Successful Use of Ertapenem for the Treatment of Enterobacter cloacae Complex Infection of the Central Nervous System (CNS)
A 55-year-old female with a past medical history of cocaine use and hypertension was admitted for intracranial hemorrhage requiring right decompressive craniotomy with duraplasty. Due to persistent fevers, a head CT scan obtained on day 28 of hospitalization identified a low-density subgaleal fluid...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Case Reports in Infectious Diseases |
| Online Access: | http://dx.doi.org/10.1155/2019/7021586 |
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| author | Sunish Shah Dayna McManus Jeffrey E. Topal |
| author_facet | Sunish Shah Dayna McManus Jeffrey E. Topal |
| author_sort | Sunish Shah |
| collection | DOAJ |
| description | A 55-year-old female with a past medical history of cocaine use and hypertension was admitted for intracranial hemorrhage requiring right decompressive craniotomy with duraplasty. Due to persistent fevers, a head CT scan obtained on day 28 of hospitalization identified a low-density subgaleal fluid collection overlying the duraplasty. Aspiration of this collection was sent for culture which grew 2+ Enterobacter cloacae complex susceptible to sulfamethoxazole-trimethoprim (SMX-TMP), gentamicin, ciprofloxacin, and ertapenem. Based on these results, the patient was transitioned from empiric vancomycin and ceftazidime to SMX-TMP and metronidazole. Despite treatment with SMX-TMP and metronidazole, aspirated subgaleal collection cultures remained positive for E. cloacae. Intrathecal gentamicin was therefore added; however, repeat subgaleal culture collections remained persistently positive. Given the persistently positive subgaleal culture collections, the patient was transitioned from SMX-TMP and metronidazole to ertapenem. After transition to ertapenem, subgaleal cultures were sterilized and the patient’s infection was resolved. This report suggests ertapenem may be a viable option for central nervous system infections; however, further study is needed. |
| format | Article |
| id | doaj-art-32bd43d850be4c7297610c3c349422e7 |
| institution | Kabale University |
| issn | 2090-6625 2090-6633 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Infectious Diseases |
| spelling | doaj-art-32bd43d850be4c7297610c3c349422e72025-02-03T01:30:06ZengWileyCase Reports in Infectious Diseases2090-66252090-66332019-01-01201910.1155/2019/70215867021586Successful Use of Ertapenem for the Treatment of Enterobacter cloacae Complex Infection of the Central Nervous System (CNS)Sunish Shah0Dayna McManus1Jeffrey E. Topal2Yale New Haven Hospital, Department of Pharmacy Services, New Haven, CT, USAYale New Haven Hospital, Department of Pharmacy Services, New Haven, CT, USAYale New Haven Hospital, Department of Pharmacy Services, New Haven, CT, USAA 55-year-old female with a past medical history of cocaine use and hypertension was admitted for intracranial hemorrhage requiring right decompressive craniotomy with duraplasty. Due to persistent fevers, a head CT scan obtained on day 28 of hospitalization identified a low-density subgaleal fluid collection overlying the duraplasty. Aspiration of this collection was sent for culture which grew 2+ Enterobacter cloacae complex susceptible to sulfamethoxazole-trimethoprim (SMX-TMP), gentamicin, ciprofloxacin, and ertapenem. Based on these results, the patient was transitioned from empiric vancomycin and ceftazidime to SMX-TMP and metronidazole. Despite treatment with SMX-TMP and metronidazole, aspirated subgaleal collection cultures remained positive for E. cloacae. Intrathecal gentamicin was therefore added; however, repeat subgaleal culture collections remained persistently positive. Given the persistently positive subgaleal culture collections, the patient was transitioned from SMX-TMP and metronidazole to ertapenem. After transition to ertapenem, subgaleal cultures were sterilized and the patient’s infection was resolved. This report suggests ertapenem may be a viable option for central nervous system infections; however, further study is needed.http://dx.doi.org/10.1155/2019/7021586 |
| spellingShingle | Sunish Shah Dayna McManus Jeffrey E. Topal Successful Use of Ertapenem for the Treatment of Enterobacter cloacae Complex Infection of the Central Nervous System (CNS) Case Reports in Infectious Diseases |
| title | Successful Use of Ertapenem for the Treatment of Enterobacter cloacae Complex Infection of the Central Nervous System (CNS) |
| title_full | Successful Use of Ertapenem for the Treatment of Enterobacter cloacae Complex Infection of the Central Nervous System (CNS) |
| title_fullStr | Successful Use of Ertapenem for the Treatment of Enterobacter cloacae Complex Infection of the Central Nervous System (CNS) |
| title_full_unstemmed | Successful Use of Ertapenem for the Treatment of Enterobacter cloacae Complex Infection of the Central Nervous System (CNS) |
| title_short | Successful Use of Ertapenem for the Treatment of Enterobacter cloacae Complex Infection of the Central Nervous System (CNS) |
| title_sort | successful use of ertapenem for the treatment of enterobacter cloacae complex infection of the central nervous system cns |
| url | http://dx.doi.org/10.1155/2019/7021586 |
| work_keys_str_mv | AT sunishshah successfuluseofertapenemforthetreatmentofenterobactercloacaecomplexinfectionofthecentralnervoussystemcns AT daynamcmanus successfuluseofertapenemforthetreatmentofenterobactercloacaecomplexinfectionofthecentralnervoussystemcns AT jeffreyetopal successfuluseofertapenemforthetreatmentofenterobactercloacaecomplexinfectionofthecentralnervoussystemcns |