論文

査読有り
2011年4月1日

Successful treatment of methicillin-resistant Staphylococcus aureus meningitis by intrathecal injection of vancomycin

Brain and Nerve
  • Kazuya Goto
  • ,
  • Takekazu Ohi
  • ,
  • Akiko Namba
  • ,
  • Norihito Uemura
  • ,
  • Hiroshi Kitaguchi

63
4
開始ページ
417
終了ページ
421
記述言語
日本語
掲載種別
研究論文(学術雑誌)

A 70-year-old Japanese man developed fever, headache, and lumbago, presumably due to an epidural abscess caused by methicillin-resistant Staphylococcus aureus (MRSA) in the L5-S2 region. On the night of admission to our hospital, he showed disorientation to places and abnormal eating behavior, indicating a complication of MRSA meningitis. Cerebrospinal fluid (CSF) examination confirmed this diagnosis. Although he was treated with venous infusion of vancomycin and meropenem, the CSF culture remained positive for MRSA even a week after the treatment, and Gram-positive cocci were also seen in the CSF. An intrathecal injection of vancomycin (10mg/day) was subsequently added, which resulted in absence of the organism on Gram-stained CSF smear and CSF culture a week later. His condition improved without any adverse effects. Vancomycin cannot freely penetrate the blood-brain barrier (BBB)
therefore, when administered intravenously, its concentration in the CSF is insufficient. Therefore, intrathecal injection of vancomycin is necessary to achieve the desired bacteriocidal level in the CSF. Thus, intrathecal administration of vancomycin seems a very effective and safe treatment for MRSA meningitis.

リンク情報
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/21441646
ID情報
  • ISSN : 1881-6096
  • PubMed ID : 21441646
  • SCOPUS ID : 79955402826

エクスポート
BibTeX RIS