Related Experiment Videos
Treatment of accidental high dose intraventricular mezlocillin application by cerebrospinal fluid exchange
R A Kristof1, H Clusmann, W Koehler
1Department of Neurosurgery, University of Bonn, Sigmund-Freud-Strasse, Germany.
Abstract:
An accidental high dose of intraventricular mezlocillin was given during antibiotic treatment for pneumonia in a patient admitted because of severe traumatic brain injury and occlusive hydrocephalus. Because of serial epileptic seizures not responsive to antiepileptic drug treatment, CSF exchange was performed. The CSF was drained through a ventricular catheter, while mock CSF was infused into the lumbar subarachnoid space. The patient soon recovered to her clinical status previous to intraventricular mezlocillin application. Side effects of CSF exchange were not seen. Under continued antiepileptic medication no more seizures occurred. It is concluded that high doses of intraventricular mezlocillin have proconvulsive effects. In this patient CSF exchange was a suitable means of preventing putatively permanent impairment of brain function caused by serial epileptic seizures due to intraventricular mezlocillin application.
Insights
High doses of intraventricular mezlocillin can cause seizures. Cerebrospinal fluid (CSF) exchange effectively removed the antibiotic, resolving the seizures and preventing potential brain damage.
Area of Science:
- Neuroscience
- Pharmacology
- Neurosurgery
Background:
- A patient with severe traumatic brain injury and occlusive hydrocephalus received intraventricular mezlocillin for pneumonia.
- The patient experienced serial epileptic seizures unresponsive to standard antiepileptic drugs.
Observation:
- Cerebrospinal fluid (CSF) exchange was performed by draining CSF via a ventricular catheter and infusing mock CSF into the lumbar subarachnoid space.
- Following CSF exchange, the patient's clinical status returned to pre-mezlocillin levels without adverse effects from the procedure.
Findings:
- High-dose intraventricular mezlocillin administration demonstrated proconvulsive effects.
- CSF exchange proved to be an effective method for removing intraventricular mezlocillin and mitigating its adverse neurological effects.
Implications:
- This case highlights the potential proconvulsive risks associated with high-dose intraventricular mezlocillin.
- CSF exchange is presented as a viable therapeutic strategy to manage antibiotic-induced seizures and prevent neurological sequelae in neurocritical care settings.