A case of Listeria monocytogenes meningitis complicated by Hydrocephalus and Intraventricular hemorrhage: A review of treatment options and outcomes

Gerstein, Shawn; Gautam-Goyal, Pranisha; Goyal, Sameer

The use of intrathecal/intraventricular antimicrobials in this setting has not been well studied. A review of the existing literature reveals no standard protocol for the administration of intraventricular antimicrobials in the setting of CNS infections [10] . The risk reward profile focuses on the advantages of higher doses of antimicrobials in the CSF than can cross the blood brain barrier alone versus the increased risk of toxicity. A clinical cohort study by Shoft and colleagues found a mortality benefit with no significant adverse events when utilizing intraventricular antimicrobials alongside systemic antimicrobials in a population of postneurosurgical patients [11] . A case report by Richards and colleagues demonstrated the efficacy of using intraventricular antimicrobials in a patient with recurrent Listeria monocytogenes meningitis following treatment failure with systemic therapy alone [12] .