Antibiotic Therapy of an Infant With a Brevibacterium casei Ventriculoperitoneal Shunt Infection
We describe a newborn infant with hydrocephalus and a ventriculoperitoneal shunt infection caused by Brevibacterium casei. Essential for correct diagnosis was rapid species identification by matrix-assisted laser desorption/ionization time-of-flight, after initial report of coryneform bacteria. The patient responded well to vancomycin and rifampicin for 15 days. The shunt was not removed. Repeated cerebrospinal fluid cultures up to 4 months after therapy remained negative.
We report the first-ever case of peritonitis caused byRoseomonas mucosa, shortly after the revision of a VPS ventricular catheter. Hardware removal and proper antibiotic therapy led to the patient ’s recovery.Roseomonas mucosa is an opportunistic skin pathogen with an antibiotic resistance profile to many beta-lactamines and a tropism for indwelling catheters and post-operative period. Nowadays, it should be taken into account in case of infection of indwelling catheters and for some implantable medical devices.
This article describes the management of the second-encountered pediatric M. abscessus shunt infection along with the management of the 4 previously reported cases. In addition, it highlights the vital role of early, aggressive surgical debridement to achieve infection eradication.
Abstract: A 4-year-old former 24-week gestation male and an 18-month-old former 26-week gestation female, both with history of intraventricular hemorrhage resulting in hydrocephalus, presented with Mycobacterium abscessus ventricular shunt infections affecting both the shunt track and the ventricular fluid. Both children required prolonged combination antimycobacterial therapy; the 4 years old required more than 2 months of triple intravenous antibiotics and intraventricular amikacin to sterilize the cerebrospinal fluid. Each infection came under control only after removal of all foreign material and multiple and extensi...
I read with great interest the article by Wang et al1 “Management of Pyogenic Cerebral Ventriculitis by Neuroendoscopic Surgery” published recently in WORLD NEUROSURGERY. Pyogenic cerebral ventriculitis is often associated with an unfavorable outcome, and the cost of therapy is high. Various management options including external ventricular drain, removal of infected and malfunctioning VP shunt, antimicrobial therapy, and endoscopic surgery are reported in the literature. Ventriculitis associated presence of intraventricular debris, bacterial plaques, formation of multiple septation, and multiloculat...
Conclusions:Neurosyphilis is a very uncommon disease nowadays. However, this disease should be borne in mind when approaching the initial work-up of a new-onset dementia, because it is a treatable condition which requires early aggressive antibiotic therapy.Disclosure: Dr. Meza has nothing to disclose. Dr. Huapaya has nothing to disclose. Dr. Castro Suárez has nothing to disclose. Dr. Meza has nothing to disclose.
Conclusions: Childhood pneumococcal meningitis may be associated with diarrhea, pneumonia, and other related complication. Appropriate antibiotic therapy alone may not be sufficient to avert complications. Communicating hydrocephalus is potentially an ominous ramification of meningitis even when the ultrasonography result is normal. Rapid diagnosis is imperative to attain good outcome. Evidence advocates further research into the risk factors of meningitis in diarrheal children that may help in early diagnosis and management to reduce meningitis-related fatal outcome.
Conclusion: Ventriculoperitoneal shunt infection has become an important concern in cases of hydrocephalus. Due to the development of a high proportion of antibiotic resistance, we recommend an empirical therapy of antibiotic therapy for prophylaxis and suspected infection in ventriculoperitoneal shunt surgery.
CONCLUSION: Shunt survival was worse in patients who developed hydrocephalus following cranial surgery performed for brain tumors and those who received either steroids or prolonged antibiotic therapy. Thus post-cranial surgery hydrocephalus represents a unique subset of hydrocephalus. PMID: 27161463 [PubMed - in process]
ConclusionsHigh‐throughput metagenomic shotgun sequencing revealed P. acnes as the cause of chronic meningitis that had eluded conventional attempts at diagnosis. Treatment directed at this organism resulted in cure of the infection and clinical improvement.This article is protected by copyright. All rights reserved.
Conclusions Non-tuberculous mycobacteria are rare, atypical organisms in the setting of ventriculoperitoneal shunt infection. Patients with ventriculitis secondary to atypical mycobacteria may exhibit drug-resistant cerebrospinal fluid pleocytosis in the face of standard antibiotic regimens.