title: Treatment of accidental high dose intraventricular mezlocillin application by cerebrospinal fluid exchange.
abstract: An accidental high dose of intraventricular mezlocillin was given during antibiotic treatment for pneumonia in a patient admitted because of severe traumatic brain injury and occlusive hydrocephalus. Because of serial epileptic seizures not responsive to antiepileptic drug treatment, CSF exchange was performed. The CSF was drained through a ventricular catheter, while mock CSF was infused into the lumbar subarachnoid space. The patient soon recovered to her clinical status previous to intraventricular mezlocillin application. Side effects of CSF exchange were not seen. Under continued antiepileptic medication no more seizures occurred. It is concluded that high doses of intraventricular mezlocillin have proconvulsive effects. In this patient CSF exchange was a suitable means of preventing putatively permanent impairment of brain function caused by serial epileptic seizures due to intraventricular mezlocillin application.
authors.affiliation: Department of Neurosurgery, University of Bonn, Sigmund-Freud-Strasse, Germany.
authors.forename: R A
authors.initials: RA
authors.lastname: Kristof
authors.forename: H
authors.initials: H
authors.lastname: Clusmann
authors.forename: W
authors.initials: W
authors.lastname: Koehler
authors.forename: K B
authors.initials: KB
authors.lastname: Fink
authors.forename: J
authors.initials: J
authors.lastname: Schramm
mesh_terms: D000328:Adult; D006259:Craniocerebral Trauma / Q000150:complications; D004322:Drainage / Q000295:instrumentation / Q000379:methods*; D016903:Drug Monitoring; D062787:Drug Overdose; D004827:Epilepsy / Q000134:cerebrospinal fluid / Q000139:chemically induced* / Q000628:therapy*; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D007276:Injections, Intraventricular; D008508:Medication Errors; D008802:Mezlocillin / Q000506:poisoning*; D010406:Penicillins / Q000506:poisoning*; D011014:Pneumonia / Q000150:complications / Q000188:drug therapy*; D014057:Tomography, X-Ray Computed; D014696:Ventriculostomy
chemical_list: D010406:Penicillins; D008802:Mezlocillin