title: Ventriculoperitoneal Shunt Infection with Mycobacterium abscessus: A Rare Cause of Ventriculitis.
abstract: BACKGROUND
  Mycobacterium abscessus is a rapidly growing atypical mycobacterium implicated in chronic lung disease, otitis media, surgical site infections, and disseminated cutaneous diseases. It is typically seen in patients with some degree of immunosuppression. Only 1 previous case has been reported in the setting of ventriculoperitoneal (VP) shunt infection. We report a case of M abscessus as the causative organism in a VP shunt infection in an immunocompetent adult.
  
  
  METHODS
  A 67-year-old woman required VP shunt placement after aneurysmal subarachnoid hemorrhage complicated by hydrocephalus. Her course was complicated by repeat hospitalization for 2 shunt infections, the second of which did not respond to standard antibiotic therapy. Cultures repeatedly grew M abscessus. The patient continued to decline and eventually died after transfer to the palliative care service.
  
  
  CONCLUSIONS
  Nontuberculous mycobacteria are rare, atypical organisms in the setting of VP shunt infection. Patients with ventriculitis secondary to atypical mycobacteria may exhibit drug-resistant cerebrospinal fluid pleocytosis in the face of standard antibiotic regimens.
authors.affiliation: Department of Emergency Medicine, Hofstra Northwell School of Medicine, Hempstead, New York, USA; Department of Neurosugery, Hofstra Northwell School of Medicine, Hempstead, New York, USA. Electronic address: zlevy@northwell.edu.
authors.forename: Zachary D
authors.initials: ZD
authors.lastname: Levy
authors.affiliation: Department of Neurosugery, Hofstra Northwell School of Medicine, Hempstead, New York, USA.
authors.forename: Victor
authors.initials: V
authors.lastname: Du
authors.affiliation: Department of Neurosugery, Hofstra Northwell School of Medicine, Hempstead, New York, USA.
authors.forename: Amrit
authors.initials: A
authors.lastname: Chiluwal
authors.affiliation: Department of Neurosugery, Hofstra Northwell School of Medicine, Hempstead, New York, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Chalif
authors.affiliation: Department of Neurosugery, Hofstra Northwell School of Medicine, Hempstead, New York, USA.
authors.forename: David E
authors.initials: DE
authors.lastname: Ledoux
mesh_terms: D000368:Aged; D055499:Catheter-Related Infections / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D058565:Cerebral Ventriculitis / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D009170:Nontuberculous Mycobacteria; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*
keywords: Hydrocephalus; Nontuberculous mycobacteria; Subarachnoid hemorrhage; Ventriculitis; Ventriculostomy