Central nervous system invasion by community-acquired meticillin-resistant Staphylococcus aureus.
We report a case of community-acquired meticillin-resistant Staphylococcus aureus (CA-MRSA) bacteraemia with cavernous sinus thrombosis, meningitis and brain abscess in a previously healthy American, who was employed in Belgium. We consecutively reviewed all published cases of CA-MRSA with central nervous system (CNS) involvement. A total of 12 similar cases were found, of which 11 were published in the last 4 years. Predominantly, young previously healthy subjects were affected (median age 28 years). The cases involved brain abscesses (5/12), disseminated disease (4/12), cavernous sinus thrombosis (2/12) and other (1/12). Infection origins were superficial skin infections (5/12), mostly of the face, sinusitis (1/12), otitis media (1/12), other or unknown (5/12). Although, in our review of the literature patients treated with linezolid had a better outcome compared to patients treated with vancomycin, the latter is still the mainstay of therapy for CNS infections associated with MRSA.
Naesens
Reinout
R
Laboratory of Medical Microbiology, GZA Hospitals, Antwerp, Belgium.
Ronsyn
Mark
M
Intensive Care Unit, GZA Hospitals, Antwerp, Belgium.
Druwé
Patrick
P
Intensive Care Unit, GZA Hospitals, Antwerp, Belgium.
Denis
Olivier
O
Laboratoire de Référence MRSA-Staphylocoques, Department of Microbiology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
Ieven
Margareta
M
Laboratory of Medical Microbiology, University Hospital Antwerp, Antwerp, Belgium.
Jeurissen
Axel
A
Laboratory of Medical Microbiology, GZA Hospitals, Antwerp, Belgium.
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia; D001922:Brain Abscess / Q000188:drug therapy / Q000382:microbiology; D020226:Cavernous Sinus Thrombosis / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D020806:Central Nervous System Bacterial Infections / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000188:drug therapy / Q000382:microbiology; D055624:Methicillin-Resistant Staphylococcus aureus; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery
D000900:Anti-Bacterial Agents