Fong I W, Ranalli P
Q J Med. 1984 Spring;53(210):289-99.
Thirty-eight cases of meningitis caused by Staphylococcus aureus, occurring from 1966 to 1981 at six hospitals associated with the University of Toronto Faculty of medicine, were reviewed. Thirteen patients were children and 25 were adults. Patients were categorised into three groups: Group A (16)--meningitis related to neurosurgery, trauma or cerebrospinal defects; Group B (7)--meningitis occurring with indwelling ventricular shunts; and Group C (15)--spontaneously occurring meningitis. Bacterial endocarditis was associated with one-third of the spontaneously occurring meningitis cases and this group in general ran a more fulminant course. Meningitis related to a ventricular shunt exhibited a more insidious onset with a lower case-fatality rate, similar to the experience with Gram-negative bacillary meningitis. Gram stain of the cerebrospinal fluid was positive in only one-third of cases. Treatment with cloxacillin, administered parenterally, achieved results similar to those with methicillin, while chloramphenicol was associated with a high failure rate.
回顾了1966年至1981年期间在多伦多大学医学院附属的六家医院发生的38例由金黄色葡萄球菌引起的脑膜炎病例。13例患者为儿童，25例为成人。患者被分为三组：A组（16例）——与神经外科手术、创伤或脑脊液缺陷相关的脑膜炎；B组（7例）——伴有留置脑室分流管时发生的脑膜炎；C组（15例）——自发性脑膜炎。三分之一的自发性脑膜炎病例伴有细菌性心内膜炎，总体而言，该组病情发展更为迅猛。与脑室分流管相关的脑膜炎起病更为隐匿，病死率较低，与革兰氏阴性杆菌性脑膜炎的情况类似。脑脊液革兰氏染色仅三分之一的病例呈阳性。经肠胃外途径给予氯唑西林治疗的效果与甲氧西林相似，而氯霉素治疗失败率较高。
