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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
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meningitis,CSF findings in
meningitis,hematogenous
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meningitis,postoperative neurosurgical
meningitis,staphylococcus
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staphylococcus aureus
treatment of neurologic disorder
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