• World Neurosurg · Mar 2017

    Case Reports

    Cryptococcal infection of the ventriculoperitoneal shunt in an HIV-infected patient with an excellent immunovirological status.

    • Miguel Genebat, María J Mayorga-Buiza, Esperanza Castillo-Ojeda, Mónica Rivero-Garvía, Francisco J Márquez-Rivas, and Manuel E Jiménez-Mejías.
    • Emergency Department, Virgen del Rocío University Hospital, Seville, Spain; Immunovirology Laboratory, Instituto de Biomedicina de Sevilla, Virgen del Rocío University Hospital/Centro Superior de Investigaciones Científicas/University of Seville, Seville, Spain.
    • World Neurosurg. 2017 Mar 1; 99: 810.e11-810.e13.

    BackgroundCryptococcus spp. is a rare cause of ventriculoperitoneal shunt (VPS) infection, with a variable clinical presentation. Diagnosis and treatment of this entity are challenging.Case DescriptionA cryptococcal VPS infection occurred in a human immunodeficiency virus-infected patient with an excellent immunovirologic status, with an abdominal mass as the only clinical sign at presentation. Microbiologic diagnosis was confirmed when Cryptococcus neoformans was isolated in 4 cerebrospinal fluid samples on different days. The patient was treated with dual antifungal therapy (liposomal amphotericin B plus flucytosine). The VPS was initially externalized and then removed. At 12-month follow-up, the patient remained asymptomatic, and no replacement VPS was required.ConclusionsThis is the first reported case of cryptococcal VPS infection in a patient with human immunodeficiency virus infection. Clinical outcome was excellent after dual antifungal therapy plus device withdrawal. Diagnosis and treatment of this entity remain a challenge for clinicians.Copyright © 2016 Elsevier Inc. All rights reserved.

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