Recent findings have focused on the possible role of
linezolid as a suitable candidate for the treatment of
central nervous system infections. The
linezolid treatment for
meningitis was sporadically reported in adults but there was no report in children. Here, we present a 6-month-old boy with
meningitis and
subdural empyema which was unresponsive to more conventional agents but successfully treated with
linezolid therapy. A previously healthy 6-month-old boy was referred to our clinic for deteriorating general condition with
fever,
vomiting and
seizures. He had
fever and tense-bulging anterior fontanelle. Based on his first cerebrospinal fluid (CSF) results, empirical
antibiotic therapy for
bacterial meningitis consisting of
vancomycin and
ceftriaxone was started. However, CSF culture yielded no micro-organisms but blood culture showed
coagulase-negative Staphylococci. On the 7th day, he still had high
fever and the erythrocyte sedimentation rate (ESR) and serum CRP levels had risen by 105 mm/h and 36.2 mg/dl, respectively. On 10th day, computerized cranial tomography showed bilateral frontoparietal
subdural empyema. Purulent material was evacuated by burr hole, and gram stains of the material showed polymorphonuclear leukocytes and no microorganisms. Clinical and CSF findings of our case were, unresponsiveness to
vancomycin,
ceftriaxone and consecutive
meropenem treatment while we still observed
subdural empyema during these treatments. For this reason we started
linezolid 10 mg/kg twice daily. Clinical signs improved dramatically, with both completely normal neurological findings and normalization of CSF and radiological findings. To the of our best knowledge,
linezolid treatment of
meningitis in children has not been reported previously. Clinical and CSF findings of our case were improved completely with
linezolid treatment. Also, control cranial computerized tomography showed the total recovery of
subdural empyema. Here we present the youngest case with
meningitis which was successfully treated with
linezolid treatment.