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Pneumococcal meningitis in a child with a ventriculo-peritoneal shunt
1St George's Hospital, London, U.K.
The Journal of Infection
|January 1, 1991
Summary
A case of pneumococcal meningitis in an infant with a ventriculo-peritoneal shunt showed initial treatment failure. Adding rifampicin to penicillin and cefotaxime successfully eradicated the infection without requiring shunt removal.
Area of Science:
- Pediatric Infectious Diseases
- Neurosurgery
- Clinical Pharmacy
Background:
- Pneumococcal meningitis is a serious infection in infants.
- Ventriculo-peritoneal shunts are used to treat hydrocephalus but can be a source of infection.
- Standard antibiotic treatment may fail in complicated cases.
Observation:
- An infant with a ventriculo-peritoneal shunt developed pneumococcal meningitis.
- Initial treatment with high-dose penicillin and cefotaxime was unsuccessful.
- The infection persisted despite standard antimicrobial therapy.
Findings:
- Adjunctive therapy with rifampicin was added to the existing antibiotic regimen.
- Complete eradication of pneumococcal meningitis was achieved.
- Successful treatment was accomplished without the need for ventriculo-peritoneal shunt removal.
Implications:
- Rifampicin can be a valuable addition to standard antibiotic regimens for treating resistant pneumococcal meningitis in infants with shunts.
- This approach may help avoid complex shunt revision surgery.
- Highlights the importance of considering combination antibiotic therapy in refractory cases.