Bacterial meningitis in dogs

Bacterial infection of the central nervous system (CNS) is rare in dogs. It may result from local extension of infection from adjacent structures such as ears, eyes, sinuses, nasal passages, or areas of osteomyelitis. Hematogenous dissemination from extracranial foci may also occur in animals with bacterial endocarditis, omphalophlebitis, prostatitis, metritis, diskospondylitis, pyoderma or pneumonia. Local extensions and hematogenous dissemination of bacterial infection to the CNS may be most common in dogs with underlying immunodeficiency. Bacteria most often implicated include Straphylococcus aureus, Straphylococcus epidermitis, Straphylococcus albus, Pasteurella multocida, Actinomyces and Nocardia.

Clinical signs of bacterial meningitis in dogs may include cervical rigidity, hyperesthesia, pyrexia, vomiting, and bradycardia; seizures may also occur. Additional neurologic deficits, such as paresis, paralysis, hyperreflexia, blindness, mystagmus, and head tilt, are common; these suggest parenchymal involvement. The clinical course is variable. However, once the meningitis occurs in dogs, it can progress rapidly. Physical examination of a dog with bacterial meningitis may reveal a focus of underlying infection. These animals are almost systemically ill. Shock, hypotension, and disseminated intravascular coagulation may be present.

Bacterial meningitis in dogs is a life-threatening infection and requires rapid and aggressive treatment. Appropriate therapy of central nervous system infections is based on identification of the causative organism and choosing an appropriate antimicrobial agent. Chloramphenicol, trimethoprim-sulfadiazine, and the quinolones can penetrate into the CNS in therapeutic concentrations. Metronidazole is also effective and is the drug of choice whenever anaerobic infection is likely. In the presence of inflammation, ampicillin, penicillin, and amoxicillin with clavulonic acid also reach adequate concentrations. Although some of the third-generation cephalosporins (cefotaxime) are expensive, most penetrate the CNS well and are effective against many infectious agents, including gram-negative bacteria.

The response to antibiotic therapy is variable, and relapses are common. The prognosis should be considered guarded, because even with appropriate therapy many animals die. However, treatment should be attempted, because some cases respond dramatically to therapy and have complete resolution of their neurologic defects.

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