Community-acquired meningitis due to Staphylococcus aureus.

Community-acquired meningitis due to Staphylococcus aureus is extremely rar e but frequently fatal. The early diagnosis is often difficult. The paucity of published data and wide diversity of available antibiotics used in S. a ureus meningitis have hindered efforts to standardize the treatment. A retr ospective study was conducted in eight cases of community-acquired S. aureu s meningitis. There were four girls and four boys, with an age range of 6 m onths to 15 years. None of the patients had a history of neurological birth defects or neurosurgical procedures. The portal of entry was identified in every case and varied in its clinical presentation across patients. Sympto m onset was abrupt. Evidence of infection and meningitis were present in al l patients. Three patients had severe alterations in consciousness. Treatme nt was with an aminoglycoside and cefotaxime in four patients, an aminoglyc oside and rifampin in one, cefotaxime and rifampin in two, and oxacillin an d gentamicin in one. Six patients recovered. No relapses were recorded. Res idual neurological impairment was noted in one patient. Community-acquired S. aureus meningitis remains a severe, potentially fatal disease. Presence of severe alterations in consciousness at admission indicates a poor progno sis. All the portals of entry for S. aureus can lead to meningitis. In comm unity-acquired S. aureus meningitis, the organism is susceptible to methici llin. The cefotaxime-rifampin combination, which ensures a high rate of pen etration into the meninges and provides excellent results, deserves to be s tudied in Morocco.