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Postoperative meningitis was a foreign body infection in 89%of the cases and had a lower mortality(18%[11/61])compared with hematogenous meningitis (56%[24/43]).Hematogenous 5 aureus meningitis seems to be part of an overwhelming,disseminated infection as indicated by the following:81%of the patients had bacteremia,21%had endocarditis,and 12%had osteomyelitis. Most patients were older,often with underlying diseases,community-acquired infections,and a clinical picture of severe meningitis.The major findings were mental status changes and a high rate(34%)of focal neurological changes.The initial leukocyte count in the cerebrospinal fluid sample was low,and the bacteria were seen in Gram's stain smears in 40%of cases only. The prognosis was related to the age of the patients and the initial antibiotic treatment.Patients treated with penicillinase-stable penicillins in combination with fusidic acid may have a better prognosis. Three(12%)of 25 surviving patients had severe sequelae.Hematogenous S aureus meningitis is a severe disease with a high mortality related to age,presence of shock,and infection with strains of phage type 95. |
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antibiotics meningitis meningitis,bacterial meningitis,bacteriologic etiology of meningitis,clinical features of meningitis,CSF findings in meningitis,hematogenous meningitis,neurologic aspects and complications of meningitis,postoperative neurosurgical meningitis,staphylococcus meningitis,treatment of neurologic complications of,surgery review article staphylococcus aureus treatment of neurologic disorder
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