title: Cerebrospinal fluid shunt infection due to Gemella haemolysans.
abstract: Gemella haemolysans has long been considered a commensal in the human upper respiratory tract. Commensals are natural inhabitants on or within another organism, deriving benefit without harming or benefiting the host. Opportunistic infection of the CNS by the species is exceedingly rare. In the present case, a 16-year-old boy was admitted with a ventriculoperitoneal shunt infection, which was confirmed to be due to G. haemolysans. Following antibiotic treatment, removal of the old shunt, and delayed insertion of a new shunt, the patient made a full neurological recovery. To the authors' knowledge, this is the eighth case of CNS infection with G. haemolysans. Although prosthesis-related infections have been reported in other systems, this is the first case of CNS infection by the bacterium associated with an implant. Previous reported cases of CNS infection by G. haemolysans are reviewed. Due to the variable Gram staining property of the organism, the difficulty in diagnosing G. haemolysans infection is emphasized.
authors.affiliation: Departments of Neurosurgery, Birmingham Children’s Hospital, Birmingham, United Kingdom. williamlo@doctors.org.uk
authors.forename: William B
authors.initials: WB
authors.lastname: Lo
authors.forename: Mitul
authors.initials: M
authors.lastname: Patel
authors.forename: Guirish A
authors.initials: GA
authors.lastname: Solanki
authors.forename: Anthony Richard
authors.initials: AR
authors.lastname: Walsh
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015984:Causality; D002442:Ceftazidime / Q000627:therapeutic use; D002494:Central Nervous System Infections / Q000188:drug therapy* / Q000382:microbiology; D003616:Dandy-Walker Syndrome / Q000601:surgery; D058834:Gemella / Q000187:drug effects / Q000302:isolation & purification*; D005839:Gentamicins / Q000008:administration & dosage / Q000627:therapeutic use*; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D007262:Infusions, Intravenous; D007278:Injections, Spinal; D008297:Male; D008826:Microbial Sensitivity Tests; D010400:Penicillin G / Q000008:administration & dosage / Q000627:therapeutic use*; D016459:Prosthesis-Related Infections / Q000188:drug therapy* / Q000382:microbiology; D016896:Treatment Outcome; D014640:Vancomycin / Q000627:therapeutic use; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D014640:Vancomycin; D002442:Ceftazidime; D010400:Penicillin G