Pyogenic Ventriculitis

Akhaddar, Ali

doi:10.1007/978-3-319-60086-4_10

Cited by 4 publications

(1 citation statement)

References 12 publications

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“…[ 15 ] Besides, we think that complications such as pyogenic ventriculitis (synonymous to pyoventriculitis) and hydrocephaly that occurred in our case were related to intravenous antibiotic treatment failures. [ 1 ] Therefore, we considered the use of IVT antibiotics after external ventricular drain, in combination with intravenous antibiotics. IVT antibiotics ensure a high concentration of antibiotic at the site of infection, bypassing BBB.…”

Section: Discussionmentioning

confidence: 99%

Pseudomonas aeruginosanosocomial meningitis following spinal anesthesia – still a significant treatment dilemma

Kolovani¹,

Ramosaço²,

Xhumari³

et al. 2022

Surgical Neurology International

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Background: Infections of central nervous system after spinal anesthesia nowadays are a rarity; however, their presence might be of concern. Case Description: We report the case of lateral ventricular empyema treated unsuccessfully with parenteral antibiotic therapy, with the clinical signs of a persisting meningitis. After several lumbar taps suggesting an infection, Pseudomonas aeruginosa was isolated and a brain magnetic resonance imaging find out the collection in the left horn of the lateral ventricle. An intrathecal/intraventricular antibiotic therapy with colistin proved highly effective combined with an extra ventricular drainage to deal with the hydrocephaly. Conclusion: Clinicians should take into account even uncommon infectious agents while facing the picture of a meningitis otherwise nonresponsive to empiric or standard therapy.

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Section: Discussionmentioning

confidence: 99%

Pseudomonas aeruginosanosocomial meningitis following spinal anesthesia – still a significant treatment dilemma

Kolovani¹,

Ramosaço²,

Xhumari³

et al. 2022

Surgical Neurology International

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Diagnosis and treatment of severe neurosurgical patients with pyogenic ventriculitis caused by gram-negative bacteria

Shang

Wang

et al. 2017

Neurol Sci

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The aim of the study is to explore the experiences in diagnosis and treatment of severe neurosurgical patients with pyogenic ventriculitis caused by gram-negative bacteria (G). Nineteen patients with pyogenic ventriculitis were reviewed for their treatment. The bacterial testing results of cerebrospinal fluid (CSF), the clinical intervention, and the patients' prognosis were evaluated. The bacterial smears of ventricular drainage from all the cases were G bacteria. Head CT and MRI scans confirmed that they were intraventricular empyema. Eighteen cases of CSF bacterial test were positive, including 12 cases of Acinetobacter baumannii positive, 2 of Klebsiella pneumonia positive, 2 of Serratia marcescens positive, 1 of Pseudomonas maltophila positive, and 1 case of Escherichia coli positive. One case of the bacterial culture was negative. All patients were treated by using intraventricular lavage in combination with intravenous and intraventricular antibiotics in accordance with the clinical conditions. After treatment for 2 to 8 weeks, 14 patients were cured (74%) and 5 were died (26%). Eight patients who were cured had received ventriculoperitoneal shunt due to hydrocephalus at 2 to 6 weeks after infection controlled, and none of them had any reinfection. Twelve of the 14 cured cases came to consciousness, but 2 were persistent in vegetative state starting before the infection; they did not show any improving consciousness after infection had been cured. Suppurative ventriculitis in severe neurosurgical patients is mainly infected by G with a higher mortality. Early diagnosis, especially in identifying pathogen types, timely ventricular irrigation, and ventricular drainage together with intravenous and intraventricular antibiotic treatment, should improve prognosis.

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When a Stroke is not Just a Stroke: Escherichia coli Meningitis with Ventriculitis and Vasculitis: A Case Report

Ribeiro

Bishop

Jalili

2020

The Journal of Critical Care Medicine

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IntroductionCommunity-acquired Escherichia coli ventriculitis is considered a rare condition. Central nervous system (CNS) infection due to gram-negative bacilli is usually associated with previous neurosurgical interventions. The recent publication of cases of Escherichia coli meningitis and ventriculitis suggests its prevalence may be underestimated by the literature.Case presentationA case of community-acquired Escherichia coli CNS infection on a 58 year old patient presenting with altered consciousness but without neck stiffness, nor significant past medical history is reported. Imaging and lumbar puncture findings suggested a complex case of meningitis with associated ventriculitis and vasculitis. Escherichia coli was later identified in cultures. Subsequent multi-organ support in Intensive Care was required. The patient was treated with a prolonged course of intravenous antimicrobials guided by microbiology, resulting in some neurological recovery. The main challenges encountered in the management of the patient were the lack of clear recommendations on the duration of treatment and the potential development of multi-resistant organisms.ConclusionBacterial central nervous system infections can have an atypical presentation, and an increasing number of cases of community-acquired ventriculitis have been reported. Early consideration should be given to use magnetic resonance imaging to help guide treatment. A long course of antibiotics is often required for these patients; however, the optimal duration for antimicrobial treatment is not well defined.

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Pyogenic Ventriculitis

Cited by 4 publications

References 12 publications

Pseudomonas aeruginosanosocomial meningitis following spinal anesthesia – still a significant treatment dilemma

Pseudomonas aeruginosanosocomial meningitis following spinal anesthesia – still a significant treatment dilemma

Diagnosis and treatment of severe neurosurgical patients with pyogenic ventriculitis caused by gram-negative bacteria

When a Stroke is not Just a Stroke: Escherichia coli Meningitis with Ventriculitis and Vasculitis: A Case Report

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