Meningitis due to Staphylococcus aureus in children.
Meningitis due to Staphylococcus aureus is uncommon, occurring primarily in patients with known preexisting abnormalities of the CNS (including patients who have undergone previous neurosurgery or trauma). We reviewed our experience with meningitis due to S. aureus in children seen at two medical centers. Among the 40 patients, 32 (80%) had a known predisposing abnormality of the CNS at the time of diagnosis of S. aureus meningitis; all of these 32 patients had had recent neurosurgery, most for placement or revision of a ventriculoperitoneal shunt. Eight patients had no known predisposing CNS abnormality. Four of these eight patients were known to be immunocompromised. The other four patients all had an occult CNS abnormality demonstrated during subsequent workup. Our series demonstrates that when the diagnosis of S. aureus meningitis is made in the absence of a known predisposing CNS abnormality or immunologic defect, then a timely search for an occult CNS abnormality should be undertaken.
Givner
L B
LB
Department of Pediatrics, Bowman Gray School of Medicine, Wake Forest University, Brenner Children's Hospital, Winston-Salem, North Carolina 27157.
Kaplan
S L
SL
D001922:Brain Abscess / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology; D001932:Brain Neoplasms / Q000150:complications / Q000000981:diagnostic imaging; D002439:Cefotaxime / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002701:Chloramphenicol / Q000627:therapeutic use; D003884:Dermoid Cyst / Q000150:complications / Q000000981:diagnostic imaging; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D016920:Meningitis, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D008588:Meningocele / Q000150:complications / Q000000981:diagnostic imaging; D010406:Penicillins / Q000627:therapeutic use; D012008:Recurrence; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D014057:Tomography, X-Ray Computed
D004338:Drug Combinations; D010406:Penicillins; D002701:Chloramphenicol; D002439:Cefotaxime