Laborada Gary, Cruz Florencia, Nesin Mirjana
Weill Medical College of Cornell University, New York, NY, USA.
Chemotherapy. 2005 Oct;51(6):363-5. doi: 10.1159/000088963. Epub 2005 Oct 14.
A 1-month-old premature infant developed persistent shunt-related methicillin-resistant Staphylococcus aureus ventriculitis that was not responsive to parenteral therapy with vancomycin plus gentamicin (or rifampin).
The infant was treated by intraventricular administration of vancomycin (5 days: 10 mg/day). In addition to standard testing of the cerebrospinal fluid (CSF), tumor necrosis factor alpha, interleukin-8 and interleukin-6 were serially measured.
Sterilization of the CSF was followed by a decline in the number of WBC and proinflammatory cytokines in the CSF.
Intraventricular administration of antibiotics may be considered if ventriculitis is refractory to systemic antimicrobial therapy. Serial measurements of inflammatory cytokines in the CSF may provide an additional diagnostic tool to monitor the outcome of therapy.
一名1个月大的早产儿发生了与分流管相关的持续性耐甲氧西林金黄色葡萄球菌脑室炎，对静脉注射万古霉素加庆大霉素（或利福平）治疗无反应。
通过脑室内给予万古霉素（5天，10毫克/天）对该婴儿进行治疗。除了对脑脊液（CSF）进行标准检测外，还连续测量肿瘤坏死因子α、白细胞介素-8和白细胞介素-6。
脑脊液除菌后，脑脊液中的白细胞数量和促炎细胞因子减少。
如果脑室炎对全身抗菌治疗无效，可考虑脑室内给予抗生素。连续测量脑脊液中的炎性细胞因子可能为监测治疗结果提供一种额外的诊断工具。
