Vu Christine A, Ladd Kelsey, Ayoade Folusakin O
Department of Pharmacy Jackson Memorial Hospital Miami Florida USA.
Division of Infectious Diseases, Department of Medicine University of Miami Miller School of Medicine Miami Florida USA.
Clin Case Rep. 2025 Sep 21;13(9):e70798. doi: 10.1002/ccr3.70798. eCollection 2025 Sep.
We report on a case of a patient in their early 60's with a history of traumatic brain injury, decompressive cranioplasty, and chronic ventriculoperitoneal (VP) shunt who presented from a nursing home with altered mental status and status epilepticus. He was found to have growing from his cerebrospinal fluid (CSF) cultures. Initial management included removal of the VP shunt, placement and two exchanges of external ventricular drains (EVD), and treatment with various antifungal regimens, including intraventricular liposomal amphotericin B. Despite these measures, the patient had a persistent ventriculitis that lasted over 4 weeks. Due to the refractory infection, we also performed therapeutic drug monitoring to determine the degree of antifungal penetration into the CSF. In this report, we aim to describe our approach in treating a challenging case of ventriculitis.
我们报告了一例60岁出头的患者，有创伤性脑损伤、去骨瓣减压术和慢性脑室腹腔（VP）分流术病史，从疗养院送来时出现精神状态改变和癫痫持续状态。脑脊液（CSF）培养发现有[此处原文未完整，可能缺失病原体信息]生长。初始治疗包括移除VP分流管、放置并两次更换外部脑室引流管（EVD），以及采用各种抗真菌方案治疗，包括脑室内注射脂质体两性霉素B。尽管采取了这些措施，患者仍持续脑室炎超过4周。由于感染难治，我们还进行了治疗药物监测，以确定抗真菌药物在脑脊液中的渗透程度。在本报告中，我们旨在描述我们治疗这例具有挑战性的脑室炎病例的方法。
