title: VP-shunt dysfunction caused by malaria CNS infection.
abstract: BACKGROUND
  Malaria is a widespread mosquito-borne infectious disease with over 300 million cases and roughly 900 thousand deaths in 2013. Cerebral involvement of malaria causes 50 % of all infection-associated deaths, especially in children below the age of 5 years. Hydrocephalus is a medical condition with abnormal accumulation of cerebrospinal fluid in physiological cavities and ventricles. Standard treatment is the implantation of a cerebrospinal fluid shunt device. A common problem associated with shunt treatment especially in pediatric patients is infection and consecutive shunt dysfunction caused by bacteriae or high protein levels clogging the valve. In these cases, Staphylococcus aureus and Staphylococcus epidermidis are predominantly found in CSF cultures.
  
  
  METHODS
  We present a case of a 2-year old boy from Saudi Arabia with a ventriculoperitoneal (VP)-shunt-dependent congenital hydrocephalus who suffered from cerebral malaria and developed consecutive shunt failure.
  
  
  CONCLUSIONS
  To the best of our knowledge, shunt failure caused by malaria CNS infection with Plasmodium falciparum has not yet been reported in the literature and should be considered as a rare cause of VP-shunt failure in patients with atypical VP-shunt infections living in or traveling from endemic areas.
authors.affiliation: Department of Neurosurgery, University Clinic of Leipzig, Liebigstr. 18, 04103, Leipzig, Sachsen, Germany. michael.fehrenbach@medizin.uni-leipzig.de.
authors.forename: Michael Karl
authors.initials: MK
authors.lastname: Fehrenbach
authors.affiliation: Department of Pediatrics Hospital for Children and Adolescents, University Clinic of Leipzig, Leipzig, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Bernhard
authors.affiliation: Department of Pediatrics Hospital for Children and Adolescents, University Clinic of Leipzig, Leipzig, Germany.
authors.forename: Manuela
authors.initials: M
authors.lastname: Siekmeyer
authors.affiliation: Institute of Medical Microbiology, University Clinic of Leipzig, Leipzig, Germany.
authors.forename: Norman
authors.initials: N
authors.lastname: Lippmann
authors.affiliation: Department of Pediatrics Hospital for Children and Adolescents, University Clinic of Leipzig, Leipzig, Germany.
authors.forename: Wieland
authors.initials: W
authors.lastname: Kiess
authors.affiliation: Department of Neurosurgery, University Clinic of Leipzig, Liebigstr. 18, 04103, Leipzig, Sachsen, Germany.
authors.forename: Ulf
authors.initials: U
authors.lastname: Nestler
authors.affiliation: Department of Neurosurgery, University Clinic of Leipzig, Liebigstr. 18, 04103, Leipzig, Sachsen, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Meixensberger
authors.affiliation: Department of Neurosurgery, University Clinic of Leipzig, Liebigstr. 18, 04103, Leipzig, Sachsen, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Preuss
mesh_terms: D002494:Central Nervous System Infections / Q000150:complications / Q000209:etiology / Q000469:parasitology; D002552:Cerebral Ventricles / Q000601:surgery; D002675:Child, Preschool; D006801:Humans; D008288:Malaria / Q000150:complications* / Q000473:pathology; D008297:Male; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*
keywords: Hydrocephalus; Malaria CNS infection; VP-shunt dysfunction