Meningitis remains one of the most dreaded complications of neurosurgical procedures and is common in patients with preexisting infection. Gram-negative organisms are the most common causative pathogens of postoperative meningitis.

Staphylococcus aureus is the most common bacterial pathogen implicated in pyomyositis. There are increasing reports of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections. The present case report brings out the diverse clinical manifestations of MRSA infection in the form of paraspinal pyomyositis, myelitis, spinal osteomyelitis, and pneumonia. Molecular typing of the organism confirmed the diagnosis. Patient was successfully treated with vancomycin and surgical drainage. Consideration of the possibility of methicillin-resistance and appropriate antibiotic selection is vital in the treatment of serious community-acquired staphylococcal infections.

Background:Neurosurgeons in developing countries come across brain abscess frequently, but Enterococcus as a cause of abscess is rare.Aims:To describe clinical profile and treatment of a series of patients with enterococcal brain abscess.Materials and Methods:We retrospectively reviewed microbiological records of patients with brain abscess to identify Enterococcus as a causative organism.Results:12 patients (nine males) were diagnosed to have enterococcal brain abscess. All were due to E. species.Conclusions:The clinical feature and management are not different from other etiological agents. The prognosis of enterococcal brain abscess is more favourable than bacteremia.

Septic cavernous sinus thrombosis (CST) is an uncommon clinical syndrome. Although Staphylococcus aureus (S aureus) is the most common bacterial pathogen causing CST, it is infrequent as a cause of meningitis. We report the first case of CST and meningitis from Bengaluru, Karnataka, caused by community-acquired epidemic methicillin resistant Staphylococcus aureus-15 (EMRSA-15), in a previously healthy individual without known risk factors; the patient recovered following treatment with vancomycin. The isolate was genotyped as belonging to staphylococcal cassette chromosome mec type IV and sequence type 22 and carried the panton-valentine leucocidin gene. It is the first Indian EMRSA-15 disease isolate from a case of meningitis. EMRSA-15 has been a major problem in hospitals in UK and it is a cause for great concern in Indian hospitals too.

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