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Intrathecal Colistin Induced Chemical Meningitis in a Case of Multi-Drug Resistant Acinetobacter baumannii Meningitis

Aysun Benli1, Serap Şimşek-Yavuz1, Haluk Eraksoy1

  • 1Department of Infectious Diseases and Clinical Microbiology, İstanbul University School of Medicine, İstanbul, Turkey.

Infectious Diseases & Clinical Microbiology
|April 18, 2024
PubMed

Insights

Intrathecal colistin for resistant Gram-negative meningitis can cause chemical meningitis. Discontinuing this treatment improved cerebrospinal fluid findings, suggesting dose reduction or cessation as management strategies.

Area of Science:

  • Neuroscience
  • Infectious Diseases
  • Pharmacology

Background:

  • Nosocomial meningitis presents a significant challenge due to multi-drug resistant Gram-negative bacteria.
  • Colistin is a critical treatment for infections caused by these resistant strains.
  • Intrathecal colistin administration is sometimes necessary but carries risks.

Observation:

  • A case of chemical meningitis occurred during treatment for multi-drug resistant *Acinetobacter baumannii* meningitis.
  • The patient received intravenous sulbactam plus colistin and intrathecal colistin.
  • Cerebrospinal fluid (CSF) findings improved upon cessation of intrathecal colistin.

Findings:

  • Intrathecal colistin therapy can precipitate reversible chemical meningitis.
  • This complication is characterized by changes in cerebrospinal fluid parameters.
  • Discontinuation or dose reduction of intrathecal colistin is a viable management approach.

Implications:

  • Clinicians should be vigilant for chemical meningitis during intrathecal colistin therapy.
  • Early recognition and management, such as drug cessation, can reverse this complication.
  • This highlights the need for careful dosing and monitoring in neuroinfectious disease treatment.
Keywords:
Acinetobacter baumanniiChemical meningitiscolistinintrathecal therapy

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