Staphylococcal meningitis
Meningitis is an infection of the membranes covering the brain and spinal cord. This covering is called the meninges.
Meningitis
Meningitis is an infection of the membranes covering the brain and spinal cord. This covering is called the meninges.
Read Article Now Book Mark ArticleBacteria are one type of germ that may cause meningitis. The staphylococcal bacteria are one type of bacteria that cause meningitis.
Causes
Staphylococcal meningitis is caused by staphylococcus bacteria. When it is caused by Staphylococcus aureus or Staphylococcus epidermidis bacteria, it usually develops as a complication of surgery or as an infection that spreads through the blood from another site.
Risk factors include:
- Infections of heart valves
- Past infection of the brain
- Past meningitis due to spinal fluid shunts
- Recent brain surgery
- The presence of a spinal fluid shunt
- Trauma
- Bloodstream infection with Staphylococcus aureus
Symptoms
Symptoms may come on quickly, and include:
- Fever and chills
- Mental status changes
Mental status changes
Confusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembe...
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- Sensitivity to light (photophobia)
- Severe headache
- Stiff neck
Other symptoms that can occur with this disease:
- Agitation
- Bulging fontanelles in infants
Bulging fontanelles
A bulging fontanelle is an outward curving of an infant's soft spot (fontanelle).
Read Article Now Book Mark Article - Decreased alertness
- Poor feeding or irritability in children
- Rapid breathing
- Unusual posture, with the head and neck arched backwards (opisthotonos)
Opisthotonos
Opisthotonos is a condition in which a person holds their body in an abnormal position. The person is usually rigid and arches their back, with thei...
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Exams and Tests
The health care provider will perform a physical exam. Questions will focus on symptoms and risk factors.
If the doctor thinks meningitis is possible, a lumbar puncture (spinal tap) is done to remove a sample of spinal fluid for testing. If you have a spinal fluid shunt, the sample may be taken from this instead.
Spinal tap
Cerebrospinal fluid (CSF) collection is a test to look at the fluid that surrounds the brain and spinal cord. CSF acts as a cushion, protecting the b...
Read Article Now Book Mark ArticleTests may include:
- Blood culture
Blood culture
A blood culture is a laboratory test to check for bacteria or other germs in a blood sample.
Read Article Now Book Mark Article - Chest x-ray
Chest x-ray
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
Read Article Now Book Mark Article - CT scan of the head
CT scan of the head
A head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.
Read Article Now Book Mark Article - Gram stain or other special stains, and culture of the spinal fluid
Culture of the spinal fluid
A cerebrospinal fluid (CSF) culture is a laboratory test to look for bacteria, fungi, and viruses in the fluid that moves in the space around the spi...
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Treatment
Antibiotics will be started as soon as possible. Vancomycin is the first choice for suspected staphylococcal meningitis. Nafcillin is used when tests show that the bacteria are sensitive to this antibiotic.
Often, treatment will include a search for, and removal of, possible sources of bacteria in the body. These include shunts or artificial heart valves.
Outlook (Prognosis)
Early treatment improves the outcome. However, some people do not survive. Young children and adults over age 50 have the highest risk for death.
Staphylococcal meningitis often improves more quickly, with fewer complications, if the source of the infection is removed. The source may include shunts, hardware in joints, or artificial heart valves.
Possible Complications
Long-term complications may include:
- Brain damage
- Buildup of fluid between the skull and brain (subdural effusion)
Subdural effusion
A subdural effusion is a collection of cerebrospinal fluid (CSF) trapped between the surface of the brain and the outer lining of the brain (the dura...
Read Article Now Book Mark Article - Buildup of fluid inside the skull that leads to brain swelling (hydrocephalus)
Hydrocephalus
Hydrocephalus is a buildup of fluid inside the skull that leads to the brain pushing against the skull. Hydrocephalus means "water on the brain. "...
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Hearing loss
Hearing loss is being partly or totally unable to hear sound in one or both ears.
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Seizures
A seizure is the physical changes in behavior that occurs during an episode of specific types of abnormal electrical activity in the brain. The term ...
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When to Contact a Medical Professional
Call 911 or the local emergency number or go to an emergency room if you suspect meningitis in a young child who has the following symptoms:
- Feeding problems
- High-pitched cry
- Irritability
- Persistent, unexplained fever
Meningitis can quickly become a life-threatening illness.
Prevention
In high-risk people, taking antibiotics before diagnostic or surgical procedures may help reduce the risk. Discuss this with your doctor.
References
Centers for Disease Control and Prevention website. Meningitis. About bacterial meningitis. www.cdc.gov/meningitis/about/bacterial-meningitis.html. Updated January 9, 2024. Accessed June 17, 2024.
Nath A. Meningitis: bacterial, viral, and other. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 384.
Hasbun R, Van de Beek D, Brouwer MC, Tunkel AR. Acute meningitis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 87.
Meninges of the brain - illustration
The organs of the central nervous system (brain and spinal cord) are covered by connective tissue layers collectively called the meninges. Consisting of the pia mater (closest to the CNS structures), the arachnoid and the dura mater (farthest from the CNS), the meninges also support blood vessels and contain cerebrospinal fluid. These are the structures involved in meningitis, an inflammation of the meninges, which, if severe, may become encephalitis, an inflammation of the brain.
Meninges of the brain
illustration
Meninges of the spine - illustration
The organs of the central nervous system (brain and spinal cord) are covered by 3 connective tissue layers collectively called the meninges. Consisting of the pia mater (closest to the CNS structures), the arachnoid and the dura mater (farthest from the CNS), the meninges also support blood vessels and contain cerebrospinal fluid. These are the structures involved in meningitis, an inflammation of the meninges, which, if severe, may become encephalitis, an inflammation of the brain.
Meninges of the spine
illustration
Central nervous system and peripheral nervous system - illustration
The central nervous system comprises the brain and spinal cord. The peripheral nervous system includes nerves outside the brain and spinal cord.
Central nervous system and peripheral nervous system
illustration
CSF cell count - illustration
CSF (cerebrospinal fluid) is a clear fluid that circulates in the space surrounding the spinal cord and brain. A CSF cell count is a test to measure the number of red and white blood cells that are in CSF.
CSF cell count
illustration
Meninges of the brain - illustration
The organs of the central nervous system (brain and spinal cord) are covered by connective tissue layers collectively called the meninges. Consisting of the pia mater (closest to the CNS structures), the arachnoid and the dura mater (farthest from the CNS), the meninges also support blood vessels and contain cerebrospinal fluid. These are the structures involved in meningitis, an inflammation of the meninges, which, if severe, may become encephalitis, an inflammation of the brain.
Meninges of the brain
illustration
Meninges of the spine - illustration
The organs of the central nervous system (brain and spinal cord) are covered by 3 connective tissue layers collectively called the meninges. Consisting of the pia mater (closest to the CNS structures), the arachnoid and the dura mater (farthest from the CNS), the meninges also support blood vessels and contain cerebrospinal fluid. These are the structures involved in meningitis, an inflammation of the meninges, which, if severe, may become encephalitis, an inflammation of the brain.
Meninges of the spine
illustration
Central nervous system and peripheral nervous system - illustration
The central nervous system comprises the brain and spinal cord. The peripheral nervous system includes nerves outside the brain and spinal cord.
Central nervous system and peripheral nervous system
illustration
CSF cell count - illustration
CSF (cerebrospinal fluid) is a clear fluid that circulates in the space surrounding the spinal cord and brain. A CSF cell count is a test to measure the number of red and white blood cells that are in CSF.
CSF cell count
illustration
Review Date: 9/10/2022
Reviewed By: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.