Treatment of shunt-related cerebral ventriculitis due to Corynebacterium jeikeium with vancomycin administered intraventricularly. Case report.
A 52-year-old female with subarachnoid haemorrhage and hydrocephalus was treated with external and later internal drainage. She developed ventriculoperitoneal shunt-related ventriculitis caused by Corynebacterium jeikeium. The infection was unsuccessfully treated with intravenous vancomycin. It was controlled only after shunt removal and administration of intraventricular vancomycin as well as systemic vancomycin, rifampicin and fusidic acid. A review of the literature confirmed our experience that vancomycin given intraventricularly is well tolerated and doses can be individualized by measuring vancomycin levels in cerebrospinal fluid.
Department of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark.
J D
JD
Knudsen
C J
CJ
Nielsen
F
F
Espersen
D002404:Catheterization / Q000009:adverse effects; D002552:Cerebral Ventricles; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects; D003352:Corynebacterium / Q000472:pathogenicity; D003354:Corynebacterium Infections / Q000188:drug therapy*; D004660:Encephalitis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D014640:Vancomycin / Q000008:administration & dosage*
D014640:Vancomycin