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Neonatal ventriculitis: a case series and review of literature

Ramitha R Bhat1, Prerna Batra2, Ravi Sachan3

  • 1Senior Resident, Department of Pediatrics, University College of Medical Sciences and Guru Tegh Bahadur Hospital, Delhi, India.

Tropical Doctor
|June 2, 2020
PubMed

Insights

Ventriculitis in newborns is serious. While intravenous antibiotics are preferred, intraventricular antibiotics may help in difficult cases, but external ventricular drains can cause complications.

Area of Science:

  • Neonatal Medicine
  • Infectious Diseases
  • Pediatric Neurology

Background:

  • Neonatal meningitis can lead to ventriculitis, a severe complication.
  • The efficacy and risks of intraventricular antibiotic administration for neonatal ventriculitis remain debated.
  • Raised intracranial pressure (ICP) in these cases often necessitates external ventricular drain (EVD) placement.

Observation:

  • This study reports on five neonatal cases of ventriculitis refractory to standard intravenous antibiotic treatment.
  • These infants presented with persistent ventriculitis and required EVD insertion due to elevated ICP.
  • Three infants received intraventricular antibiotics, with two experiencing EVD-related complications.

Findings:

  • Intraventricular antibiotic therapy, while potentially beneficial for refractory neonatal ventriculitis, is associated with significant risks, including EVD-related complications.
  • Early diagnosis and prompt treatment of ventriculitis are crucial for preventing fatal outcomes.
  • External ventricular drains, when used, require meticulous care and timely removal to mitigate the high incidence of associated infections.

Implications:

  • Intravenous antibiotics should remain the first-line treatment for neonatal ventriculitis.
  • Intraventricular antibiotic administration should be reserved for carefully selected, refractory cases under strict monitoring.
  • Improved EVD management protocols are essential to reduce the incidence of secondary ventriculitis in neonates.

Keywords:
Neonatesexternal ventricular drainmeningitisventriculitis

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