Vancomycin-resistant Enterococcus faecium (VREF) isolates have emerged as significant nosocomial pathogens. Central nervous system infections involving VREF have rarely been documented and pose significant therapeutic difficulties due to frequent multidrug resistance and the difficulty in reaching therapeutic drug
concentrations in the cerebrospinal fluid. We present a case of external ventricular drainage related infection with VREF who was treated suscessfully with ciprofloxacin and tetracycline (MIC for vancomycin and teicoplanin were > 256 µg/mL, and > 256 µg/mL, respectively)