ESBL Escherichia coli Ventriculitis after Aneurysm Clipping: A Rare and Difficult Therapeutic ChallengeReportar como inadecuado

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Case Reports in Neurological Medicine - Volume 2015 2015, Article ID 694807, 4 pages -

Case ReportSection of Neurosurgery, University of Manitoba, Winnipeg, MB, Canada R3A 1R9

Received 18 February 2015; Accepted 19 April 2015

Academic Editor: Mehmet Turgut

Copyright © 2015 F. A. Zeiler and J. Silvaggio. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Extended spectrum beta-lactamase ESBL produced Escherichia coli E. coli ventriculitis is a rare infection of the central nervous system, with increasing rarity in the adult population. The therapeutic strategy to achieve cure may need to involve a combination of intraventricular and intravenous IV therapy. Objective. To describe a case of ESBL E. coli meningitis-ventriculitis in an adult and outline the antimicrobial therapy that leads to cure. Methods. We retrospectively reviewed the records of a patient admitted to the neurosurgical department for aneurysmal subarachnoid hemorrhage, who developed ESBL E. coli ventriculitis. Results. A 55-year-old female, admitted for a Fisher grade 3, World Federation of Neurological Surgeons grade 1, subarachnoid hemorrhage, developed ESBL E. coli ventriculitis requiring a combination of intraventricular gentamicin and high dose intravenous meropenem for clearance. Cerebrospinal fluid clearance occurred at 7 days after initiation of combined therapy. The patient remained shunt dependent. Conclusions. Meningitis and ventriculitis caused by ESBL E. coli species are rare and pose significant challenges to the treating physician. Early consideration for combined intraventricular and IV therapy should be made.

Autor: F. A. Zeiler and J. Silvaggio



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