Sequential intraventricular injection of tigecycline and polymyxin B in the treatment of intracranial Acinetobacter baumannii infection after trauma: a case report and review of the literature

Mil Med Res. 2020 May 10;7(1):23. doi: 10.1186/s40779-020-00253-9.

Abstract

Background: Intracranial infection after craniotomy is one of the most serious postoperative complications, especially multidrug-resistant (MDR) or extensively drug-resistant (XDR) bacterial meningitis, and strongly affects the prognosis of patients. Current treatment experience regarding these infections is scarce.

Case presentation: We report a case of severe intracranial infection of XDR Acinetobacter baumannii (A. baumannii) that was treated by intravenous (IV) injection, sequential intraventricular (IVT) injection of tigecycline and polymyxin B, and other anti-infective drugs. Good results were obtained, and the patient was eventually discharged from the hospital. This case is characterized by intracranial infection.

Conclusions: The polymyxin B IV + IVT pathway is an ideal treatment strategy for XDR A. baumannii. The tigecycline IVT pathway is also a safe treatment option.

Keywords: Acinetobacter baumannii; Intracranial infection; Intraventricular injection of tigecycline; Polymyxin B.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acinetobacter Infections / drug therapy*
  • Acinetobacter Infections / physiopathology
  • Acinetobacter baumannii / drug effects
  • Acinetobacter baumannii / pathogenicity
  • Adult
  • Humans
  • Injections, Intraventricular / methods
  • Injections, Intraventricular / standards
  • Injections, Intraventricular / statistics & numerical data
  • Male
  • Meningitis, Bacterial / drug therapy
  • Meningitis, Bacterial / physiopathology
  • Polymyxin B / pharmacology*
  • Polymyxin B / therapeutic use
  • Tigecycline / pharmacology*
  • Tigecycline / therapeutic use
  • Tomography, X-Ray Computed / methods

Substances

  • Tigecycline
  • Polymyxin B