Pyogenic Ventriculitis Associated with Urosepsis: A Rare Case Report

Pyogenic ventriculitis is an infection of the cerebral ventricles usually associated with neurosurgery or head trauma. There are less than 10 reported cases of community-acquired pyogenic ventriculitis in adults. We present the case of a 71-year-old man with a medical history of type 2 diabetes mellitus, hospitalized due to urosepsis caused by E. coli. Because he had a fluctuant level of consciousness, he underwent magnetic resonance imaging that diagnosed pyogenic ventriculitis. He was treated with ceftriaxone 2 g 12/12h for a total of 6 weeks and recovered without neurological deficits. Pyogenic ventriculitis is a clinical challenge due to its rarity, atypical presentation and variety of aetiological microorganisms. LEARNING POINTS Pyogenic ventriculitis is an infection of the cerebral ventricles usually associated with neurosurgery or head trauma; community-acquired primary pyogenic ventriculitis is very rare.Presentation is atypical (no meningism), multiple microorganisms can be involved, and it should be treated with prolonged antibiotic regimens.MRI is the most useful exam for diagnosis.