Meropenem Administered as a Prolonged Infusion to Treat Serious Gram-Negative Central Nervous System Infections

2004 ◽  
Vol 24 (6) ◽  
pp. 803-807 ◽  
Author(s):  
Blair Capitano ◽  
David P. Nicolau ◽  
Brian A. Potoski ◽  
Karin E. Byers ◽  
Michael Horowitz ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Central Nervous System Infections ◽  
Prolonged Infusion ◽  
Gram Negative

scholarly journals Successful Management of Nosocomial Ventriculitis and Meningitis Caused by Extensively Drug-ResistantAcinetobacter baumanniiin Austria

2013 ◽  
Vol 24 (3) ◽  
pp. e88-e90 ◽  
Author(s):  
M Hoenigl ◽  
M Drescher ◽  
G Feierl ◽  
T Valentin ◽  
G Zarfel ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Nosocomial Infections ◽  
Antimicrobial Agents ◽  
Northern Italy ◽  
Drug Resistant ◽  
Central Nervous System Infections ◽  
Successful Management ◽  
Gram Negative ◽  
Extensively Drug Resistant

Nosocomial infections caused by the Gram-negative coccobacillusAcinetobacter baumanniihave substantially increased over recent years. BecauseAcinetobacteris a genus with a tendency to quickly develop resistance to multiple antimicrobial agents, therapy is often complicated, requiring the return to previously used drugs. The authors report a case of meningitis due to extensively drug-resistantA baumanniiin an Austrian patient who had undergone neurosurgery in northern Italy. The case illustrates the limits of therapeutic options in central nervous system infections caused by extensively drug-resistant pathogens.

Intrathecal Colistin and Sterilization of Resistant Pseudomonas Aeruginosa Shunt Infection

2005 ◽  
Vol 39 (5) ◽  
pp. 949-952 ◽  
Author(s):  
Andrea L Quinn ◽  
Jorge P Parada ◽  
Jaime Belmares ◽  
J Paul O'Keefe
Keyword(s):  
Central Nervous System ◽  
Pseudomonas Aeruginosa ◽  
Nervous System ◽  
Renal Function ◽  
Central Nervous System Infections ◽  
Gram Negative ◽  
Cell Counts ◽  
Blood Cell Counts ◽  
History Of ◽  
White Blood Cell Counts

OBJECTIVE: To report 2 cases of multidrug-resistant (MDR) Pseudomonas aeruginosa meningitis and ventriculo-peritoneal shunt (VPS) infection successfully sterilized with intrathecal colistin 10 mg/day after development of nephrotoxicity associated with intravenous administration. CASE SUMMARIES: Case 1. A 69-year-old African American woman with a history of subarachnoid hemorrhage and hydrocephalus requiring VPS placement was admitted with VPS infection and meningitis. Cerebrospinal fluid (CSF) cultures revealed MDR P. aeruginosa susceptible only to colistin. Intravenous colistin was initiated but rapidly discontinued due to development of renal dysfunction. Intravenous colistin was the probable cause of the adverse effect. Intrathecal colistin was initiated via an externalized VPS, with subsequent improvement in white blood cell counts in the CSF. Follow-up CSF cultures remained sterile and renal function returned to baseline. Case 2. A 69-year-old white woman with a history of subarachnoid hemorrhage, hydrocephalus, and VPS was transferred from an extended-care facility for management of a VPS infection. CSF cultures revealed MDR P. aeruginosa susceptible only to colistin. Intravenous colistin was initiated but subsequently discontinued due to worsening renal function that, as with the first case, probably correlated with colistin administration and persisted despite dose adjustment. Therapy was changed to intrathecal administration, with subsequent normalization of her CSF white blood cell counts and sterilization of cultures. DISCUSSION: The limited availability of antibiotics for treatment of highly resistant or MDR gram-negative organisms has prompted clinicians to reconsider the use of older drugs. Prior reports have suggested that intravenous colistin is a potential alternative for treating highly resistant gram-negative central nervous system infections, specifically Acinetobacter, but its use is limited by nephrotoxicity. Our experience suggests that intrathecal colistin is a potentially curative intervention for the treatment of severe MDR P. aeruginosa meningitis and VPS infections in patients in whom intravenous colistin is not an option. CONCLUSIONS: Intrathecal use of colistin is a potentially safe, effective, and viable treatment option for MDR P. aeruginosa central nervous system infections when intravenous administration is not feasible.

scholarly journals Meningitis Caused by Salmonella Newport in a Five-Year-Old Child

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Ana De Malet ◽  
Sheila Ingerto ◽  
Israel Gañán
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Neurological Disorders ◽  
Invasive Disease ◽  
Salmonella Typhi ◽  
Gram Negative ◽  
Negative Bacillus ◽  
Salmonella Newport ◽  
Gram Negative Bacillus ◽  
The Central Nervous System

Salmonella Newport is a Gram-negative bacillus belonging to the Enterobacteria family and the nontyphi Salmonella (NTS), usually related to gastroenteritis. Main difference between NTS and Salmonella typhi is that the last one evolves to an invasive disease easier than NTS. These can progress to bacteremias in around 5% of cases and secondary focuses can appear occasionally, as in meningitis. An infection of the central nervous system is uncommon, considering its incidence in 0.6–8% of the cases; most of them are described in developing countries and mainly in childhood, especially neonates. Bacterial meningitis by NTS mostly affects immunosuppressed people in Europe. Prognosis is adverse, with a 50% mortality rate, mainly due to complications of infection: hydrocephalus, ventriculitis, abscesses, subdural empyema, or stroke. Choice antibiotic treatments are cefotaxime, ceftriaxone, or ceftazidime. The aim of this paper is to present a case of meningitis caused by Salmonella Newport diagnosed in a five-year-old girl living in a rural area of the province of Ourense (Spain), with favorable evolution and without neurological disorders.

Management of central nervous system infections during an epidemic of enteroviral aseptic meningitis

1980 ◽  
Vol 96 (3) ◽  
pp. 559-563 ◽  
Author(s):  
Jonathan I. Singer ◽  
Philip R. Maur ◽  
John P. Riley ◽  
Pamela Burger Smith
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Aseptic Meningitis ◽  
Central Nervous System Infections

Diffusion imaging in pediatric central nervous system infections

2001 ◽  
Vol 43 (12) ◽  
pp. 1031-1039 ◽  
Author(s):  
J. Teixeira ◽  
R. Zimmerman ◽  
J. Haselgrove ◽  
L. Bilaniuk ◽  
J. Hunter
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Diffusion Imaging ◽  
Central Nervous System Infections
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