Serial cytokine profiles in shunt-related ventriculitis treated with intraventricular vancomycin.
BACKGROUND
A 1-month-old premature infant developed persistent shunt-related methicillin-resistant Staphylococcus aureus ventriculitis that was not responsive to parenteral therapy with vancomycin plus gentamicin (or rifampin).


METHODS
The infant was treated by intraventricular administration of vancomycin (5 days: 10 mg/day). In addition to standard testing of the cerebrospinal fluid (CSF), tumor necrosis factor alpha, interleukin-8 and interleukin-6 were serially measured.


RESULTS
Sterilization of the CSF was followed by a decline in the number of WBC and proinflammatory cytokines in the CSF.


CONCLUSIONS
Intraventricular administration of antibiotics may be considered if ventriculitis is refractory to systemic antimicrobial therapy. Serial measurements of inflammatory cytokines in the CSF may provide an additional diagnostic tool to monitor the outcome of therapy.
Laborada
Gary
G
Weill Medical College of Cornell University, New York, NY, USA.
Cruz
Florencia
F
Nesin
Mirjana
M
D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D016207:Cytokines / Q000134:cerebrospinal fluid* / Q000187:drug effects; D016903:Drug Monitoring; D004660:Encephalitis / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007276:Injections, Intraventricular; D016106:Methicillin Resistance; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D014640:Vancomycin / Q000008:administration & dosage*; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects
D000900:Anti-Bacterial Agents; D016207:Cytokines; D014640:Vancomycin