[Vancomycin-resistant Enterococcal meningitis in patients with ventriculoperitoneal shunt: two cases report and review of the literature].

Enterococcal meningitis often occurs in patients with head trauma, cerebrospinal fluid leakage, or shunt devices. Herein, we describe two patients, a 12-year-old boy and a 57-year-old man, who developed meningitis due to vancomycin-resistant Enterococcus (VRE) gallinarum. Both of them had a ventriculoperitoneal shunt for hydrocephalus. The meningitis in one patient was due to fecal transmission of VRE derived from the gut and in the other from prolonged use of vancomycin. In addition, both patients were immunocompromised due to radiotherapy and steroid therapy. The mechanism of developing resistancy and the management of VRE meningitis is discussed.