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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Staph Infection, Aortic Aneurysm Repair, Altered Mental Status, Effect On Brain

My husband is in the hospital with a staph infection in the area of an aortic aneurysm repair that was performed in 2008. He is being treated with antibiotics and surgery is in the future to remove the aortic graft and do a new graft when the infection is more under control. He is showing signs of an altered mental status over the last 3-4 days. The CT done so far is normal. Doctors have said the staph infection is in his bloodstream. My question is: can the staph infect his brain and, if so, would that show on a CT scan? thank you.
Thu, 24 May 2012
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General & Family Physician,  's  Response
Dear edavis,
Thanks for posting here.

The staphylococcus has the potential to enter the brain if already circulating in the blood stream, and it can lead to infection of the meninges (the membranes covering our brains). This is called bacterial meningitis. Meningitis caused by staph can be a serous and one must remain concerned and alert to prevent this from progress.

However, in your case it is not clear whether the altered mental staus is because of meningitis or something else. To confirm please ask your clinician to do a CSF fluid (fluid taken from spinal cord through a needle) culture, as this would give you the proper diagnosis.
CT scan can show inflammed meninges in such case, but it can be missed sometimes in earlier stages.

Your husband must be on staph specific antibniotics, if not please ask your clinicians to do as fast as possible as correct antibiotics wi help him improve faster.

Do well.
Dr Rakesh.




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Psychiatrist,  Dr. Sivaraman's  Response
Hai
Altered mental state after a bacterial infection may be due to meningitis/electrolyte imbalance because of decreased food intake or fluids ... CT Scan may be normal but CSF exmination may be impotatnt to rule out infection in brain. Also kindly do serum electrolytes , blood urea , serum creatinine,EEG to get more information regarding the status. Though treatment of the cause will settle down altered mental status , Low dose antipsychotics may control the behavioural abnormalities.
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General & Family Physician,  Dr. Buddhika's  Response
you can not see staph infection in CT.But it may end up with brain abscess rarely and then you can see brain abscess in CT. According your history sepsis (Sepsis is a severe illness in which the bloodstream is overwhelmed by bacteria.) may course to confusion.There are some other courses too.
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Staph Infection, Aortic Aneurysm Repair, Altered Mental Status, Effect On Brain

Dear edavis, Thanks for posting here. The staphylococcus has the potential to enter the brain if already circulating in the blood stream, and it can lead to infection of the meninges (the membranes covering our brains). This is called bacterial meningitis. Meningitis caused by staph can be a serous and one must remain concerned and alert to prevent this from progress. However, in your case it is not clear whether the altered mental staus is because of meningitis or something else. To confirm please ask your clinician to do a CSF fluid (fluid taken from spinal cord through a needle) culture, as this would give you the proper diagnosis. CT scan can show inflammed meninges in such case, but it can be missed sometimes in earlier stages. Your husband must be on staph specific antibniotics, if not please ask your clinicians to do as fast as possible as correct antibiotics wi help him improve faster. Do well. Dr Rakesh.