Good outcomes with the intraventricular vancomycin therapy in a patient with ruptured brain abscesses
Ninh Doan1, Ha Nguyen1, Li Luyuan2, Saman Shabani1, Michael Gelsomino1, Vijay Johnson3
1 Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, 53226, USA
2 Medical College of Wisconsin, Milwaukee, Wisconsin, 53226, USA
3 Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, 53226, USA
Department of Neurosurgery, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, Wisconsin, 53226
Source of Support: None, Conflict of Interest: None
Brain abscesses are associated with high morbidity and mortality rates. In particular, patients with intraventricular rupture of brain abscess (IVROBA) exhibit mortality rates up to 85%. Treatment options are lacking for IVROBA, once patients become refractory to intravenous antibiotics and surgical drainage. Limited data exist regarding the risks and benefits of intraventricular therapy in such a scenario. We report a patient with IVROBA, who deteriorated while on systemic antibiotics; once intraventricular vancomycin was employed, the patient demonstrated remarkable improvement without perceivable side effects. This case suggests that intraventricular vancomycin may be a safe, effective, and viable option for the treatment of IVROBA, especially for patients becoming refractory to systemic antibiotics.