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

Intraventricular Vancomycin Therapy for Intractable Bacillus cereus Ventriculitis

• Hahn JW
• Ju HY
• Park M
• Yi ES
• Park BK
• Shin SH
• Lee SH
• Park HJ
• Kang JM

• KMID: 2455531
• DOI: http://doi.org/10.14776/piv.2019.26.e15

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.

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