1887

Abstract

Pyogenic ventriculitis is a well-known complication of meningitis, brain abscesses and intraventricular drains. Primary pyogenic ventriculitis is a rare entity and few cases have been described so far. We report the first case of primary pyogenic ventriculitis in an adult caused by and present an overview of all reported adult primary pyogenic ventriculitis cases in the English literature.

A PubMed search was performed using the terms ependymitis, ventricular empyema, pyocephalus and ventriculitis. Filter was set for adults and English. Articles in which pyogenic ventriculitis was a complication of well-known risk factors were excluded. A total of five cases of primary pyogenic ventriculitis were identified.

There were seven adult patients. Only one patient showed signs of meningeal irritation. Four patients had positive blood cultures with (one patient), methicillin-resistant (one patient), one patient was bacteraemic with , and spp., and (our patient). In four patients cerebrospinal fluid was sent for culture, which yielded methicillin-sensitive (one patient), spp. (one patient), (one patient, identified via 16S PCR) and (one patient). Cerebrospinal fluid cell count was determined in four patients and showed pleocytosis in all four cases. Ventricular drainage was performed in four patients. Five patients survived.

We report the first case of pyogenic ventriculitis caused by . Primary pyogenic ventriculitis is a rare entity with various clinical presentations caused by various bacterial species. Treatment consists of adequate antimicrobial therapy, and ventricular drainage may be necessary.

Loading

Article metrics loading...

/content/journal/jmmcr/10.1099/jmmcr.0.005078
2017-01-31
2020-09-30
Loading full text...

Full text loading...

/deliver/fulltext/jmmcr/4/1/jmmcr005078.html?itemId=/content/journal/jmmcr/10.1099/jmmcr.0.005078&mimeType=html&fmt=ahah

References

  1. Kiyan S, Aksay E, Ersel M, Yanturali S. A rare diagnosis in ED: cerebral pyogenic ventriculitis due to infective endocarditis. Am J Emerg Med 2007;25:120–122 [CrossRef][PubMed]
    [Google Scholar]
  2. Kobayashi H, Suzuki T, Tokuda Y. Pyogenic ventriculitis following urosepsis caused by Escherichia coli. BMJ Case Rep 2013;2013: [CrossRef][PubMed]
    [Google Scholar]
  3. Agrawal A, Cincu R, Timothy J. Current concepts and approach to ventriculitis. Infect Dis Clin Pract 2008;16:100–104 [CrossRef]
    [Google Scholar]
  4. Barloon TJ, Yuh WT, Knepper LE, Biller J, Ryals TJ et al. Cerebral ventriculitis: MR findings. J Comput Assist Tomogr 1990;14:272–275[PubMed][CrossRef]
    [Google Scholar]
  5. Fukui MB, Williams RL, Mudigonda S. CT and MR imaging features of pyogenic ventriculitis. AJNR Am J Neuroradiol 2001;22:1510–1516[PubMed]
    [Google Scholar]
  6. Han KT, Choi DS, Ryoo JW, Cho JM, Jeon KN et al. Diffusion-weighted MR imaging of pyogenic intraventricular empyema. Neuroradiology 2007;49:813–818 [CrossRef][PubMed]
    [Google Scholar]
  7. Public Health England Meningococcal, chapter 22. In: The Green Book v10.0 2016
    [Google Scholar]
  8. Nau R, Sörgel F, Eiffert H. Penetration of drugs through the blood-cerebrospinal fluid/blood-brain barrier for treatment of central nervous system infections. Clin Microbiol Rev 2010;23:858–883 [CrossRef][PubMed]
    [Google Scholar]
  9. Beer R, Pfausler B, Schmutzhard E. Management of nosocomial external ventricular drain-related ventriculomeningitis. Neurocrit Care 2009;10:363–367 [CrossRef][PubMed]
    [Google Scholar]
  10. Beer R, Lackner P, Pfausler B, Schmutzhard E. Nosocomial ventriculitis and meningitis in neurocritical care patients. J Neurol 2008;255:1617–1624 [CrossRef][PubMed]
    [Google Scholar]
  11. Ng K, Mabasa VH, Chow I, Ensom MH. Systematic review of efficacy, pharmacokinetics, and administration of intraventricular vancomycin in adults. Neurocrit Care 2014;20:158–171 [CrossRef][PubMed]
    [Google Scholar]
  12. Lebras M, Chow I, Mabasa VH, Ensom MH. Systematic review of efficacy, pharmacokinetics, and administration of intraventricular aminoglycosides in adults. Neurocrit Care 2016;25:492–507 [CrossRef][PubMed]
    [Google Scholar]
  13. Lee HK. Unilateral pyogenic ventriculitis. J Nucl Med 1977;18:403[PubMed]
    [Google Scholar]
  14. Vajramani GV, Akrawi H, Jones G, Sparrow OC. Primary ventriculitis caused by Streptococcus intermedius. Br J Neurosurg 2007;21:293–296 [CrossRef][PubMed]
    [Google Scholar]
  15. Ito H, Kobayashi S, Iino M, Kamei T, Takanashi Y. Listeria monocytogenes meningoencephalitis presenting with hydrocephalus and ventriculitis. Intern Med 2008;47:323–324[PubMed][CrossRef]
    [Google Scholar]
  16. Marinelli L, Trompetto C, Cocito L. Diffusion magnetic resonance imaging diagnostic relevance in pyogenic ventriculitis with an atypical presentation: a case report. BMC Res Notes 2014;7:149 [CrossRef][PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmmcr/10.1099/jmmcr.0.005078
Loading
/content/journal/jmmcr/10.1099/jmmcr.0.005078
Loading

Data & Media loading...

Most cited this month Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error