[Neonatal meningitis, ventriculitis, intraventricular therapy or not?].
Neonatal meningitis still remains a disease with high mortality in spite of systemic treatment with in vitro active antibiotics. Of 42 consecutive cases, the fatality rate was 36%; Among the 27 survivors, there were 7 patients with extensive neurological and psychological impairment. The pathogenesis of the ventriculitis is discussed on the basis of the histomorphological structure of the ependyma, the subependymal tissue and the glycogen-rich choroid plexus within the first few weeks after birth. It seems, that this structure facilitates local bacterial growth and acts as a bacterial reservoir, relatively resistant to antimicrobial agents. The goal of therapy in neonatal meningitis should be directed to achieve a high concentration of the antimicrobial agent in the fore mentioned tissues. The intraventricular route should be considered.
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000378:metabolism / Q000627:therapeutic use*; D001812:Blood-Brain Barrier; D002552:Cerebral Ventricles; D004660:Encephalitis / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007231:Infant, Newborn; D007276:Injections, Intraventricular; D008581:Meningitis / Q000150:complications / Q000188:drug therapy*
D000900:Anti-Bacterial Agents
Neonatale meningitis, ventriculitis, wel of geen intraventriculaire therapie?