Pseudomonas aeruginosa

see Pseudomonas aeruginosa ventriculitis.

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Pseudomonas aeruginosa is a common encapsulated, Gram negative, rod-shaped bacterium that can cause disease in plants and animals, including humans. A species of considerable medical importance, P. aeruginosa is a multidrug resistant pathogen recognized for its ubiquity, its intrinsically advanced antibiotic resistance mechanisms, and its association with serious illnesses – hospital-acquired infections such as ventilator-associated pneumonia and various sepsis syndromes.

Sepsis and tetanus are severe forms of general wound infection. Causative agents include staphylococci, Pseudomonas aeruginosa, and colon bacillus. Associations of these microorganisms are frequently observed. The causative agents of anaerobic infection are less commonly observed. Microorganisms always penetrate a wound, although infection rarely develops if the body and injured tissues are adequately resistant and primary surgical treatment is prompt.

Prevention of a wound infection depends on adequate primary surgical treatment of a wound. Treatment is aimed at suppressing the development of infection through the administration of antibiotics and other antimicrobial preparations and at strengthening the defensive mechanisms of the afflicted individual; an adequate diet, transfusions of blood and protein preparations, and the administration of specific serums, toxoids, autovaccines, and gamma globulin serve the latter purpose.

If ventriculitis: consider intrathecal gentamicin or tobramycin

Pseudomonas aeruginosa is a rare cause of osteomyelitis of the cervical spine and is usually seen in the background of intravenous drug use and immunocompromised state. Very few cases of osteomyelitis of the cervical spine caused by pseudomonas aeruginosa have been reported in otherwise healthy patients. This is a case presentation of a young female, who in the absence of known risk factors for cervical osteomyelitis presented with progressively worsening neurological signs and symptoms ¹⁾.

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A hydrocephalic child, who was operated with a ventriculo-peritoneal shunt at the age of 1 month, developed ventriculitis due to Pseudomonas aeruginosa at 8 months. After removal of the shunt and successively increasing intramuscular and intraventricular doses of gentamicin the patient was cured and a new shunt could be inserted. As high 24-hour gentamicin level in the cerebrospinal fluid as 76 microgram/ml was reached without any apparent toxic signs ²⁾

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One patient of sepsis by P. aeruginosa after the implanting of a ventriculoatrial valve following extirpation of an expansive intracranial process is studied. During the evolution of the septic process there appeared as associated nephrotic syndrome with histologic lesions corresponding to an acute exudative glomerular nephritis. The germ became resistant to the antibiotics used, carbenicillin plus gentamicin, being later sensitive only to fosfomycin with which finally complete cure was achieved ³⁾.

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