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Successful treatment of vancomycin-resistant enterococcus meningitis with linezolid: Case report and review of the literature

Steinmetz, Michael P. MD; Vogelbaum, Michael A. MD, PhD; De Georgia, Michael A. MD; Andrefsky, John C. MD; Isada, Carlos MD

CASE REPORT
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Objective  To describe the successful treatment of a case of vancomycin-resistant enterococcus meningitis with linezolid.

Design  Case report and review of the literature.

Patients  The patient is a 35-yr-old man who suffered a cerebellar hemorrhage after embolization of a cerebellar arteriovenous malformation. The patient underwent ventriculostomy drainage and craniectomy. The patient was on broad-spectrum antibiotics for pneumonia including vancomycin. The patient remained febrile and grew vancomycin-resistant Enterococcus faecium from the cerebrospinal fluid.

Interventions  The patient was treated with intravenous chloramphenicol without success. On postoperative day 16, the patient was begun on intravenous linezolid.

Main Results  The patient received 4 wks of intravenous linezolid with complete eradication of the meningitis.

Conclusions  Intravenous linezolid appears to be a safe and effective therapy for vancomycin-resistant enterococcus meningitis.

From the Departments of Neurosurgery (MPS, MAV, JCA), Neurology (MAD), and Infectious Disease (CI), Cleveland Clinic Foundation, Cleveland, OH.

Intravenous linezolid appears to be a safe and effective therapy for vancomycin-resistant enterococcus meningitis.

© 2001 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins