Central nervous system invasion by community-acquired meticillin-resistant Staphylococcus aureus

J Med Microbiol. 2009 Sep;58(Pt 9):1247-1251. doi: 10.1099/jmm.0.011130-0. Epub 2009 Jun 15.

Abstract

We report a case of community-acquired meticillin-resistant Staphylococcus aureus (CA-MRSA) bacteraemia with cavernous sinus thrombosis, meningitis and brain abscess in a previously healthy American, who was employed in Belgium. We consecutively reviewed all published cases of CA-MRSA with central nervous system (CNS) involvement. A total of 12 similar cases were found, of which 11 were published in the last 4 years. Predominantly, young previously healthy subjects were affected (median age 28 years). The cases involved brain abscesses (5/12), disseminated disease (4/12), cavernous sinus thrombosis (2/12) and other (1/12). Infection origins were superficial skin infections (5/12), mostly of the face, sinusitis (1/12), otitis media (1/12), other or unknown (5/12). Although, in our review of the literature patients treated with linezolid had a better outcome compared to patients treated with vancomycin, the latter is still the mainstay of therapy for CNS infections associated with MRSA.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia
  • Brain Abscess / drug therapy
  • Brain Abscess / microbiology
  • Cavernous Sinus Thrombosis / drug therapy
  • Cavernous Sinus Thrombosis / microbiology*
  • Cavernous Sinus Thrombosis / surgery
  • Central Nervous System Bacterial Infections / drug therapy
  • Central Nervous System Bacterial Infections / microbiology*
  • Central Nervous System Bacterial Infections / surgery
  • Community-Acquired Infections / drug therapy
  • Community-Acquired Infections / microbiology*
  • Community-Acquired Infections / surgery
  • Fatal Outcome
  • Humans
  • Male
  • Meningitis, Bacterial / drug therapy
  • Meningitis, Bacterial / microbiology
  • Methicillin-Resistant Staphylococcus aureus*
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / microbiology*
  • Staphylococcal Infections / surgery

Substances

  • Anti-Bacterial Agents