Escherichia coli Pyogenic Ventriculitis in an Infant Following Abdominal Surgery: A Rare Case Report

Abstract

Pyogenic ventriculitis is a severe and uncommon bacterial infection of the brain's ventricular system, most often associated with neurosurgical procedures or trauma, but it can rarely occur in other clinical settings. This case report describes an unusual presentation in an eight-month-old infant with no prior medical history, who developed this condition following abdominal surgery for acute intussusception. After an initially uneventful postoperative course, the patient presented with persistent high fever, seizures, and neurological deterioration. Diagnostic imaging revealed triventricular hydrocephalus on computed tomography (CT), and magnetic resonance imaging (MRI) confirmed the presence of pyogenic ventriculitis. Laboratory analysis of cerebrospinal fluid and blood cultures identified multidrug-resistant Escherichia coli as the pathogen. The infant was treated with mechanical ventilation, Anti-seizure medications, corticosteroids, broad-spectrum antibiotics, and external ventricular drainage. Clinical improvement was observed, and the patient was transferred for continued care. This case highlights the importance of considering central nervous system infections in infants with atypical postoperative courses and reinforces the value of MRI in early and accurate diagnosis, as well as the need for prompt, multidisciplinary management.