PMC5480626_01
CT scan on hospital admission (a) demonstrating herniation of cerebral tissue and (b) on follow-up visit after 6 months subsequent to the cranioplasty of the skull defect.
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To document the intracranial status on admission, he received a computed tomography (CT) scan (Figure 1(a)). On follow-up 6 months later, he was intermittently awake, was able to respond adequately questions and followed requests, for example, pressed right hand and moved his right leg (CT; Figure 1(b)).
Cerebral spinal fluid colistin levels measured with HPLC-tandem mass spectroscopy during 37 days of intensive care treatment.
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TDM (displayed in Figure 2) and renal function (Table 2). ICP via the EVD and subsequently using a lumbar Tuohy catheter (Figure 2). Intrathecal colistin was stopped after a course of altogether 26 days (total amount of 6.5 MIU CMS) and the patient was switched to intravenous colistin monotherapy.
Cerebral spinal fluid drainage and colistin application during 37 days of intensive care treatment.
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TDM in ce-rebrospinal fluid (CSF) samples repeatedly reported high concentrations of colistin, local application was reduced to 0.25 MIU via EVD once daily (days 15-16), and paused from day 17 to 20 (Figure 3). The TDM showed decreasing levels of colistin and therapy was continued with 0.25 MIU once daily (days 21-25) resulting in unexpected high levels of colistin.