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Published on: May 7, 2020

Vancomycin-resistant enterococcal meningitis treated with intrathecal streptomycin

Panayiotis N Varelas1, Mohammed Rehman, Wendy Pierce

  • 1Department of Neurology, Henry Ford Hospital, Detroit, MI 48202, United States. varelas@neuro.hfh.edu

Clinical Neurology and Neurosurgery
|December 29, 2007
PubMed

Insights

Vancomycin-resistant enterococcal meningitis, a rare neurosurgical complication, was successfully treated with intrathecal streptomycin. This novel approach offers hope for managing difficult-to-treat central nervous system infections.

Area of Science:

  • Neurosurgery
  • Infectious Diseases
  • Microbiology

Background:

  • Enterococcal meningitis is a rare but serious complication following neurosurgical interventions.
  • The rise of vancomycin-resistant enterococci (VRE) presents significant challenges in treating central nervous system infections.

Observation:

  • A patient developed ventriculitis-meningitis caused by vancomycin-resistant enterococci post-brain tumor resection and shunt placement.
  • Standard antibiotic regimens were insufficient to clear the infection.

Findings:

  • Successful treatment was achieved using intrathecal streptomycin delivered via bilateral cerebrospinal fluid drainage catheters, alongside systemic antibiotics.
  • This represents the first reported case of successful management of vancomycin-resistant enterococcal meningitis with this specific therapeutic strategy.

Implications:

  • Intrathecal streptomycin may be a viable therapeutic option for refractory vancomycin-resistant enterococcal meningitis.
  • This case highlights the importance of exploring alternative treatment modalities for multidrug-resistant organisms in neurosurgical patients.
  • Further research is warranted to evaluate the efficacy and safety of intrathecal streptomycin for central nervous system infections.

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