minocycline and Cerebral-Ventriculitis

Chryseobacterium arthrosphaerae is a gram-negative bacteria, known for its intrinsic multidrug resistance, which can lead to treatment difficulties.. A 56-year-old male had an indwelling external ventricular drainage catheter for 6 months and had been frequently treated with antibiotics for nosocomial infections. He showed cerebrospinal fluid pleocytosis and an abrupt fever during hospitalization.. He was diagnosed as a ventriculitis caused by Chryseobacterium arthrosphaerae (C arthrosphaerae).. Initially, we used ciprofloxacin as the backbone in combination with minocycline (and rifampin). However, fever and pleocytosis persisted, and improvement was slow. We then switched the minocycline and rifampin regiment to trimethoprim/sulfamethoxazole. Following this switch of antibiotics, the patient's pleocytosis rapidly improved, allowing the replacement of his external ventricular drainage catheters. C arthrospharae was no longer growing in cerebrospinal fluid and he was recovered from ventriculitis.. The patient remains alive without any incidence of C arthrosphaerae recurrence.. We propose trimethoprim/sulfamethoxazole alone or in combination with ciprofloxacin to be good candidates for the treatment of ventriculitis by C arthrosphaerae.

Topics: Anti-Bacterial Agents; Catheters, Indwelling; Cerebral Ventriculitis; Chryseobacterium; Drainage; Drug Therapy, Combination; Humans; Leukocytosis; Male; Middle Aged; Minocycline; Rifampin; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Anti-Bacterial Agents; Cerebral Ventriculitis; Cerebrospinal Fluid Shunts; Coated Materials, Biocompatible; Drainage; Female; Humans; Hydrocephalus; Male; Minocycline; Rifampin; Staphylococcal Infections; Staphylococcus epidermidis; Ventriculostomy