Although we have reported the first case of Staphylococcus aureus meningitis due to pyogenic arthritis of the sacroiliac joint, this finding is actually not surprising, given the strong association between this form of meningitis and underlying bone, joint, and soft tissue infections. The physician faced with a case of meningitis due to S aureus in a patient without a history of trauma or neurosurgical manipulation must do a prompt and thorough search for underlying infectious conditions. In the case of sacroiliitis in particular, a high index of suspicion needs to be maintained, given the difficulties and delays in diagnosis associated with this infection. Radionuclide scanning with 99mTc or 67Ga is usually helpful in the early confirmation of this condition, the presence of which may be suspected on the basis of thorough physical examination.
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