Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. X:X | DOI: 10.5507/bp.2024.029

Primary ventriculitis caused by Streptococcus intermedius - a rare case and challenge with uncertain clinical outcome. Case report

Stefan Trnka1, 2, Premysl Stejskal1, 2, Jakub Jablonsky1, 2, David Krahulik1, 2, Eva Cechakova2, 3, Lumir Hrabalek1, 2
1 Department of Neurosurgery, University Hospital Olomouc, Olomouc, Czech Republic
2 Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic
3 Department of Radiology, University Hospital Olomouc, Olomouc, Czech Republic

Aims: To present a case of primary ventriculitis in a 53-year-old patient caused by Streptococcus intermedius, emphasizing the rarity of the condition and the challenges in achieving clinical improvement despite targeted therapy.

Methods: The patient underwent clinical evaluation, including CT and MRI imaging, as well as CSF analysis. Empirical antibiotic therapy was initiated with cefotaxime and metronidazole, followed by targeted therapy based on CSF culture results. External ventricular drainage was performed surgically.

Results: No predisposing factors were identified in the patient. Initial imaging showed no acute changes, but follow-up imaging revealed significant ventricular inflammation. CSF analysis confirmed the presence of Streptococcus intermedius. Despite early and targeted antibiotic therapy, and surgical intervention, the patient's clinical condition did not improve.

Conclusion: This case highlights the rarity of primary ventriculitis caused by Streptococcus intermedius and the challenges in managing it. The lack of clinical improvement despite prompt and targeted treatment underscores the need for further research to develop more effective therapeutic strategies for such infections.

Keywords: ventriculitis, Streptococcus intermedius, ventricular debris, infection of central nervous system

Received: July 22, 2024; Revised: August 21, 2024; Accepted: September 12, 2024; Prepublished online: September 27, 2024 

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