Macfarlane D E, Baum-Thureen P, Crandon I
J Infect. 1985 Nov;11(3):233-8. doi: 10.1016/s0163-4453(85)93228-1.
A 6-week-old infant admitted to the University Hospital of the West Indies with hydrocephalus later developed ventriculitis. A heavy growth of Flavobacterium odoratum susceptible to gentamicin and cefotaxime was recovered from the ventricular fluid. Since intraventricular therapy was envisaged, a Pudenz reservoir was installed and ventricular fluid aspirated every 24 h to monitor treatment. Initial therapy consisted of intravenous cefotaxime, 50 mg/kg q.i.d. for 4 days. No significant reduction in the number of organisms in the ventricular fluid was achieved with this regimen. Intravenous therapy was therefore discontinued. On day 5 intraventricular therapy began with 5 mg cefotaxime 24 h for 6 days, followed by 1 mg/24 h for 4 days. Daily monitoring of intraventricular fluid indicated a high degree of antibacterial activity with rapid elimination of bacteria. Ventricular fluid remained sterile 10 days after therapy stopped. The Pudenz reservoir was removed, a ventriculoperitoneal shunt installed, and the patient discharged from hospital 4 days later without noticeable sequelae.
一名6周大的婴儿因脑积水入住西印度群岛大学医院，后来发展为脑室炎。从脑室液中培养出大量对庆大霉素和头孢噻肟敏感的芳香黄杆菌。由于设想进行脑室内治疗，安装了一个普登斯贮液器，每24小时抽取脑室液以监测治疗情况。初始治疗包括静脉注射头孢噻肟，50毫克/千克，每日4次，共4天。该治疗方案未能使脑室液中的细菌数量显著减少。因此停止了静脉治疗。在第5天开始进行脑室内治疗，每天24小时使用5毫克头孢噻肟，持续6天，随后每天24小时使用1毫克，持续4天。对脑室液的每日监测显示有高度的抗菌活性，细菌迅速被清除。治疗停止10天后，脑室液保持无菌状态。取出了普登斯贮液器，安装了脑室腹腔分流术，4天后患者出院，没有明显的后遗症。
