Cure of post-traumatic recurrent multiresistant Gram-negative rod meningitis with intraventricular colistin

Sofia K Kasiakou1, Petros I Rafailidis, Konstantinos Liaropoulos

  • 1Department of Medicine, Henry Dunant Hospital, Athens, Greece.

Insights

Recurrent meningitis caused by multidrug-resistant Gram-negative rods was successfully treated with a prolonged 6-week course of intraventricular and intravenous colistin and amikacin.

Area of Science:

  • Neuroscience
  • Infectious Diseases
  • Pharmacology

Background:

  • Head trauma can lead to serious complications, including central nervous system infections.
  • Multidrug-resistant Gram-negative rods pose a significant challenge in treating bacterial meningitis.

Observation:

  • A 28-year-old male patient experienced five episodes of meningitis over seven months following head trauma.
  • The meningitis was consistently caused by multiresistant Gram-negative bacteria.

Findings:

  • Intraventricular administration of colistin and amikacin, in addition to intravenous therapy, was crucial for resolving the recurrent meningitis.
  • A prolonged treatment duration of six weeks was required for successful eradication of the infection.

Implications:

  • This case highlights the potential efficacy of combined intraventricular and intravenous antibiotic therapy for complex, recurrent meningitis.
  • Extended treatment courses may be necessary for multidrug-resistant Gram-negative bacterial meningitis, particularly in cases associated with neurological trauma.

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