Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 26, 2021; 9(3): 651-658
Published online Jan 26, 2021. doi: 10.12998/wjcc.v9.i3.651
Successful treatment of pyogenic ventriculitis caused by extensively drug-resistant Acinetobacter baumannii with multi-route tigecycline: A case report
Wei Li, Dan-Dong Li, Bo Yin, Dong-Dong Lin, Han-Song Sheng, Nu Zhang
Wei Li, Dan-Dong Li, Bo Yin, Dong-Dong Lin, Han-Song Sheng, Nu Zhang, Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
Author contributions: Li DD was in charge of case reviewing and preparation of the manuscript; Li W collected clinic opinions regarding this case and drafted the manuscript; Yin B and Sheng HS participated in the coordination; Zhang N and Lin DD revised the manuscript; all authors read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dan-Dong Li, PhD, Doctor, Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109 West Xueyuan Road, Wenzhou 325000, Zhejiang Province, China. andonglmn@163.com
Received: September 2, 2020
Peer-review started: September 2, 2020
First decision: November 8, 2020
Revised: November 19, 2020
Accepted: November 29, 2020
Article in press: January 26, 2021
Published online: January 26, 2021
Abstract
BACKGROUND

Pyogenic ventriculitis caused by extensively drug-resistant Acinetobacter baumannii (A. baumannii) is one of the most severe complications associated with craniotomy. However, limited therapeutic options exist for the treatment of A. baumannii ventriculitis due to the poor penetration rate of most antibiotics through the blood-brain barrier.

CASE SUMMARY

A 68-year-old male patient with severe traumatic brain injury developed pyogenic ventriculitis on postoperative day 24 caused by extensively drug-resistant A. baumannii susceptible to tigecycline only. Successful treatment was accomplished through multi-route administration of tigecycline, including intravenous combined with continuous ventricular irrigation plus intraventricular administration. The pus was cleared on the 3rd day post-irrigation, and cerebrospinal fluid cultures were negative after 12 d.

CONCLUSION

Our findings suggest that multi-route administration of tigecycline can be a therapeutic option against pyogenic ventriculitis caused by extensively drug-resistant A. baumannii.

Keywords: Pyogenic ventriculitis, Acinetobacter baumannii, Extensively drug-resistant, Tigecycline, Ventricular irrigation, Case report

Core Tip: Pyogenic Ventriculitis caused by extensively drug-resistant (XDR) Acinetobacter baumannii (A. baumannii) is one of the most severe complications associated with craniotomy. We present herein a rare case of pyogenic ventriculitis caused by XDR A. baumannii. Successful treatment was accomplished through multi-route administration of tigecycline, including intravenous combined with continuous ventricular irrigation plus intraventricular administration. This case suggests that multi-route administration of tigecycline can be a therapeutic option against pyogenic ventriculitis caused by XDR A. baumannii.