Therapeutic Drug Monitoring-Guided Linezolid Therapy for the Treatment of Multiple Staphylococcal Brain Abscesses in a 3-Month-Old Infant
Brain abscesses are invasive infections of the central nervous system with a high level of treatment complexity especially in pediatric patients. Here, we describe a 3-month-old infant with multiple brain abscesses caused by methicillin-susceptible <i>Staphylococcus aureus</i> (MSSA). Th...
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MDPI AG
2024-12-01
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| Series: | Pathogens |
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| Online Access: | https://www.mdpi.com/2076-0817/14/1/4 |
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| author | Anna Cascone Maia De Luca Raffaele Simeoli Bianca Maria Goffredo Laura Cursi Costanza Tripiciano Lorenza Romani Stefania Mercadante Martina Di Giuseppe Francesca Ippolita Calo Carducci Davide Luglietto Paola Bernaschi Laura Lancella |
| author_facet | Anna Cascone Maia De Luca Raffaele Simeoli Bianca Maria Goffredo Laura Cursi Costanza Tripiciano Lorenza Romani Stefania Mercadante Martina Di Giuseppe Francesca Ippolita Calo Carducci Davide Luglietto Paola Bernaschi Laura Lancella |
| author_sort | Anna Cascone |
| collection | DOAJ |
| description | Brain abscesses are invasive infections of the central nervous system with a high level of treatment complexity especially in pediatric patients. Here, we describe a 3-month-old infant with multiple brain abscesses caused by methicillin-susceptible <i>Staphylococcus aureus</i> (MSSA). The patient was initially treated with empirical antibiotics (ceftriaxone, metronidazole, vancomycin). Upon MSSA identification, therapy was optimized by switching vancomycin to linezolid to improve tissue penetration. Therapeutic drug monitoring (TDM) was performed to check linezolid levels in the plasma and pus of the abscess, confirming drug penetration into brain tissue. A two-stage surgical drainage approach, consisting of repeated pus aspiration through an intracystic catheter, was then performed to achieve a significant reduction in abscess size. After nine weeks of antibiotic therapy, the patient was discharged in good clinical condition. This case highlights the role of linezolid for the treatment of complicated CNS infections and the importance of a multidisciplinary approach, combining TDM-based antibiotic therapy with timely and eventually repeated surgery, in order to effectively treat brain abscesses. |
| format | Article |
| id | doaj-art-120fab5d0e7a43e487fb5d2ff8e294d9 |
| institution | Kabale University |
| issn | 2076-0817 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pathogens |
| spelling | doaj-art-120fab5d0e7a43e487fb5d2ff8e294d92025-01-24T13:44:33ZengMDPI AGPathogens2076-08172024-12-01141410.3390/pathogens14010004Therapeutic Drug Monitoring-Guided Linezolid Therapy for the Treatment of Multiple Staphylococcal Brain Abscesses in a 3-Month-Old InfantAnna Cascone0Maia De Luca1Raffaele Simeoli2Bianca Maria Goffredo3Laura Cursi4Costanza Tripiciano5Lorenza Romani6Stefania Mercadante7Martina Di Giuseppe8Francesca Ippolita Calo Carducci9Davide Luglietto10Paola Bernaschi11Laura Lancella12Residency School of Pediatrics, Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, ItalyInfectious Disease Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, ItalyDivision of Metabolic Diseases and Drug Biology, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, ItalyDivision of Metabolic Diseases and Drug Biology, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, ItalyInfectious Disease Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, ItalyInfectious Disease Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, ItalyInfectious Disease Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, ItalyInfectious Disease Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, ItalyInfectious Disease Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, ItalyInfectious Disease Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, ItalyNeurosurgery Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, ItalyMicrobiology and Diagnostic Immunology Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, ItalyInfectious Disease Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, ItalyBrain abscesses are invasive infections of the central nervous system with a high level of treatment complexity especially in pediatric patients. Here, we describe a 3-month-old infant with multiple brain abscesses caused by methicillin-susceptible <i>Staphylococcus aureus</i> (MSSA). The patient was initially treated with empirical antibiotics (ceftriaxone, metronidazole, vancomycin). Upon MSSA identification, therapy was optimized by switching vancomycin to linezolid to improve tissue penetration. Therapeutic drug monitoring (TDM) was performed to check linezolid levels in the plasma and pus of the abscess, confirming drug penetration into brain tissue. A two-stage surgical drainage approach, consisting of repeated pus aspiration through an intracystic catheter, was then performed to achieve a significant reduction in abscess size. After nine weeks of antibiotic therapy, the patient was discharged in good clinical condition. This case highlights the role of linezolid for the treatment of complicated CNS infections and the importance of a multidisciplinary approach, combining TDM-based antibiotic therapy with timely and eventually repeated surgery, in order to effectively treat brain abscesses.https://www.mdpi.com/2076-0817/14/1/4brain abscessmethicillin-sensitive <i>Staphylococcus aureus</i> (MSSA)therapeutic drug monitoring (TDM)linezolidmultidisciplinary approach |
| spellingShingle | Anna Cascone Maia De Luca Raffaele Simeoli Bianca Maria Goffredo Laura Cursi Costanza Tripiciano Lorenza Romani Stefania Mercadante Martina Di Giuseppe Francesca Ippolita Calo Carducci Davide Luglietto Paola Bernaschi Laura Lancella Therapeutic Drug Monitoring-Guided Linezolid Therapy for the Treatment of Multiple Staphylococcal Brain Abscesses in a 3-Month-Old Infant Pathogens brain abscess methicillin-sensitive <i>Staphylococcus aureus</i> (MSSA) therapeutic drug monitoring (TDM) linezolid multidisciplinary approach |
| title | Therapeutic Drug Monitoring-Guided Linezolid Therapy for the Treatment of Multiple Staphylococcal Brain Abscesses in a 3-Month-Old Infant |
| title_full | Therapeutic Drug Monitoring-Guided Linezolid Therapy for the Treatment of Multiple Staphylococcal Brain Abscesses in a 3-Month-Old Infant |
| title_fullStr | Therapeutic Drug Monitoring-Guided Linezolid Therapy for the Treatment of Multiple Staphylococcal Brain Abscesses in a 3-Month-Old Infant |
| title_full_unstemmed | Therapeutic Drug Monitoring-Guided Linezolid Therapy for the Treatment of Multiple Staphylococcal Brain Abscesses in a 3-Month-Old Infant |
| title_short | Therapeutic Drug Monitoring-Guided Linezolid Therapy for the Treatment of Multiple Staphylococcal Brain Abscesses in a 3-Month-Old Infant |
| title_sort | therapeutic drug monitoring guided linezolid therapy for the treatment of multiple staphylococcal brain abscesses in a 3 month old infant |
| topic | brain abscess methicillin-sensitive <i>Staphylococcus aureus</i> (MSSA) therapeutic drug monitoring (TDM) linezolid multidisciplinary approach |
| url | https://www.mdpi.com/2076-0817/14/1/4 |
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