Related Experiment Videos
Staphylococcus aureus meningitis: a review of 28 consecutive community-acquired cases
A Lerche1, N Rasmussen, J H Wandall
1Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark.
Abstract:
From 1966 to 1989 a total of 1,830 cases of bacterial meningitis were recorded at the Department of Infectious Diseases, Rigshospitalet, Denmark. Staphylococcus aureus meningitis accounted for 44 (2.4%) of these cases. Among these, 28 cases were classified as community-acquired S. aureus meningitis. The mortality rate for these cases was 43%. A retrospective study of clinical features and parameters in these community-acquired cases showed the following conditions to be associated with a high mortality risk: advanced age, an underlying condition requiring artificial ventilation, cardiovascular disease and immune deficiencies. At admission, more than 75% of the patients had fever, nuchal rigidity and decreased consciousness. In 57% of cases the focus for the S. aureus infection was endocarditis, pneumonia or skin infections. All the patients had complications due to the meningitis, the major one being insufficient respiration. Autopsy performed in 9 of the 12 fatalities showed endocarditis in 5, pneumonia in 4, and pyelonephritis in 2. All of the brains examined at autopsy showed cerebral and subarachnoid hemorrhage.
Insights
Staphylococcus aureus meningitis is a serious infection with a 43% mortality rate in community-acquired cases. Risk factors include advanced age, underlying conditions, and specific infections like endocarditis.
Area of Science:
- Infectious Diseases
- Neurology
- Bacteriology
Background:
- Bacterial meningitis remains a significant public health concern.
- Staphylococcus aureus is an important cause of bacterial meningitis, particularly in certain populations.
- Understanding the epidemiology and clinical characteristics of Staphylococcus aureus meningitis is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the clinical features and mortality risk factors of community-acquired Staphylococcus aureus meningitis.
- To identify common sources of Staphylococcus aureus infection leading to meningitis.
- To describe complications and autopsy findings in fatal cases.
Main Methods:
- Retrospective study of 1,830 bacterial meningitis cases from 1966-1989.
- Analysis of 28 community-acquired Staphylococcus aureus meningitis cases.
- Review of clinical data, risk factors, and autopsy findings.
Main Results:
- Staphylococcus aureus meningitis accounted for 2.4% of bacterial meningitis cases.
- Community-acquired S. aureus meningitis had a 43% mortality rate.
- High mortality was associated with advanced age, artificial ventilation, cardiovascular disease, and immune deficiencies. Common sources included endocarditis, pneumonia, and skin infections. Insufficient respiration was a major complication.
Conclusions:
- Community-acquired Staphylococcus aureus meningitis is associated with high mortality.
- Prompt identification of risk factors and sources of infection is vital for management.
- Cerebral and subarachnoid hemorrhage are common autopsy findings in fatal cases.