PMID: 26778598Jan 19, 2016Paper

Cryptococcal Infection of the Ventriculoperitoneal Shunt in an Immunocompetent Patient

The American Journal of Case Reports
Kap Sum FoongGustavo Vasquez

Abstract

Ventriculoperitoneal shunting is an effective treatment for hydrocephalus. Ventriculoperitoneal shunt (VPS) infection is a common complication. Cryptococcus neoformans as an implicated organism is rare. In this report, we describe a patient with cryptococcal VPS infection. A 52-year-old male with normal pressure hydrocephalus, status post implantation of VPS one year prior to the presentation; who was admitted with a fever, lethargy and confusion for three days. He was treated empirically with intravenous cefepime and vancomycin for VPS infection. The CSF analysis from both the lumbar puncture and the VPS was significant for a low white blood count, low glucose and high protein. Other work-up including India ink and cryptococcal antigen was unrevealing. He remained febrile despite antibiotic treatment for 5 days. The CSF from the shunt was sent for analysis again and it demonstrated similar results from the prior study, but the culture was now positive for Cryptococcus neoformans. The patient was started on oral flucytosine and intravenous liposomal amphotericin B. The VPS was removed and an externalized ventricular catheter was placed. The patient showed rapid resolution of the symptoms. To date, there was a total of nine repo...Continue Reading

Citations

Aug 20, 2018·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Adrian CaceresMarco Luis Herrera

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