Pediatr Infect Vaccine.  2019 Aug;26(2):124-128. 10.14776/piv.2019.26.e15.

Intraventricular Vancomycin Therapy for Intractable Bacillus cereus Ventriculitis

Affiliations
  • 1Department of Pediatrics, Seoul National University College of Medicine, Seoul, the Republic of Korea.
  • 2Center for Pediatric Cancer, National Cancer Center, Goyang, the Republic of Korea. umi87c.pid@gmail.com
  • 3Department of Pediatrics, Korea University Guro Hospital, Korea University College of Medicine, Seoul, the Republic of Korea.
  • 4Neuro-Oncology Clinic, National Cancer Center, Goyang, the Republic of Korea.
  • 5Department of Radiology, National Cancer Center, Goyang, the Republic of Korea.

Abstract

Bacillus cereus causes serious central nervous system infections, especially in immunocompromised patients. Successful treatment requires adequate antimicrobial concentrations in the cerebrospinal fluid; however, in some cases, achieving this with systemic treatment alone is difficult. We treated intractable B. cereus ventriculitis with intraventricular vancomycin, with no major adverse events.

Keyword

Bacillus cereus; Injections, intraventricular; Central nervous system infection; Vancomycin; Pharmacokinetics; Cerebral ventriculitis

MeSH Terms

Bacillus cereus*
Bacillus*
Central Nervous System Infections
Cerebral Ventriculitis
Cerebrospinal Fluid
Immunocompromised Host
Injections, Intraventricular
Pharmacokinetics
Vancomycin*
Vancomycin

Figure

  • Fig. 1 Clinical course and CSF vancomycin pharmacokinetic data of our patient. (A) Clinical course, (B) CSF vancomycin levels during IVT infusion on days 1 and 2. The peak level was 110.7 µg/mL 1 hour after infusion with 5 mg vancomycin with 30-minute clamping. The triangle indicates the CSF vancomycin level; at time points of 2 hours, 8 hours, and 24 hours, we used an average CSF vancomycin level for plotting. Abbreviations: VAN, vancomycin; CFP, cefepime; Levo, levofloxacin; LZD, linezolid; MER, meropenem; RIF, rifampin; IVT, intraventricular; CSF, cerebrospinal fluid; WBC, white blood cell.


Reference

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