Related Experiment Video
Updated: Jul 8, 2026
05:55
Induction of Leptomeningeal Cells Modification Via Intracisternal Injection
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
Summary
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.
Related Concept Videos
01:27Cryptococcal Meningitis
Cryptococcal meningitis is a life-threatening opportunistic infection predominantly associated with HIV/AIDS, accounting for over 100,000 deaths annually worldwide. However, it also affects individuals with other forms of immunosuppression, including those undergoing immunosuppressive therapy, organ transplant recipients, patients with innate immunodeficiencies, and individuals with hematological disorders. The infection is caused mainly by Cryptococcus neoformans and Cryptococcus gattii,...
01:24Bacterial Meningitis
Bacterial meningitis is a severe infectious disease involving inflammation of the meninges, the protective membranes surrounding the brain and spinal cord. It occurs when pathogenic bacteria cross the blood–brain barrier and enter the cerebrospinal fluid. Common causative organisms include Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae type b, Listeria monocytogenes, and Escherichia coli K1. The exact route of entry varies by pathogen and host condition.Routes of Entry...
01:26Bacterial Meningitis II: Pathophysiology
Bacterial meningitis typically begins when pathogens such as Neisseria meningitidis and Streptococcus pneumoniae colonize the nasopharynx and invade the bloodstream. This process is facilitated by bacterial virulence factors, such as polysaccharide capsules, which resist phagocytosis and complement-mediated killing. Less commonly, bacteria reach the central nervous system via contiguous spread from infections like otitis media or sinusitis, through congenital or acquired dural defects, or...
01:22Bacterial Meningitis I: Introduction
Bacterial meningitis is a severe, life-threatening inflammation of the meninges, particularly the pia mater and arachnoid mater, affecting the subarachnoid space, ventricles, and cerebrospinal fluid (CSF). If untreated, it can lead to significant neurological complications or death.Causative AgentsCommon pathogens vary with age and immune status. In adults, major organisms include Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Streptococcus agalactiae (group B...
01:25Clinical Significance of Antibiotic Resistance
Methicillin-resistant Staphylococcus aureus (MRSA) presents a critical public health threat, arising from its capacity to resist β-lactam antibiotics due to acquisition of the mecA gene within the staphylococcal cassette chromosome mec (SCCmec). This gene encodes penicillin-binding protein 2a (PBP2a), which impairs binding efficacy of methicillin and other β-lactams. MRSA has evolved into distinct clonal lineages impacting humans and animals alike, reinforcing its significance within the One...
01:25Mechanism of Antibiotic Resistance in MRSA
Antibiotic resistance in bacteria arises when microorganisms evolve the ability to withstand drugs designed to kill them or inhibit their growth, rendering once-effective treatments useless. This phenomenon, driven by genetic change and selection under antibiotic exposure, poses a profound threat to modern medicine. Mechanisms include drug-inactivating enzymes (e.g., β-lactamases), efflux pumps that eject antibiotics, mutations altering antibiotic targets, decreased drug uptake, and acquisition...