Background: Ventriculoperitoneal (VP) shunt infection, which is 1 of the most important complications of VP shunt is observed at a rate of 4%-17%. Staphylococcus epidermidis is the most common causative agent. Vancomycin-resistant Enterococcus (VRE) is an increasingly common nosocomial pathogen that rarely causes central nervous system infections globally. Current treatment options that have shown appreciable activity against various VRE infections include daptomycin, linezolid, inquinupristin/dalfopristin, and tigecycline. Daptomycin has a particular mode of action and a potent bactericidal activity, making it a useful addition to the clinician's antibiotic collection. Global surveillance data indicate <1.0% rates of daptomycin resistance in enterococci.
Case Description: Here, we describe, to the best of our knowledge, the first case of successful intraventricular plus intravenous use of tigecycline to treat VP shunt infections caused by daptomycin resistant VRE faecium.
Conclusion: Tigecycline is a life-saving option in the treatment of resistant nosocomial infections but it has not yet been approved for use and there are not enough data in terms of dose and side effects associated with its use in children.
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http://dx.doi.org/10.1016/j.wneu.2019.07.045 | DOI Listing |
Front Cardiovasc Med
January 2025
Department of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
Background: Painful left bundle branch block (LBBB) syndrome is an uncommon disease that is defined as intermittent episodes of angina associated with simultaneous LBBB changes on an electrocardiogram (ECG) with the absence of flow-limiting coronary artery disease or ischemia on functional testing. Vasovagal syncope (VVS) is the most common cause of syncope and can be provoked by sublingual nitroglycerin (NTG). Herein, we report a case of painful LBBB syndrome complicated with VVS, which was misdiagnosed as acute coronary syndrome and cardiogenic shock.
View Article and Find Full Text PDFNeurosurgery
January 2025
Department of Neurosurgery, Hershey Medical Center, Hershey, Pennsylvania, USA.
Background And Objectives: Administration of intraventricular chemotherapy through Ommaya reservoir is indicated for certain forms of leptomeningeal disease. However, ventricular reservoirs carry a substantial risk of infection. The conventional approach to managing reservoir-associated infections involves removal of the reservoir and systemic antibiotic therapy, but this strategy necessitates additional procedures to remove and subsequently replace the device.
View Article and Find Full Text PDFHeliyon
December 2024
Department of Critical Care Medicine, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen, 518020, China.
is a major pathogen of nosocomial meningitis and ventriculitis. Due to very limited antibiotic treatment options, polymyxins are often used as a last-line therapy. To optimise polymyxin use in the intraventricular environment, cerebrospinal fluid (CSF) proteomics was employed to investigate host-pathogen-polymyxin interactions in a 69-year-old patient with multidrug-resistant ventriculitis treated with a combination of intrathecal (ITH; 50,000 IU q24h/q48h), intraventricular (IVT; 50,000 IU q48h), and intravenous (500,000 IU, q12h) polymyxin B.
View Article and Find Full Text PDFEarly Hum Dev
January 2025
Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Programa de Pós-Graduação em Ciências Médicas: Endocrinologia, Porto Alegre, Rio Grande do Sul, Brazil; Hospital de Clínicas de Porto Alegre, Serviço de Neonatologia, Porto Alegre, Rio Grande do Sul, Brazil; Hospital de Clínicas de Porto Alegre, Serviço de Nutrologia, Porto Alegre, Rio Grande do Sul, Brazil. Electronic address:
Background: Metabolic bone disease (MBD) of newborns (NB) is characterized by tissue reduction and inadequate postnatal bone mineralization with clinical, laboratory, and/or radiologic repercussions between the third and twelfth weeks of postnatal life, which, in its most severe forms, can lead to a growth deficit and fractures. The aim of our study is to evaluate the incidence of MBD in premature patients receiving parenteral nutrition for >15 days in the neonatal intensive care unit (NICU) and assess their clinical and laboratory characteristics.
Methods: Single-center retrospective cohort study.
Multiple drug resistance to infection treatment is a great challenge for neuro-intensivists due to poor drug penetration through the blood-brain barrier (BBB). Fortunately, the intraventricular administration of polymyxin-B and tigecycline seems to be effective; there are few case reports demonstrating the effectiveness of such treatments. Here, we report the case of a 24-year-old male who presented with fever and neck rigidity after intracranial drainage following lung infection caused by MDR .
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