Cearns Michael D, McLintock Bruce T, Suttner Nigel, Khalsa Kamaljit
Department of Neurosurgery, Institute of Neurological Sciences, 1345 Govan Road, Glasgow G51 4TF, UK.
Department of Medical Microbiology, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF, UK.
Access Microbiol. 2022 Mar 29;4(3):000335. doi: 10.1099/acmi.0.000335. eCollection 2022.
Hydrocephalus is a common condition worldwide, and is frequently managed by diversion of cerebrospinal fluid (CSF), either externally with a drain or internally with a shunt. An external ventricular drain (EVD) can be an essential treatment modality, but is associated with a risk of infection, most commonly caused by species, which can result in meningitis or ventriculitis and a delay in the definitive management of the hydrocephalus. Here, we report the case of a patient who required an EVD to manage post-operative hydrocephalus following a craniotomy and microvascular decompression for trigeminal neuralgia. He subsequently developed EVD-associated infection with a vancomycin-resistant (VRE), which was treated successfully with a 2-week course of intravenous linezolid monotherapy. The authors believe this to be the only described case of successful treatment within this time frame of a CSF VRE infection associated with indwelling foreign material.
脑积水在全球范围内是一种常见病症，通常通过脑脊液（CSF）分流来治疗，分流方式要么是通过外部引流，要么是通过内部植入分流管。外部脑室引流（EVD）可能是一种重要的治疗方式，但存在感染风险，最常见的是由某种细菌引起，这可能导致脑膜炎或脑室炎，并延误脑积水的最终治疗。在此，我们报告一例患者，该患者在接受三叉神经痛开颅手术和微血管减压术后，需要通过EVD来治疗术后脑积水。他随后发生了与耐万古霉素肠球菌（VRE）相关的EVD感染，通过静脉注射利奈唑胺单药治疗2周疗程后成功治愈。作者认为这是在与留置异物相关的脑脊液VRE感染的这个时间范围内唯一报道的成功治疗案例。
