Pyogenic ventriculitis is defined as exudative inflammation of the ependymal lining of ventricles, resulting
in accumulation of pus in the ventricular system. Common organisms causing pyogenic ventriculitis are
gram negative species, followed by staphylococcus, streptococcus and enterobacter species. Clinical features
of patient with ventriculitis are variable. High grade fever, nuchal rigidity, photophobia, delirium, seizures
in a clinically moribund patient should raise suspicion of ventriculitis. CSF picture showing rapidly declining
glucose (< 25 gm/dl) with sharp raise in protein levels (>50 gm/dl) and neutrophilic pleocytosis (10-11 cells/
μL) is highly suggestive of pyogenic ventriculitis. Neuroimaging plays a pivotal role in management of
ventriculitis. Once the diagnosis is established, appropriate treatment must be started based on antibiotic
sensitivity of organism. Mortality following pyogenic ventriculitis is high (30-70%).
Key words: Keywords: Pyogenic ventriculitis, ependymitis, pyocephalus, streptococcus pneumoniae, pneumococcus,
immunocompetent.
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