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Meningitis - staphylococcal

Staphylococcal meningitis

 

Meningitis is an infection of the membranes covering the brain and spinal cord. This covering is called the meninges.

Bacteria are one type of germ that may cause meningitis. The staphylococcal bacteria is one type of bacteria that causes meningitis.

Causes

 

Staphylococcal meningitis is caused by staphylococcus bacteria. When it is caused by Staphylococcus aureus or Staphylococcus epidermidis bacteria, it usually develops as a complication of surgery or as an infection that spreads through the blood from another site.

Risk factors include:

  • Infections of heart valves
  • Past infection of the brain
  • Past meningitis due to spinal fluid shunts
  • Recent brain surgery
  • Spinal fluid shunt
  • Trauma

 

Symptoms

 

Symptoms may come on quickly, and include:

  • Fever and chills
  • Mental status changes
  • Nausea and vomiting
  • Sensitivity to light ( photophobia )
  • Severe headache
  • Stiff neck

Other symptoms that can occur with this disease:

  • Agitation
  • Bulging fontanelles in infants
  • Decreased alertness
  • Poor feeding or irritability in children
  • Rapid breathing
  • Unusual posture, with the head and neck arched backwards ( opisthotonos )

 

Exams and Tests

 

The health care provider will perform a physical exam. Questions will focus on symptoms and risk factors.

If the doctor thinks meningitis is possible, a lumbar puncture ( spinal tap ) is done to remove a sample of spinal fluid for testing. If you have a spinal fluid shunt, the sample may be taken from this instead.

Tests may include:

  • Blood culture
  • Chest x-ray
  • CT scan of the head
  • Gram stain, other special stains, and culture of CSF

 

Treatment

 

Antibiotics will be started as soon as possible. Vancomycin is the first choice for suspected staphylococcal meningitis. Nafcillin is sometimes used instead.

Often, treatment will include a search for, and removal of, possible sources of bacteria in the body. These include shunts or artificial heart valves.

 

Outlook (Prognosis)

 

Early treatment improves the outcome. However, some people do not survive. Young children and adults over age 50 have the highest risk for death.

Staphylococcal meningitis often improves more quickly, with fewer complications, if the source of the infection is removed. The source may include shunts, hardware in joints, or artificial heart valves.

 

Possible Complications

 

Long-term complications may include:

  • Brain damage
  • Buildup of fluid between the skull and brain ( subdural effusion )
  • Buildup of fluid inside the skull that leads to brain swelling ( hydrocephalus )
  • Hearing loss
  • Seizures
  • Staph infection in another area of the body

 

When to Contact a Medical Professional

 

Call the local emergency number (such as 911) or go to an emergency room if you suspect meningitis in a young child who has the following symptoms:

  • Feeding problems
  • High-pitched cry
  • Irritability
  • Persistent, unexplained fever

Call the local emergency number if you develop any of the serious symptoms listed above. Meningitis can quickly become a life-threatening illness.

 

Prevention

 

In high-risk people, taking preventive antibiotics before diagnostic or surgical procedures may help reduce the risk. Discuss this with your doctor.

 

 

Open References

References

Nath A. Meningitis: bacterial, viral, and other. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 412.

Tunkel AR, Van de Beek D, Scheld WM. Acute meningitis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Updated Edition . 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 89.

 
  • Central nervous system

    Central nervous system - illustration

    The central nervous system is comprised of the brain and spinal cord. The peripheral nervous system includes all peripheral nerves.

    Central nervous system

    illustration

    • Central nervous system

      Central nervous system - illustration

      The central nervous system is comprised of the brain and spinal cord. The peripheral nervous system includes all peripheral nerves.

      Central nervous system

      illustration

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        Tests for Meningitis - staphylococcal

         
           

          Review Date: 7/31/2016

          Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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