A retrospective analysis of 10 adult patients with community-acquired Staphylococcus aureus meningitis was performed in order to elucidate the characteristics and treatment of this lethal disease. In all patients, a focus of infection outside the central nervous system was apparent at presentation. A poor prognosis was associated with severe underlying disease, greater degree of hyponatremia at presentation, development of seizures, failure of nuchal rigidity to develop, persistent or recurrent bacteremia, and the presence of concurrent S. aureus bronchopneumonia. Degree of deterioration in mental status and cerebrospinal fluid pleocytosis, protein levels, and glucose levels did not appear to have any prognostic significance. Therapy with rifampin and a semisynthetic penicillin effected a cure in all six patients treated with this regimen. In contrast, three of four patients treated with other antibiotic combinations died. On the basis of this experience, it is concluded that further trials with rifampin in combination with another anti-staphylococcal antibiotic for the treatment of S. aureus meningitis are warranted.
Yes, some forms of bacterial meningitis are contagious. The bacteria are spread through the exchange of respiratory and throat secretions (for example, coughing, kissing, sharing of utensils). Sometimes the bacteria that cause meningitis can spread to other people who have had close or prolonged contact with a patient with meningitis. Meningitis caused by Neisseria meningitidis (also called meningococcal meningitis ) is the most important example. People in the same household, dormitory, or day-care center, or anyone with direct contact with a patient's oral secretions would be considered at increased risk of acquiring the infection. This also holds true for health-care professionals involved in direct, prolonged contact, especially during procedures such as intubations (placing a breathing tube ). People who qualify as close contacts of a person with meningitis caused by N. meningitidis should receive antibiotics to prevent them from getting the disease.