Successful treatment of vancomycin-resistant enterococcal ventriculitis in a pediatric patient with linezolid

Although vancomycin-resistant Enterococcus infection of the central nervous system is not common, this organism is becoming an increasing problem in nosocomial infections. We report a 17-month-old male infant with an externalized ventricular peritoneal shunt secondary to infection who subsequently developed a vancomycin-resistant Enterococcus faecium ventriculitis. This infection was successfully treated with a 28-day course of linezolid while monitoring linezolid drug levels in both the cerebral spinal fluid and serum. This case supports the use of linezolid in treating such resistant infections. However, our drug level results suggest that further investigation is needed to determine the optimal dosing of linezolid in treatment of central nervous system infection in pediatric patients.