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Case Reports
. 2024 Sep 19:14:1444172.
doi: 10.3389/fonc.2024.1444172. eCollection 2024.

Ceftazidime/avibactam combined with colistimethate sodium successfully cures carbapenem-resistant Pseudomonas aeruginosa-induced brain abscess in a child post-craniotomy: a case report

Minglu Yuan  1 , Miao Zong  2 , Cong Ren  2 , Wenjing Zong #  3 , Zhongdong Li #  1
Affiliations
Case Reports

Ceftazidime/avibactam combined with colistimethate sodium successfully cures carbapenem-resistant Pseudomonas aeruginosa-induced brain abscess in a child post-craniotomy: a case report

Minglu Yuan et al. Front Oncol. .

Abstract

The treatment of brain abscess induced by carbapenem-resistant Pseudomonas aeruginosa (CRPA) is a clinical challenge around the world. Apart from novel β-lactam/β-lactamase inhibitors and polymyxins, there are few sufficiently powerful antibiotics that are effective against CRPA-induced infections. Considering the blood-brain barrier factor, there are even fewer drugs that can be used to treat intracranial CRPA-induced infections. In this article, we reported a case of CRPA-induced brain abscess that was successfully treated with intravenous ceftazidime/avibactam and intrathecal colistimethate sodium in a child after intracranial tumor resection.

Keywords: brain abscess; carbapenem-resistant pseudomonas aeruginosa; ceftazidime/avibactam; central nervous system infections; colistimethate sodium.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
CT scanning before the new therapeutic regimen showed a round cystic-solid lesion in the operative area, with the interior of the lesion being hypointense and the surrounding solid cystic wall being hyperintense. The brain tissue around the lesion was evidently edematous.
Figure 2
Figure 2
Results of MRI before the new therapeutic regimen. T2 scanning showed that the T2 signal from the interior of the lesion was long, while that from the surrounding cystic wall was short. Enhanced MRI scanning showed significant enhancement along the surgical path. The lesion localized in the surgical area formed a complete cystic wall and was significantly enhanced.
Figure 3
Figure 3
CT scanning results after treatment with the new regimen for 14 days showed that the abscess had disappeared and that there was little edema in the surrounding brain tissue.
Figure 4
Figure 4
Enhanced MRI scanning after treatment with the new regimen for 14 days showed that the abscess had disappeared, with little enhancement along the surgical path.
Figure 5
Figure 5
A summary of the clinical treatment process.
See this image and copyright information in PMC

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