Staphylococcal infections: neurologic manifestations

Jeffrey A Rumbaugh MD (Dr. Rumbaugh of the Johns Hopkins University has no relevant financial relationships to disclose.)
Karen L Roos MD FAAN, editor. (Dr. Roos of Indiana University School of Medicine has no relevant financial relationships to disclose.)
Originally released October 19, 2006; last updated October 6, 2008; expires October 6, 2011
Notice: This article has expired and is therefore not available for CME credit.

This article includes discussion of Staphylococcal infections: neurologic manifestations, staphylococci, Staphylococcus, Staphylococcus aureus, and Staphylococcus epidermidis. The foregoing terms may include synonyms, similar disorders, variations in usage, and abbreviations.

Overview

Staphylococcus is the leading cause of bacterial meningitis in patients with CSF shunts or following neurosurgical procedures or neurologic trauma. Additionally, community-acquired staphylococcal infection, including meningitis, is becoming increasingly common and accounts for significant morbidity and mortality in essentially all age groups. Prompt recognition and treatment can improve outcomes. In this article, the author reviews the clinical manifestations of Staphylococcus infections, with emphasis on neurologic symptoms and key features that can help physicians avoid pitfalls leading to missed or late diagnosis. The most up-to-date treatment recommendations are incorporated into this update.

Historical note and terminology

Staphylococci were first identified and cultured by Pasteur and Koch in the late 1800s, but Ogston, in 1881, was the first to study the organism carefully and coin the name (Ogston 1881). “Staphylococcus” comes from the Greek “staphyle,” meaning “bunch of grapes,” and was introduced because of the grape-like clusters that these organisms form when observed in pus from human abscesses. In 1884, Rosenbach was the first to grow this organism in pure culture and added the term “aureus” to the name because of its yellow-orange color in colonies. Staphylococci were initially grouped together with micrococci but differ in several important aspects, including nucleic acid composition, respiratory chain composition, and cell wall structure. Staphylococci now belong to the broad Bacillus-Lactobacillus-Streptococcus cluster (Moreillon et al 2005).

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