title: Neurologic manifestations of Staphylococcus aureus infections. Analysis of 43 patients.
abstract: We present an analysis of the neurologic manifestations of Staphylococcus aureus infections in 43 patients. Half of the infections whose source could be identified were nosocomial. The spectrum of neurological sequelae included meningitis, solitary and multiple intracerebral and epidural abscesses, cerebral ischemia and hemorrhage, acute encephalopathies, subdural empyemas, spinal abscesses, and radicular compression syndromes. In the majority of patients the course was severe and protracted and relapses were frequent. Mortality was high (28%), even with early diagnosis and treatment; diabetes mellitus, alcohol abuse, and chronic renal failure were unfavorable prognostic factors. In patients with abscess formation early surgical drainage improved the outcome. However, often treatment was complicated by sequestration at inaccessible foci and secondary dissemination. Combined antibiotic therapy with flucloxacillin and chloramphenicol may be the most successful antibiotic regimen.
authors.affiliation: Department of Neurology, University of Bern Inselspital, Switzerland.
authors.forename: F
authors.initials: F
authors.lastname: Schäfer
authors.forename: H P
authors.initials: HP
authors.lastname: Mattle
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000785:Aneurysm, Infected / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001922:Brain Abscess / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D002493:Central Nervous System Diseases / Q000175:diagnosis*; D003428:Cross Infection / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D013354:Empyema, Subdural / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D004660:Encephalitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D002542:Intracranial Embolism and Thrombosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D008297:Male; D008581:Meningitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D008590:Meningoencephalitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009460:Neurologic Examination; D012189:Retrospective Studies; D013166:Spondylitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D013203:Staphylococcal Infections / Q000175:diagnosis*
chemical_list: D000900:Anti-Bacterial Agents