Epidural abscess due to deep-neck infection.

scan revealed anterior and posterior cerebral artery infarctions of to determine its safety and the minimum dosage needed to eradicate VREF from the CSF. unknown origin. Electroencephalography was performed, which detected no brain activity, and the decision was made to withdraw Gretchen M. Tush, Scott Huneycutt, Amy Phillips, life support. A CSF culture performed on a specimen obtained and John D. Ward antemortem yielded no growth of organisms. Departments of Pharmacy and Neurosurgery, Virginia Commonwealth The five doses of intraventricular quinupristin/dalfopristin and University, Medical College of Virginia Hospitals, Richmond, Virginia 10-day course of iv quinupristin/dalfopristin administered to the patient did eradicate VREF from the CSF after unsuccessful treatReferences ment with iv chloramphenicol for ú2 months. The reason for 1. Finch RG. Antibacterial activity of quinupristin/dalfopristin: rationale for the failure of chloramphenicol and the success of quinupristin/ clinical use. Drugs 1996;51(suppl 1): 31–7. 2. Agapito T, Dever LL, Tomasz A. Activity of quinupristin/dalfopristin dalfopristin, both bacteriostatic agents, is unclear. Because there against Streptococcus pneumoniae in vitro and in vivo in the rabbit model are no known reports of quinupristin/dalfopristin–associated cereof experimental meningitis. J Antimicrob Agents Chemother 1997; bral vasospasm or thromboembolic events, we believed the pa39(suppl A):121–7. tient’s cerebral infarctions could be considered only remotely re3. Nachman SA, Verma R, Egnor M. Vancomycin-resistant Enterococcus faelated to quinupristin/dalfopristin. cium shunt infection in an infant: an antibiotic cure. Microb Drug Resist The eradication of VREF after therapy with quinupristin/dalfo1995;1:95–6. pristin administered intraventricularly and iv to this patient is 4. Barry AL, Fuchs PC, Brown SD. Provisional interpretive criteria for quinupromising; however, the fatal outcome is of concern. Intraventricupristin/dalfopristin susceptibility tests. J Antimicrob Agents Chemother 1997;39 (suppl A):87–92. lar administration of quinupristin/dalfopristin needs to be studied