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[Meningitis caused by Staphylococcus aureus. Analysis of 16 cases]
V Falcó Ferrer1, B Almirante Gragera, A Pahissa Berga
1Servicio de Medicina Interna-Patología Infecciosa, Hospital Vall d'Hebron, Universidad Autónoma de Barcelona.
Abstract:
During the period between 1982 and 1987, 16 cases of meningitis due to Staphylococcus aureus were diagnosed. Nine patients (56%) had undergone a previous neurosurgical operation and 5 of them were carriers of a cerebrospinal fluid (CSF) shunt. Seven patients (44%) had spontaneous meningitis. Fever and meningeal signs were the most common clinical findings. 50% of patients were comatose. The Gram stain of CSF showed Gram positive cocci in 7 cases. Blood cultures were positive in all patients with spontaneous meningitis and negative in the neurosurgical group. Overall mortality rate was 37.5%, and it was lower in the neurosurgical group than in the spontaneous meningitis. Other factors associated with a poor outcome were advanced age, bacteremia and septic shock.
Insights
Staphylococcus aureus meningitis occurred in 16 patients, with neurosurgical operations or cerebrospinal fluid (CSF) shunts in over half. Outcomes were poorer in spontaneous meningitis cases.
Area of Science:
- Infectious Diseases
- Neurosurgery
- Microbiology
Context:
- Meningitis caused by Staphylococcus aureus is a serious infection.
- This study examines cases diagnosed between 1982 and 1987.
- Patients presented with either neurosurgical complications or spontaneous meningitis.
Purpose:
- To analyze the clinical characteristics, outcomes, and mortality rates of Staphylococcus aureus meningitis.
- To compare outcomes between neurosurgical and spontaneous meningitis cases.
Summary:
- 16 cases of Staphylococcus aureus meningitis were identified.
- Nine patients had prior neurosurgery (5 with CSF shunts), and seven had spontaneous meningitis.
- Common symptoms included fever, meningeal signs, and coma (50%). Gram-positive cocci were seen in CSF Gram stains.
- Blood cultures were positive in spontaneous cases but negative in the neurosurgical group.
- Overall mortality was 37.5%, lower in the neurosurgical group. Advanced age, bacteremia, and septic shock correlated with poor outcomes.
Impact:
- Highlights the significant mortality associated with Staphylococcus aureus meningitis.
- Differentiates outcomes based on meningitis origin (neurosurgical vs. spontaneous).
- Identifies key prognostic factors for adverse outcomes in these patients.