Ventricular CSF shunt infections associated with Corynebacterium jeikeium: report of three cases and review.
Ventricular CSF shunt infections due to Corynebacterium jeikeium are rare. Such infections may become manifest weeks to months after surgery. They are difficult to eradicate and often recur. We report three cases of C. jeikeium ventricular CSF shunt infections, all of which occurred in patients who received long-term prophylactic therapy with antibiotics and had protracted hospitalizations. Two patients had multiple recurrences, and all patients required shunt revision. Additional therapy with intrathecal vancomycin for 6-10 days after surgery was effective for this unusual cause of ventricular CSF shunt infection. On the basis of our experience and a review of six previously published case reports, we recommend CSF sterilization with intravenous and intrathecal vancomycin, followed by replacement of shunt hardware.
Greene
K A
KA
Division of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona 85013.
Clark
R J
RJ
Zabramski
J M
JM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects*; D002648:Child; D003354:Corynebacterium Infections / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male