STAPHYLOCOCCUS-AUREUS MENINGITIS - A REVIEW OF 28 CONSECUTIVE COMMUNITY-ACQUIRED CASES

From 1966 to 1989 a total of 1,830 cases of bacterial meningitis were recorded at the Department of Infectious Diseases, Rigshospitalet, Den mark, Staphylococcus aureus meningitis accounted for 44 (2.4%) of thes e cases. Among these, 28 cases were classified as community-acquired S . aureus meningitis. The mortality rate for these cases was 43%. A ret rospective study of clinical features and parameters in these communit y-acquired cases showed the following conditions to be associated with a high mortality risk: advanced age, an underlying condition requirin g artificial ventilation, cardiovascular disease and immune deficienci es, At admission, more than 75% of the patients had fever, nuchal rigi dity and decreased consciousness. In 57% of cases the focus for the S. aureus infection was endocarditis, pneumonia or skin infections. All the patients had complications due to the meningitis, the major one be ing insufficient respiration. Autopsy performed in 9 of the 12 fatalit ies showed endocarditis in 5, pneumonia in 4, and pyelonephritis in 2, All of the brains examined at autopsy showed cerebral and subarachnoi d hemorrhage.