Meningitis - staphylococcal

• Alternative Names

  Staphylococcal meningitis

• Causes, incidence, and risk factors

  Meningitis is caused by Staphylococcus bacteria. When it is caused by Staphylococcus aureus or Staphylococcus epidermidis bacteria, it usually develops as a complication of a surgical procedure, or as an infection spread by the blood from another site.

  Risk factors include:

  • Infections of heart valves
  • Past infection of the brain
  • Past meningitis associated with spinal fluid shunts
  • Recent brain surgery
• Symptoms
  • Change in mental status (confusion)
  • Fever
  • Nausea and vomiting
  • Rash
  • Sensitivity to light (photophobia)
  • Severe headache
  • Stiff neck
• Signs and tests

  A physical exam may show:

  • Fast heart rate
  • Low blood pressure
  • Stiff neck

  For any patient with meningitis, it is important to perform a lumbar puncture ("spinal tap"), in which a sample of spinal fluid (known as cerebrospinal fluid, or CSF) is taken and sent to the lab for testing.

  Tests may include:

  • Blood culture
  • Spinal fluid culture
  • White blood cell count
• Treatment

  Antibiotic therapy should be started as soon as possible to decrease the chances of serious illness or death. Often, treatment will include a search for, and removal of, possible sources of bacteria in the body. These include shunts or artificial heart valves.

• Expectations (prognosis)

  This form of infection can be very serious in people with suppressed immune systems. It often leads to death. Recognizing the symptoms of meningitis is very important to prevent serious illness.

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

• Complications

  Patients may develop a brain infection or staph infections at other parts of the body. Serious bleeding and shock may develop.

• Calling your health care provider

  Go to the emergency room or call the local emergency number (such as 911) if you have symptoms of meningitis. This disease can be life-threatening.

• Prevention

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

• References

  Swartz MN. Meningitis: bacterial, viral, and other. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 437.

Review Date: 9/28/2008

Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Jatin M. Vyas, PhD, MD, Instructor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.