Staphylococcus aureus meningitis
Introduction
Introduction to Staphylococcus aureus meningitis Meningitis caused by Staphylococcus aureus is secondary to S. aureus sepsis, especially in patients with left endocarditis, which invade the meninges through blood flow through bacterial emboli. Facial spasm with cavernous sinus thrombophlebitis can further lead to meningitis, craniocerebral injury, post-cranial surgery and lumbar puncture can not be accompanied by meningitis. Infected lesions near the meninges such as otitis media, mastoiditis, sinusitis, etc. can also cause the disease, neonatal umbilical cord and skin Staphylococcus aureus infection can also be secondary to meningitis, the onset time is more than 2 weeks after delivery. Other predisposing factors are: diabetes, intravenous drug abuse, hemodialysis, and malignant tumors. basic knowledge The proportion of illness: 0.002% Susceptible people: no special people Mode of infection: non-infectious Complications: brain abscess
Cause
Causes of Staphylococcus aureus meningitis
Staphylococcus aureus infection (35%):
Meningitis caused by Staphylococcus aureus is secondary to Staphylococcus aureus sepsis, especially in patients with left endocarditis, through the blood vessels invading the meninges through the blood vessels, facial paralysis and cavernous sinus thrombophlebitis can be Further cause meningitis, craniocerebral injury, post-cranial surgery and lumbar puncture can not be accompanied by meningitis, infections near the meninges such as otitis media, mastoiditis, sinusitis can also cause the disease, neonatal umbilical cord Meningitis can also be secondary to Staphylococcus aureus infection of the skin.
Brain surgery infection (15%):
The contamination of brain surgery, ventricular drainage and angiography directly inoculate the pyogenic bacteria in the subarachnoid space, and the bacteria reach the meninges to cause brain formation. The pathogenic mechanism and pathological changes are similar to meningococcal meningitis.
Direct spread infection (10%):
It can be a traumatic brain injury from the extracranial, such as ear or nasal infection, to the intracranial.
Prevention
Staphylococcus aureus meningitis prevention
1. Because Staphylococcus aureus is resistant to many antibiotics, and meningitis is a serious infection, it should try to cultivate bacteria for drug sensitivity test to guide rational drug use.
2. Pay attention to liver and kidney function during medication.
3. The course of treatment should be continued for about 2 weeks after the body temperature drops, so as to avoid recurrence.
Complication
Staphylococcus aureus meningitis complications Complications
1. Hydrocephalus: due to meningeal adhesions, cerebrospinal fluid circulation disorders.
2. Cranial nerve damage paralysis: such as deafness, visual impairment, strabismus, facial nerve spasm and so on.
3. Bone vasculitis caused by luminal obstruction: causing cerebral ischemia and infarction at the corresponding site.
4. Subdural effusion: more common in infants, antibiotic treatment, such as excessive effusion and increased intracranial pressure or nerve irritation, need to do subdural puncture and release effusion to relieve symptoms and facilitate meningitis restore.
Symptom
Staphylococcus aureus meningitis symptoms common symptoms chills meningeal irritation pustular neck tonic scarlet fever-like rash meningitis encephalitis-like changes
The onset is not very urgent, often in the first few days or weeks after the primary purulent infection, many symptoms of systemic infection, chills and fever, accompanied by persistent and severe headache, neck stiffness is more obvious than general meningitis, except for meninges In addition to the symptoms of inflammation, there are local infections. Patients with sepsis may have other migratory lesions, and rashes such as urticaria, scarlet fever-like rash or small pustules may appear. The skin may have bleeding spots, but rarely merge into pieces. Different from meningococcal meningitis, such as headache, vomiting, change of mind, and meningeal irritation during sepsis, cerebrospinal fluid examination should be performed in time. The lesions are mainly subarachnoid, frontal, temporal, and parietal. The site is more obvious, subdural effusion, empyema, skull base adhesion, can cause brain damage, and brain abscess can occur in the course of the disease, limb paralysis can occur.
Examine
Examination of Staphylococcus aureus meningitis
The appearance of cerebrospinal fluid varies depending on the severity of the lesion and the early and late stage of the disease. The appearance can be self-small, glassy or even milky, and the protein content is generally high. The culture is often positive. The smear can find staphylococcus, blood culture. Staphylococcus aureus growth, convective immunoelectrophoresis, latex agglutination test, and fluorescent antibody determination of staphylococcal-specific antigen in cerebrospinal fluid often contribute to rapid diagnosis.
Diagnosis
Diagnosis and identification of Staphylococcus aureus meningitis
Staphylococcus can be found based on medical history and clinical manifestations as well as smears, and septicemia and blood culture of Staphylococcus aureus can be diagnosed.
It should be differentiated from pneumococcal meningitis, influenza bacillus meninges, and Listeria meningitis.
