title: Ventriculoatrial shunt infection due to Cryptococcus neoformans: an ultrastructural and quantitative microbiological study.
abstract: A 28-year-old man presented with hydrocephalus due to an infection by Cryptococcus neoformans involving his ventriculoatrial shunt. Ultrastructural studies of the ventriculoatrial shunt demonstrated yeastlike organisms consistent with C. neoformans within a biofilm on the appliance. Quantitative microbiological studies of segments of the shunt demonstrated C. neoformans in a concentration gradient from 9 X 10(6) colony-forming units (CFU)/0.5-cm section involving the ventricular portion of the catheter to 1 X 10(2) CFU/0.5-cm section at the vascular tip. The clinical, microbiological, and ultrastructural data suggest that this cryptococcal infection started as a ventriculitis or encephalitis with extension to the meningeal surface. Future application of these methods may further elucidate the pathogenesis of ventriculoatrial shunt infections.
mesh_terms: D000328:Adult; D001431:Bacteriological Techniques; D002557:Cerebrospinal Fluid Shunts; D003453:Cryptococcosis / Q000382:microbiology*; D003455:Cryptococcus neoformans / Q000648:ultrastructure; D006325:Heart Atria; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D008297:Male; D008855:Microscopy, Electron, Scanning; D013530:Surgical Wound Infection / Q000382:microbiology*