were retrospectively reviewed. Staphylococcus aureus was the fifth most common cause of bacterial meningitis (10.2% of cases). There were 28 (63%) cases of postoperative meningitis and 16 (37%) of spontaneous meningitis. Patients with postoperative meningitis were younger than patients with spontaneous meningitis (mean age, 40.3 vs. 59.3 years; P=0.04) and had a lower frequency of community-acquired infection (32.1% vs. 93.8%; P<0.01), severe underlying diseases (28% vs. 87%; P<0.01) and associated staphylococcal infection (35% vs. 75%; P=0.01). The clinical presentation was similar in both groups, but patients with postoperative meningitis had a lower frequency of altered mental status (39% vs. 75%; P=0.02), meningeal signs (28% vs. 62%; P=0.02), petechial rash (0% vs. 18%; P=0.04), bacteremia (7% vs. 75%; P<0.01), and septic shock (0% vs. 44%; P<0.01). Most patients were treated with cloxacillin or vancomycin, with or without rifampicin, for a mean period of 22.5 days (range, 1-100 days). Overall mortality was 27%, and the mortality rate was higher for cases of spontaneous than postoperative meningitis (50% vs. 14%; P=0.01). Mortality correlated significantly with advanced age, spontaneous meningitis, altered mental status, and the presence of severe underlying diseases, bacteremia, and septic shock.
Insights
Staphylococcus aureus meningitis is a serious infection. Postoperative cases had better outcomes than spontaneous meningitis, with lower mortality rates.
Area of Science:
- Infectious Diseases
- Neurology
- Bacteriology
Background:
- Staphylococcus aureus is a significant cause of bacterial meningitis.
- Distinguishing between postoperative and spontaneous meningitis is crucial for understanding patient profiles and outcomes.
Purpose of the Study:
- To describe the clinical features and outcomes of Staphylococcus aureus meningitis.
- To compare characteristics and prognoses of postoperative versus spontaneous Staphylococcus aureus meningitis.
Main Methods:
- Retrospective chart review of 44 patients with Staphylococcus aureus meningitis over 20 years.
- Analysis of clinical presentation, treatment, and mortality rates.
- Comparison of patient demographics and risk factors between postoperative and spontaneous meningitis groups.
Main Results:
- Staphylococcus aureus accounted for 10.2% of bacterial meningitis cases.
- Postoperative meningitis patients were younger and had fewer comorbidities than spontaneous cases.
- Overall mortality was 27%, with significantly higher mortality in spontaneous meningitis (50%) compared to postoperative (14%).
- Factors associated with mortality included advanced age, spontaneous meningitis, altered mental status, severe underlying diseases, bacteremia, and septic shock.
Conclusions:
- Staphylococcus aureus meningitis presents differently in postoperative versus spontaneous cases.
- Prompt recognition and treatment are vital, though outcomes vary significantly based on etiology and patient factors.
- Postoperative meningitis generally has a better prognosis than spontaneous meningitis.
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