Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Case Report
  • Published:

Successful treatment of meningoencephalitis caused by methicillin-resistant Staphylococcus aureus with intrathecal vancomycin in an allogeneic peripheral blood stem cell transplant recipient

Summary:

Methicillin-resistant Staphylococcus aureus (MRSA) is a common infectious pathogen during stem cell trans-plantation. We report a case of meningoencephalitis with multiple abscess formation caused by MRSA, which occurred in a 4-year-old boy soon after allogeneic peri-pheral blood stem cell transplantation. We successfully cured the infection with a combination of intravenous and intrathecal vancomycin.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Bayston R, Hart CA, Barnicoat M . Intraventricular vancomycin in the treatment of ventriculitis associated with cerebrospinal fluid shunting and drainage. J Neurol Neurosurg Psychiatr 1987; 50: 1419–1423.

    Article  CAS  Google Scholar 

  2. Reesor C, Chow AW, Kureishi A et al. Kinetics of intraventricular vancomycin in infections of cerebrospinal fluid shunts. J Infect Dis 1988; 158: 1142–1143.

    Article  CAS  Google Scholar 

  3. Redfield DC, Underman A, Normal D et al. Cerebrospinal fluid penetration of vancomycin in bacterial meningitis. In: Nelson JD, Grassi C (eds). Current Chemotherapy and Infectious Disease. Proceedings of the International Congress of Chemotherapy and the 19th Interscience Conference on Antimicrobial Agents and Chemotherapy, Vol 1. Am Soc Microbiol: Washington, DC, 1980, pp 638–640.

    Google Scholar 

  4. Luer MS, Hatton J . Vancomycin administration into the cerebrospinal fluid: a review. Ann Pharmacother 1993; 27: 912–921.

    Article  CAS  Google Scholar 

  5. Golledge CL, McKenzie T . Monitoring vancomycin concentrations in CSF after intraventricular administration. J Antimicrob Chemother 1988; 21: 262–263.

    Article  CAS  Google Scholar 

  6. Sutherland GE, Palitang EG, Marr JJ et al. Sterilization of Ommaya reservoir by instillation of vancomycin. Am J Med 1981; 71: 1068–1070.

    Article  CAS  Google Scholar 

  7. Congeni BL, Tan J, Salstrom SJ, et al. Kinetics of vancomycin (V) after intraventricular and intravenous administration (abstract). Pediatr Res 1979; 13: 459.

    Google Scholar 

  8. Pfausler B, Haring HP, Kampfl A et al. Cerebrospinal fluid (CSF) pharmacokinetics of intraventricular vancomycin in patients with Staphylococcal ventriculitis associated with external CSF drainage. Clin Infect Dis 1997; 25: 733–735.

    Article  CAS  Google Scholar 

  9. Biavasco F, Vignaroli C, Varaldo PE . Glycopeptide resistance in coagulase-negative staphylococci. Eur J Clin Microbiol Infect Dis 2000; 19: 403–417.

    Article  CAS  Google Scholar 

  10. Guerra-Romero L, Tauber MG, Fournier MA et al. Lactate and glucose concentrations in brain interstitial fluid, cerebrospinal fluid, and serum during experimental pneumococcal meningitis. J Infect Dis 1992; 166: 546–550.

    Article  CAS  Google Scholar 

  11. Betriu C, Redondo M, Boloix A et al. Comparative activity of linezolid and other new agents against methicillin-resistant Staphylococcus aureus and teicoplanin-intermediate coagulase-negative Staphylococci. J Antimicrob Chemother 2001; 48: 911–913.

    Article  CAS  Google Scholar 

  12. Chein JW, Kucia ML, Salata RA . Use of linezolid, an oxazolidinone, in the treatment of multidrug-resistant gram-positive bacterial infections. Clin Infect Dis 2000; 30: 146–151.

    Article  Google Scholar 

  13. Zeane C, Kubin CJ, Della-Latta P et al. Vancomycin-resistant Enterococcus faecium meningitis successfully managed with linezolid: case report and review of the literature. Clin Infect Dis 2001; 33: 477–482.

    Article  Google Scholar 

  14. Steinmetz MP, Vogelbaum MA, De Georgia MA et al. Successful treatment of vancomycin-resistant enterococcus meniongitis with linezolid: case report and review of the literature. Crit Care Med 2001; 29: 2383–2385.

    Article  CAS  Google Scholar 

  15. Hachem R, Afif C, Gokaslan Z et al. Successful treatment of vancomycin-resistant enterococcus meningitis with linezolid. Eur J Clin Microbiol Infect Dis 2001; 20: 432–434.

    Article  CAS  Google Scholar 

  16. Shaikh ZH, Peloquin CA, Ericsson CD . Successful treatment of vancomycin-resistant Enterococcus faecium meningitis with linezolid: case report and literature review. Scand J Infect Dis 2001; 33: 375–379.

    Article  CAS  Google Scholar 

  17. Villani P, Regazzi MB, Marubbi F et al. Cerebrospinal fluid linezolid concentrations in postneurosurgical central nervous system infections. Antimicrob Agents Chemother 2002; 46: 936–937.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The authors thank Michihiro Shino and Yoshiko Kawamoto, Department of Pharmacy, for analyzing the pharmacokinetics of VCM. This research was supported by a Grant-in-Aid for Scientific Research from the Ministry of Health, Labor and Welfare.

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Matsubara, H., Makimoto, A., Higa, T. et al. Successful treatment of meningoencephalitis caused by methicillin-resistant Staphylococcus aureus with intrathecal vancomycin in an allogeneic peripheral blood stem cell transplant recipient. Bone Marrow Transplant 31, 65–67 (2003). https://doi.org/10.1038/sj.bmt.1703799

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1703799

Keywords

This article is cited by

Search

Quick links