Published date: Nov 21 2024

Journal Title: Dubai Medical Journal

Issue title: Dubai Medical Journal (DMJ): Volume 7 Issue 2

Pages: 105–114

DOI: 10.18502/dmj.v7i2.17676

Farhad Bal’afiffarblf@ub.ac.idNeurosurgery, Department of Surgery, Faculty of Medicine, Universitas Brawijaya / Dr. Saiful Anwar General Hospital, Malang, East Java

Tommy A NazwarNeurosurgery, Department of Surgery, Faculty of Medicine, Universitas Brawijaya / Dr. Saiful Anwar General Hospital, Malang, East Java

Donny W WardhanaNeurosurgery, Department of Surgery, Faculty of Medicine, Universitas Brawijaya / Dr. Saiful Anwar General Hospital, Malang, East Java

Oei Thomas SanjayaSpecialist Doctor Education Program, Department of Surgery Brawijaya University Malang Indonesia, Universitas Brawijaya / Dr. Saiful Anwar General Hospital, Malang, East Java

Keneysha Naomi MataniariMedicine Bachelor Study Program, Faculty of Medicine, Brawijaya University, Malang, East Java

Farahiyah Sharfina SaputriMedicine Bachelor Study Program, Faculty of Medicine, Brawijaya University, Malang, East Java

Liliana DewiMedicine Bachelor Study Program, Faculty of Medicine, Brawijaya University, Malang, East Java

Hisanifa ArifaniMedicine Bachelor Study Program, Faculty of Medicine, Brawijaya University, Malang, East Java

Ni Nyoman TrianaMedicine Bachelor Study Program, Faculty of Medicine, Brawijaya University, Malang, East Java

Mustofa ‎ Neurosurgery, Department of Surgery, Faculty of Medicine, Universitas Brawijaya / Dr. Saiful Anwar General Hospital, Malang, East Java

Introduction: Ventricular empyema, or pyogenic ventriculitis, is a severe condition characterized by pus accumulation in the cerebral ventricles due to intracranial infection, often caused by Gram-negative bacteria. Early diagnosis and treatment are crucial to prevent fatal neurological damage.

Case Report: A 3-month-old infant with severe hydrocephalus and ventricular empyema was admitted with symptoms of seizures, fever, and diarrhea. Initial examination showed decreased consciousness and significant leukocytosis. CT scans confirmed severe hydrocephalus and ventricular empyema. Despite resistance to standard antibiotics, neuroendoscopic lavage (NEL) and bilateral external ventricular drainage (EVD) were performed, leading to substantial improvement.

Discussion: The patient’s condition improved significantly post-surgery, with a decrease in leukocyte count and resolution of empyema as shown in follow-up imaging. This case demonstrates the efficacy of NEL in treating complex pediatric neurosurgical conditions.

Conclusion: NEL proves to be an effective treatment for intraventricular empyema in pediatric patients, improving clinical outcomes and reducing hospital stays. The success of this approach emphasizes the need for tailored neurosurgical interventions and regular follow-ups to ensure patient recovery and prevent recurrence.

Keywords: ventricular empyema, neuroendoscopic lavage (NEL), hydrocephalus, pediatric neurosurgery, gram-negative bacteria

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