Peritonitis caused by Roseomonas mucosa after ventriculoperitoneal shunt revision: a case report
- PDF / 225,838 Bytes
- 4 Pages / 595.276 x 790.866 pts Page_size
- 35 Downloads / 183 Views
CASE REPORT - INFECTION
Peritonitis caused by Roseomonas mucosa after ventriculoperitoneal shunt revision: a case report N. Beucler 1
&
M. Meyer 2 & A. Choucha 2 & P. Seng 3 & H. Dufour 2,4
Received: 29 March 2020 / Accepted: 4 June 2020 # Springer-Verlag GmbH Austria, part of Springer Nature 2020
Abstract Ventriculoperitoneal shunt (VPS) is an adequate treatment for congenital hydrocephalus or chronic hydrocephalus in adults. Yet, it is a surgery associated with a significant rate of complications amongst neurosurgical procedures, with frequent shunt obstructions and infections. We report the first-ever case of peritonitis caused by Roseomonas mucosa, shortly after the revision of a VPS ventricular catheter. Hardware removal and proper antibiotic therapy led to the patient’s recovery. Roseomonas mucosa is an opportunistic skin pathogen with an antibiotic resistance profile to many beta-lactamines and a tropism for indwelling catheters and post-operative period. Nowadays, it should be taken into account in case of infection of indwelling catheters and for some implantable medical devices. Keywords Ventriculoperitoneal shunt . Ventriculoperitoneal shunt infection . Roseomonas mucosa . Peritonitis
Introduction
Case study
Cerebrospinal fluid (CSF) shunt is an adequate treatment for congenital hydrocephalus or chronic hydrocephalus in adults. Nevertheless, ventriculoperitoneal shunt (VPS) is associated with a significant rate of complications amongst neurosurgical procedures despite the rigorous precautions taken for its implantation. We report the case of a 27-year-old patient who suffered from peritonitis caused by Roseomonas mucosa, shortly after the revision of the ventricular catheter of his VPS. The shunt infection was successfully managed with hardware removal and broad spectrum antibiotic therapy.
A 27-year-old man was treated for congenital hydrocephalus with a VPS. Three months ago, he presented VPS malfunction and he benefited from revision of the whole system, with an uneventful recovery. Thereafter, he presented episodes of faintness and vomiting with diplopia. The head CT did not show hydrocephalus or overdrainage, and the dilated fundus exam did not show papilledema. He benefited from hardware revision with a new shunt in the frontal horn of the right lateral ventricle, which was connected to the native Codman Certas® adjustable valve (Integra LifeSciences, Plainsboro, NJ, USA) with an opening pressure of 4 (146 mm of water). Two weeks later, he was admitted for headaches. On admission, his GCS was 15 and he did not present symptoms of intracranial hypertension. The frontal scar was not inflammatory. The head CT was stable, and the abdominal CT did not show pseudocyst at the shunt extremity or peritoneal effusion. White blood cell count (WBC) was 8.2 G/L, C-reactive protein (CRP) was 74.8 mg/L and procalcitonin (PCT) was 0.12 μg/L. CSF was obtained through the valve reservoir; protein level was slightly elevated (0.81 g/L), glucose level was normal (4.37 mmol/L) and the culture was negative. WBC
Data Loading...
