ABSTRACT
Enterococci are an uncommon cause of CNS infection. A 20 month-old boy, diagnosed with hydrocephalus with ventriculoperitoneal shunt and history of lengthy hospitalization and use of wide spectrum antibiotics, was admitted to the pediatric intensive care unit diagnosed with ventriculitis. On the 14th day of empirical antibiotic therapy (vancomycin and meropenem) the child presented fever while the CSF sample culture evidenced vancomycin-resistant Enterococcus faecium. The patient received intravenous linezolid achieving cerebrospinal fluid sterilization. Conclusion: Intravenous linezolid appears to be a safe and effective therapy for vancomycin-resistant enterococcus ventriculoperitoneal shunt infection.
Subject(s)
Humans , Infant , Male , Acetamides/therapeutic use , Anti-Infective Agents/therapeutic use , Cerebral Ventricles/microbiology , Encephalitis/drug therapy , Enterococcus faecium/isolation & purification , Gram-Positive Bacterial Infections/drug therapy , Oxazolidinones/therapeutic use , Vancomycin Resistance , Encephalitis/microbiology , Enterococcus faecium/drug effects , Gram-Positive Bacterial Infections/microbiology , Hydrocephalus/drug therapy , Hydrocephalus/microbiology , Treatment Outcome , Ventriculoperitoneal ShuntABSTRACT
Twenty-one patients with clinical and laboratory diagnosis of tuberculous meningitis were studied at the paediatric department and neuroradiology unit of Bangur Institute of Neurology, both attached to IPGME & R, Kolkata, during the period from 1st February, 1996 to 31 st July, 1996. The age group of the patients were between 1 and 8 years. It clearly appears that CT is an extremely powerful investigative modality for the diagnosis, management and follow-up assessment of development of any complications like hydrocephalus, cerebral infarction, etc. CT examination also can predict the prognosis of the patients.
Subject(s)
Cerebral Infarction/microbiology , Child , Child, Preschool , Cisterna Magna/microbiology , Diagnosis, Differential , Female , Humans , Hydrocephalus/microbiology , Infant , Male , Predictive Value of Tests , Prognosis , Sensitivity and Specificity , Thalamus/microbiology , Tomography, X-Ray Computed , Tuberculosis, Meningeal/complicationsABSTRACT
We report a child with hydrocephalus due to tuberculous meningitis who developed a subcutaneous fluid collection around the ventriculoperitoneal shunt tube entry point, after one month of shunting. On investigation, he had decompressed ventricles with bilateral fronto parietal subdural hygroma. Bifrontal burr hole drainage helped resolution of both subdural effusion and subcutaneous scalp swelling. This complication is unique and its pathogenesis has been postulated.
Subject(s)
Antitubercular Agents/therapeutic use , Cerebrospinal Fluid Shunts/adverse effects , Child, Preschool , Edema/etiology , Humans , Hydrocephalus/microbiology , Male , Subdural Effusion/etiology , Tomography, X-Ray Computed , Tuberculosis, Meningeal/complicationsABSTRACT
Meningitis of bacterial (including tubercular) or non bacterial origin is a common and lethal infection of central nervous system in children. Although, with the use of modern medical facilities including antibiotics, the mortality rates of meningitis have decreased, yet the number of patients surviving with complications such as hydrocephalus have greatly increased. In this article the etiopathogenesis of post meningitis hydrocephalus has been reviewed. Effective use of appropriate antibiotics and shunt procedures have improved the outcome of post meningitic hydrocephalus of bacterial origin but the same is not true with that of fungal origin, which still carries high mortality and morbidity.