title: A variant epidemic methicillin resistant Staphylococcus aureus-15 cavernous sinus thrombosis and meningitis: a rare occurrence with unusual presentation.
abstract: Septic cavernous sinus thrombosis (CST) is an uncommon clinical syndrome. Although Staphylococcus aureus (S aureus) is the most common bacterial pathogen causing CST, it is infrequent as a cause of meningitis. We report the first case of CST and meningitis from Bengaluru, Karnataka, caused by community-acquired epidemic methicillin resistant Staphylococcus aureus-15 (EMRSA-15), in a previously healthy individual without known risk factors; the patient recovered following treatment with vancomycin. The isolate was genotyped as belonging to staphylococcal cassette chromosome mec type IV and sequence type 22 and carried the panton-valentine leucocidin gene. It is the first Indian EMRSA-15 disease isolate from a case of meningitis. EMRSA-15 has been a major problem in hospitals in UK and it is a cause for great concern in Indian hospitals too.
authors.affiliation: Department of Hospital Infection Surveillance System, Neuromicrobiology, Bengaluru 560029, India.
authors.forename: H B
authors.initials: HB
authors.lastname: Veena Kumari
authors.forename: D
authors.initials: D
authors.lastname: Nagaraja
authors.forename: S
authors.initials: S
authors.lastname: Nagarathna
authors.forename: G B
authors.initials: GB
authors.lastname: Kulkarni
authors.forename: C S
authors.initials: CS
authors.lastname: Praveen
authors.forename: S
authors.initials: S
authors.lastname: Nadig
authors.forename: G
authors.initials: G
authors.lastname: Arakere
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001427:Bacterial Toxins / Q000235:genetics; D015373:Bacterial Typing Techniques; D020226:Cavernous Sinus Thrombosis / Q000150:complications / Q000188:drug therapy / Q000382:microbiology*; D017714:Community-Acquired Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D016172:DNA Fingerprinting; D004269:DNA, Bacterial / Q000235:genetics; D016521:Electrophoresis, Gel, Pulsed-Field; D005098:Exotoxins / Q000235:genetics; D005838:Genotype; D006801:Humans; D007194:India; D007956:Leukocidins / Q000235:genetics; D008297:Male; D016920:Meningitis, Bacterial / Q000150:complications / Q000188:drug therapy / Q000382:microbiology*; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D014640:Vancomycin / Q000627:therapeutic use; D037521:Virulence Factors / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D001427:Bacterial Toxins; D004269:DNA, Bacterial; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin; D037521:Virulence Factors; D014640:Vancomycin