Résumé
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.
Sujets)
Humains , Nourrisson , Mâle , Acétamides/usage thérapeutique , Anti-infectieux/usage thérapeutique , Ventricules cérébraux/microbiologie , Encéphalite/traitement médicamenteux , Enterococcus faecium/isolement et purification , Infections bactériennes à Gram positif/traitement médicamenteux , Oxazolidinones/usage thérapeutique , Résistance à la vancomycine , Encéphalite/microbiologie , Enterococcus faecium/effets des médicaments et des substances chimiques , Infections bactériennes à Gram positif/microbiologie , Hydrocéphalie/traitement médicamenteux , Hydrocéphalie/microbiologie , Résultat thérapeutique , Dérivation ventriculopéritonéaleRésumé
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.
Sujets)
Infarctus cérébral/microbiologie , Enfant , Enfant d'âge préscolaire , Citerne cérébellomédullaire postérieure/microbiologie , Diagnostic différentiel , Femelle , Humains , Hydrocéphalie/microbiologie , Nourrisson , Mâle , Valeur prédictive des tests , Pronostic , Sensibilité et spécificité , Thalamus/microbiologie , Tomodensitométrie , Méningite tuberculeuse/complicationsRésumé
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.
Sujets)
Antituberculeux/usage thérapeutique , Dérivations du liquide céphalorachidien/effets indésirables , Enfant d'âge préscolaire , Oedème/étiologie , Humains , Hydrocéphalie/microbiologie , Mâle , Épanchement subdural/étiologie , Tomodensitométrie , Méningite tuberculeuse/complicationsRésumé
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.