{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:04:11Z","timestamp":1790726651399,"version":"4.1.0"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":29,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Healthcare-associated bacterial meningitis is a rare but life-threatening complication of spinal surgery, most commonly associated with incidental durotomy. A 59-year-old man developed fever, altered mental status, and generalized seizures 1week after uncomplicated revision L4\u2013L5 microdiscectomy. Magnetic resonance imaging demonstrated diffuse intracranial and spinal leptomeningeal enhancement with a postoperative lumbar fluid collection. Cerebrospinal fluid (CSF) analysis was consistent with bacterial meningitis. Emergent irrigation and debridement revealed copious purulent fluid without evidence of a CSF leak despite meticulous dural exploration. Wound and CSF cultures grew methicillin-resistant Staphylococcus aureus (MRSA). Following surgical debridement and targeted intravenous vancomycin, the patient achieved substantial neurological recovery and was independently ambulatory with only mild residual cognitive impairment at 6\u00a0months. MRSA meningitis may occur after revision lumbar microdiscectomy without a recognized dural tear. Early recognition, surgical source control, and targeted antimicrobial therapy are essential to optimize outcomes.<\/jats:p>","DOI":"10.1093\/jscr\/rjag868","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T19:23:42Z","timestamp":1789673022000},"source":"Crossref","is-referenced-by-count":0,"title":["Methicillin-resistant\n                    <i>Staphylococcus aureus<\/i>\n                    meningitis following revision microdiscectomy: a case report"],"prefix":"10.1093","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2798-0208","authenticated-orcid":false,"given":"Zachary","family":"Troiani","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, University of Buffalo , 462 Grider St., Buffalo, NY 14215 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meaghan","family":"Gleason","sequence":"additional","affiliation":[{"name":"Jacobs School of Medicine and Biomedical Sciences , 955 Main St., Buffalo, NY 14203 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Kowalski","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of Buffalo , 462 Grider St., Buffalo, NY 14215 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Lutnick","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of Buffalo , 462 Grider St., Buffalo, NY 14215 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxwell","family":"Scott","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of Buffalo , 462 Grider St., Buffalo, NY 14215 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Kowalski","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of Buffalo , 462 Grider St., Buffalo, NY 14215 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"2026092919194248400_ref1","doi-asserted-by":"publisher","first-page":"e34","DOI":"10.1093\/cid\/ciw861","article-title":"2017 Infectious Diseases Society of America's clinical practice guidelines for healthcare-associated ventriculitis and meningitis","volume":"64","author":"Tunkel","year":"2017","journal-title":"Clin Infect Dis"},{"key":"2026092919194248400_ref2","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1086\/518580","article-title":"Postoperative central nervous system infection: incidence and associated factors in 2111 neurosurgical procedures","volume":"45","author":"McClelland","year":"2007","journal-title":"Clin Infect Dis"},{"key":"2026092919194248400_ref3","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1097\/00007632-199603150-00022","article-title":"Meningitis complicating spinal surgery","volume":"21","author":"Twyman","year":"1996","journal-title":"Spine"},{"key":"2026092919194248400_ref4","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1186\/1471-2334-14-220","article-title":"Postoperative meningitis after spinal surgery: a review of 21 cases from 20,178 patients","volume":"14","author":"Lin","year":"2014","journal-title":"BMC Infect Dis"},{"key":"2026092919194248400_ref5","doi-asserted-by":"publisher","first-page":"E1425","DOI":"10.1097\/BRS.0b013e3182a42a68","article-title":"Surgical site infections in spine surgery: identification of microbiologic and surgical characteristics in 239 cases","volume":"38","author":"Abdul-Jabbar","year":"2013","journal-title":"Spine"},{"key":"2026092919194248400_ref6","doi-asserted-by":"publisher","first-page":"1106","DOI":"10.1097\/BRS.0000000000002088","article-title":"Reoperation for recurrent intervertebral disc herniation in the spine patient outcomes research trial: analysis of rate, risk factors, and outcome","volume":"42","author":"Abdu","year":"2017","journal-title":"Spine"},{"key":"2026092919194248400_ref7","doi-asserted-by":"publisher","first-page":"e279","DOI":"10.5435\/jaaos-d-20-00210","article-title":"Incidental durotomy in lumbar spine surgery; risk factors, complications, and perioperative management","volume":"29","author":"Hassanzadeh","year":"2021","journal-title":"J Am Acad Orthop Surg"},{"key":"2026092919194248400_ref8","doi-asserted-by":"publisher","first-page":"E155","DOI":"10.1097\/brs.0000000000003213","article-title":"The true effect of a lumbar Dural tear on complications and cost","volume":"45","author":"Alluri","year":"2020","journal-title":"Spine (Phila Pa 1976)"},{"key":"2026092919194248400_ref9","doi-asserted-by":"publisher","first-page":"1171","DOI":"10.1016\/S0140-6736(21)00883-7","article-title":"Community-acquired bacterial meningitis","volume":"398","author":"Beek","year":"2021","journal-title":"Lancet"},{"key":"2026092919194248400_ref10","doi-asserted-by":"publisher","first-page":"R136","DOI":"10.1186\/cc10254","article-title":"Meningitis in adult patients with a negative direct cerebrospinal fluid examination: value of cytochemical markers for differential diagnosis","volume":"15","author":"Viallon","year":"2011","journal-title":"Crit Care"},{"key":"2026092919194248400_ref11","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1097\/MAJ.0000000000000217","article-title":"The differential diagnosis of hypoglycorrhachia in adult patients","volume":"348","author":"Chow","year":"2014","journal-title":"Am J Med Sci"}],"container-title":["Journal of Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2026\/9\/rjag868\/71469097\/rjag868.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2026\/9\/rjag868\/71469097\/rjag868.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T23:19:48Z","timestamp":1790723988000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jscr\/article\/doi\/10.1093\/jscr\/rjag868\/8845820"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,31]]},"references-count":11,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,8,31]]}},"URL":"https:\/\/doi.org\/10.1093\/jscr\/rjag868","relation":{},"ISSN":["2042-8812"],"issn-type":[{"value":"2042-8812","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,9]]},"published":{"date-parts":[[2026,8,31]]},"article-number":"rjag868"}}