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Successful treatment of vancomycin-resistant enterococcus ventriculitis in a child

Paulo Sérgio Lucas da Silva1, Henrique Monteiro Neto, Lílian Márcia Sejas

  • 1Pediatric Intensive Care Unit, Department of Pediatrics, State Hospital of Diadema, Federal University of São Paulo, São Paulo, SP, Brazil. psls.nat@terra.com.br

The Brazilian Journal of Infectious Diseases : an Official Publication of the Brazilian Society of Infectious Diseases
|July 13, 2007
PubMed

Insights

Vancomycin-resistant Enterococcus faecium CNS infections are rare. Intravenous linezolid effectively treated ventriculitis in a pediatric patient with a ventriculoperitoneal shunt, achieving cerebrospinal fluid sterilization.

Area of Science:

  • Pediatric Infectious Diseases
  • Neuro-Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Enterococci are an infrequent cause of central nervous system (CNS) infections.
  • The patient, a 20-month-old boy, had hydrocephalus with a ventriculoperitoneal (VP) shunt, a history of prolonged hospitalization, and broad-spectrum antibiotic exposure.
  • He was admitted to the pediatric intensive care unit with a diagnosis of ventriculitis.

Observation:

  • Empirical antibiotic therapy with vancomycin and meropenem was initiated.
  • On day 14, the patient developed a fever.
  • Cerebrospinal fluid (CSF) culture identified vancomycin-resistant Enterococcus faecium (VRE).

Findings:

  • The patient was treated with intravenous linezolid.
  • Cerebrospinal fluid sterilization was achieved with linezolid therapy.
  • This indicates linezolid's efficacy in treating VRE ventriculitis.

Implications:

  • Intravenous linezolid presents a safe and effective treatment option for VRE ventriculoperitoneal shunt infections.
  • This case highlights the importance of timely diagnosis and appropriate antibiotic selection for CNS infections caused by resistant organisms.
  • Further research may explore linezolid's role in managing similar complex pediatric neuro-infections.
Abstract

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