Chryseobacterium arthrosphaerae ventriculitis: A case report

Chryseobacterium arthrosphaerae is a gram-negative bacteria, known for its intrinsic multidrug resistance, which can lead to treatment difficulties. A 56-year-old male had an indwelling external ventricular drainage catheter for 6 months and had been frequently treated with antibiotics for nosocomia...

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Bibliographic Details
Published in:Medicine (Baltimore) 2020-08, Vol.99 (34), p.e21751-e21751
Main Authors: Im, Jae Hyoung, Kim, Donghwi, Kim, Jin Ju, Kim, Eun Young, Park, Young Kyoung, Kwon, Hea Yoon, Chung, Moon-Hyun, Baek, Ji Hyeon, Lee, Jin-Soo
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - administration & dosage
Anti-Bacterial Agents - therapeutic use
Catheters, Indwelling
Cerebral Ventriculitis - complications
Cerebral Ventriculitis - diagnosis
Cerebral Ventriculitis - drug therapy
Chryseobacterium
Clinical Case Report
Drainage
Drug Therapy, Combination
Humans
Leukocytosis - etiology
Male
Middle Aged
Minocycline - therapeutic use
Rifampin - therapeutic use
Trimethoprim, Sulfamethoxazole Drug Combination - therapeutic use
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Summary:Chryseobacterium arthrosphaerae is a gram-negative bacteria, known for its intrinsic multidrug resistance, which can lead to treatment difficulties. A 56-year-old male had an indwelling external ventricular drainage catheter for 6 months and had been frequently treated with antibiotics for nosocomial infections. He showed cerebrospinal fluid pleocytosis and an abrupt fever during hospitalization. He was diagnosed as a ventriculitis caused by Chryseobacterium arthrosphaerae (C arthrosphaerae). Initially, we used ciprofloxacin as the backbone in combination with minocycline (and rifampin). However, fever and pleocytosis persisted, and improvement was slow. We then switched the minocycline and rifampin regiment to trimethoprim/sulfamethoxazole. Following this switch of antibiotics, the patient's pleocytosis rapidly improved, allowing the replacement of his external ventricular drainage catheters. C arthrospharae was no longer growing in cerebrospinal fluid and he was recovered from ventriculitis. The patient remains alive without any incidence of C arthrosphaerae recurrence. We propose trimethoprim/sulfamethoxazole alone or in combination with ciprofloxacin to be good candidates for the treatment of ventriculitis by C arthrosphaerae.
ISSN:0025-7974
1536-5964
DOI:10.1097/MD.0000000000021751