Cerebrospinal fluid antibiotic levels during treatment of shunt infections

1980 ◽  
Vol 52 (1) ◽  
pp. 41-46 ◽  
Author(s):  
Steven L. Wald ◽  
Robert L. McLaurin
Keyword(s):  
Cerebrospinal Fluid ◽  
Inhibitory Concentration ◽  
External Ventricular Drainage ◽  
Cerebrospinal Fluid Shunt ◽  
Ventricular Drainage ◽  
Antibiotic Concentration ◽  
Content Type ◽  
Intraventricular Injections ◽  
Shunt Infections ◽  
Fine Print

✓ Twenty patients with documented cerebrospinal fluid shunt infections were treated with daily intraventricular injections of methicillin, cephalothin, or gentamicin without removal of the shunt or external ventricular drainage. Periodic determinations of intraventricular antibiotic concentration revealed significant levels in relation to the established minimum inhibitory concentration in all cases.

Cerebrospinal fluid shunt infections with anaerobic diphtheroids (Propionibacterium species)

1976 ◽  
Vol 44 (5) ◽  
pp. 580-584 ◽  
Author(s):  
E. Dale Everett ◽  
Theodore C. Eickhoff ◽  
Richard H. Simon
Keyword(s):  
Cerebrospinal Fluid ◽  
Spinal Fluid ◽  
Cerebrospinal Fluid Shunts ◽  
Cerebrospinal Fluid Shunt ◽  
Laboratory Findings ◽  
Content Type ◽  
Central Nervous System Dysfunction ◽  
Symptoms And Signs ◽  
Shunt Infections ◽  
Fine Print

✓ The clinical and laboratory findings in six cases of anaerobic diphtheroid infection of cerebrospinal fluid shunts are described. These organisms have been infrequently reported as a cause of shunt infections but our data indicate that such infections may be more common than currently appreciated. Propionibacterium species are common contaminants of cerebrospinal fluid specimens, but when isolated from the spinal fluid of a patient with a shunt who has symptoms and signs compatible with infection, the organism should not be dismissed as a contaminant. Fever was a constant finding frequently accompanied by signs of central nervous system dysfunction. Spinal fluid pleocytosis was usually limited to 1 to 200 cells and protein and sugar values were variable. The organisms grow slowly, therefore spinal fluid cultures should be held for at least 14 days before they are reported as negative.

Vancomycin treatment of cerebrospinal fluid shunt infections

1979 ◽  
Vol 51 (2) ◽  
pp. 245-246 ◽  
Author(s):  
Ernest B. Visconti ◽  
Georges Peter
Keyword(s):  
Cerebrospinal Fluid ◽  
Staphylococcus Epidermidis ◽  
Cerebrospinal Fluid Shunt ◽  
Content Type ◽  
Therapeutic Measures ◽  
Shunt Removal ◽  
Micro Organisms ◽  
Vancomycin Treatment ◽  
Shunt Infections ◽  
Fine Print

✓ The successful use of vancomycin is reported in two children with shunt infections due to Staphylococcus epidermidis which failed to respond to shunt removal. The previously reported experience with this drug is reviewed. The use of vancomycin should be considered in cases of shunt infections due to susceptible micro-organisms and refractory to other therapeutic measures.

Intraventricular Cerebrospinal Fluid Antibiotic Concentrations in Patients with Intraventricular Infections

Neurosurgery ◽  
1982 ◽  
Vol 10 (1) ◽  
pp. 50-54 ◽  
Author(s):  
H. E. James ◽  
H. D. Wilson ◽  
J. D. Connor ◽  
J. W. Walsh
Keyword(s):  
Cerebrospinal Fluid ◽  
Antibiotic Therapy ◽  
Lateral Ventricle ◽  
External Ventricular Drainage ◽  
Cerebrospinal Fluid Shunt ◽  
Ventricular Drainage ◽  
High Concentration ◽  
Antibiotic Concentration ◽  
Intravenous Antibiotic ◽  
Ventricular Puncture

Abstract The antibiotic concentration of the fluid from either lateral ventricle was determined 104 times in 37 patients through direct ventricular puncture, external ventricular drainage (EVD). or cerebrospinal fluid shunt sampling. The patients were 1 month to 12 years old. When the patients were receiving maximal intravenous antibiotic therapy alone, the concentrations for the most part were below 5 μg/ml. whereas patients receiving an antibiotic through direct ventricular puncture, EVD. or a shunt reservoir usually had concentrations over 5 μ/ml. However, wide variations from patient to patient were found with all forms of treatment despite similar dosages. Clustering of the concentration tended to occur in each individual patient. The authors conclude that, to obtain a high concentration of an antibiotic in the ventricular fluid, one should administer it directly into the ventricle.

scholarly journals High-Dosage Cefazolin Achieves Sufficient Cerebrospinal Diffusion To Treat an External Ventricular Drainage-Related Staphylococcus aureus Ventriculitis

2018 ◽  
Vol 63 (2) ◽  
pp. e01844-18 ◽  
Author(s):  
Matthieu Grégoire ◽  
Benjamin Gaborit ◽  
Colin Deschanvres ◽  
Raphaël Lecomte ◽  
Guillaume Deslandes ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Cerebrospinal Fluid ◽  
Continuous Infusion ◽  
External Ventricular Drainage ◽  
High Dose ◽  
Ventricular Drainage ◽  
Content Type

ABSTRACT A patient received continuous infusion of cefazolin 10 g then 8 g daily for an external ventricular drainage-related methicillin-susceptible Staphylococcus aureus (MSSA) ventriculitis. Median free concentrations in the cerebrospinal fluid were 11.9 and 6.1 mg/liter after 10- and 8-g doses, respectively. Free concentrations in the cerebrospinal fluid were always above the MIC usually displayed by methicillin-susceptible Staphylococcus aureus (MSSA) isolates. These results support the use of high-dose cefazolin to achieve sufficient meningeal concentrations.

Cerebral cyst infection with Micrococcus sedentarius

1980 ◽  
Vol 52 (1) ◽  
pp. 126-128 ◽  
Author(s):  
Gerald R. Greene ◽  
Catherine Mc Ninch ◽  
Eldon L. Foltz
Keyword(s):  
Cerebrospinal Fluid ◽  
Local Therapy ◽  
Shunt Infection ◽  
Congenital Hydrocephalus ◽  
Content Type ◽  
Cyst Infection ◽  
Focus Of Infection ◽  
Brain Cysts ◽  
Shunt Infections ◽  
Fine Print

✓ A 7-year-old boy with congenital hydrocephalus and a left septate cerebral cyst presented with a shunt infection due to Micrococcus sedentarius, resistant to all penicillins. The shunt infection was persistent despite several courses of parenteral, intraventricular, and intracyst antibiotics. Evaluation of the ventricular fluid revealed adequate “killing power” against the patient's microorganism. No extracranial focus of infection could be found. Computerized tomographic scanning, along with air ventriculography, identified a noncommunicating area of the cerebral cyst. Only when communication between this location and the rest of the cyst was established were the antibiotics efficacious. Undercirculated areas of cerebrospinal fluid should be sought when shunt infections and ventriculitis persist in spite of adequate parenteral and local therapy in patients with brain cysts.

Cerebrospinal fluid shunt colonization and obstruction by Paecilomyces variotii

1981 ◽  
Vol 54 (2) ◽  
pp. 257-260 ◽  
Author(s):  
Rodger Fagerburg ◽  
Byungse Shu ◽  
Helen R. Buckley ◽  
Bennett Lorber ◽  
John Karian
Keyword(s):  
Cerebrospinal Fluid ◽  
Ventriculoperitoneal Shunt ◽  
Cerebrospinal Fluid Shunt ◽  
Human Pathogen ◽  
Cardiac Valves ◽  
Paecilomyces Variotii ◽  
Content Type ◽  
Lens Implantation ◽  
Noncommunicating Hydrocephalus ◽  
Fine Print

✓ A 57-year-old woman underwent ventriculoperitoneal shunt placement for noncommunicating hydrocephalus. She required several shunt revisions over a 2-year period for recurrent hydrocephalus. The shunt was subsequently found to be obstructed by growth of the saprophytic fungus, Paecilomyces variotii, an infrequent human pathogen. Paecilomyces infections have caused complications associated with prosthetic cardiac valves and synthetic lens implantation; this is the first reported association with a cerebrospinal fluid shunt.

Telemetric ICP monitoring after surgery for posterior fossa and third ventricular tumors

1984 ◽  
Vol 60 (3) ◽  
pp. 649-651 ◽  
Author(s):  
Paul H. Chapman ◽  
Eric Cosman ◽  
Michael Arnold
Keyword(s):  
Posterior Fossa ◽  
External Ventricular Drainage ◽  
Ventricular Catheter ◽  
Ventricular Drainage ◽  
Icp Monitoring ◽  
Pressure Monitoring ◽  
Content Type ◽  
Clinical Observations ◽  
Ventricular Tumors ◽  
Fine Print

✓ After surgery for posterior fossa or third ventricular tumors, hydrocephalus may persist or evolve. Proper management of this complication requires timely detection. Temporary external ventricular drainage has been suggested by some authors as an adjunct to clinical observations and radiographic studies for unshunted patients. As an alternative, the authors have used a telemetric method of pressure monitoring in association with a ventricular catheter and subcutaneous reservoir. This has been found useful in eight patients without the disadvantages inherent in other methods of management.

Acute hydrocephalus in posterior fossa injury

1997 ◽  
Vol 86 (4) ◽  
pp. 629-632 ◽  
Author(s):  
Hideharu Karasawa ◽  
Hajime Furuya ◽  
Hiromichi Naito ◽  
Ken Sugiyama ◽  
Junji Ueno ◽  
...  
Keyword(s):  
Posterior Fossa ◽  
Fourth Ventricle ◽  
Ct Scanning ◽  
Mortality Rates ◽  
External Ventricular Drainage ◽  
Ventricular Drainage ◽  
Content Type ◽  
Acute Hydrocephalus ◽  
Significant Difference ◽  
Fine Print

✓ This is the first known report of the use of computerized tomography (CT) scanning to examine acute hydrocephalus in posterior fossa injury. Of the 1802 patients with acute head trauma treated at Funabashi Municipal Medical Center, 53 (2.9%) had suffered injury to the posterior fossa. Of these, 12 patients (22.6%) had associated acute hydrocephalus: nine patients with acute epidural hematoma (AEH) and three with intracerebellar hematoma and contusion (IH/C). There was a significant relationship between cases of AEH with hydrocephalus and supratentorial extension, hematoma thickness of 15 mm or more, and abnormal mesencephalic cisterns. In cases of IH/C, bilateral lesions and no visible fourth ventricle were significant causes of hydrocephalus. According to these results, possible mechanisms of acute hydrocephalus in posterior fossa injury may be as follows: in cases of AEH, hematoma that extends to the supratentorial area compresses the aqueduct posteriorly and causes hydrocephalus; in cases of IH/C, hematoma and contusional lesions may directly occlude the fourth ventricle and cause acute hydrocephalus. Seven patients suffering from AEH with acute hydrocephalus underwent evacuation of their hematoma without external ventricular drainage. In these cases, CT scanning showed that the hydrocephalus improved immediately after evacuation of the hematoma. Two patients suffering from IH/C with hydrocephalus underwent a procedure for evacuation of the hematoma and external ventricular drainage. The authors do not believe that ventricular drainage is necessary in treating posterior fossa AEH. However, both evacuation of the hematoma and ventricular drainage are necessary in cases of IH/C with hydrocephalus to provide the patient with every chance for survival. There was no significant difference in mortality rates when cases of AEH with acute hydrocephalus (0%) were compared with cases of AEH without hydrocephalus (7.7%). The observed mortality rates in cases of IH/C with hydrocephalus and those without hydrocephalus were 100% and 15.4%, respectively; this is statistically significant.

Thermosensitive determination of patency in lumboperitoneal shunts

1989 ◽  
Vol 70 (1) ◽  
pp. 143-145 ◽  
Author(s):  
Yusuke Ishiwata ◽  
Yasuhiro Chiba ◽  
Toshinori Yamashita ◽  
Gakuji Gondo ◽  
Kaoru Ide ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Normal Pressure ◽  
Cerebrospinal Fluid Shunt ◽  
Surface Cooling ◽  
Content Type ◽  
Ventriculoperitoneal Shunts ◽  
Upward Deflection ◽  
Shunt Tubing ◽  
Fine Print

✓ Surface cooling and thermistor recording over shunt tubing was used in 23 studies of cerebrospinal fluid shunt patency in 19 patients with lumboperitoneal shunts and normal-pressure hydrocephalus. Shunt patency was shown by downward reflection of the recording trace similar to that obtained for ventriculoperitoneal shunts. Obstruction was demonstrated by a flat-line recording or an upward deflection.

Dangers of collapsible ventricular drainage systems

1982 ◽  
Vol 56 (2) ◽  
pp. 305-306
Author(s):  
Andrew H. Kaye ◽  
David Wallace
Keyword(s):  
Cerebrospinal Fluid ◽  
Experimental Situation ◽  
Fluid Collection ◽  
Fluid Pressure ◽  
Back Pressure ◽  
Ventricular Drainage ◽  
Drainage Systems ◽  
Content Type ◽  
Plastic Bag ◽  
Fine Print

✓ Ventricular drainage systems employing a collapsible plastic bag for fluid collection were postulated to cause an increasing back-pressure produced in part by the elasticity of the bag. This postulate was shown to be correct in an experimental situation. There was a logarithmic rise in cerebrospinal fluid pressure as the bag filled. By increasing the size of the bag, the problem was overcome.

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