%0 Case Reports
%T Ventriculoperitoneal shunt infection by Cryptococcus neoformans sensu stricto: Case report and literature review.
%A Kumar A
%A Udayakumaran S
%A Sachu A
%A Shashindran N
%A Baby P
%A Thaha A
%A Kurien A
%A Chowdhary A
%A Kumar A
%A Udayakumaran S
%A Sachu A
%A Shashindran N
%A Baby P
%A Thaha A
%A Kurien A
%A Chowdhary A
%A Kumar A
%A Udayakumaran S
%A Sachu A
%A Shashindran N
%A Baby P
%A Thaha A
%A Kurien A
%A Chowdhary A
%J Rev Iberoam Micol
%V 39
%N 1
%D Jan-Mar 2022
%M 35248468
%F 1.385
%R 10.1016/j.riam.2021.11.003
%X <B>BACKGROUND: </B>Cryptococcal ventriculoperitoneal shunt infection is known to occur due to an underlying infection in the patient rather than by nosocomial transmission of Cryptococcus during shunt placement. A case of chronic hydrocephalus due to cryptococcal meningitis that was misdiagnosed as tuberculous meningitis is described.<BR><B>METHODS: </B>Patient details were extracted from charts and laboratory records. The identification of the isolate was confirmed by PCR-restriction fragment length polymorphism of the orotodine monophosphate pyrophosphorylase (URA5) gene. Antifungal susceptibility was determined using the CLSI M27-A3 broth microdilution method. Besides, a Medline search was performed to review all cases of Cryptococcus ventriculoperitoneal shunt infection. Cryptococcus neoformans sensu stricto (formerly Cryptococcus neoformans var. grubii), mating-type MATα was isolated from the cerebrospinal fluid and external ventricular drain tip. The isolate showed low minimum inhibitory concentrations for voriconazole (0.06mg/l), fluconazole (8mg/l), isavuconazole (<0.015mg/l), posaconazole (<0.03mg/l), amphotericin B (<0.06mg/l) and 5-fluorocytosine (1mg/l). The patient was treated with intravenous amphotericin B deoxycholate, but died of cardiopulmonary arrest on the fifteenth postoperative day.<BR><B>CONCLUSIONS: </B>This report underlines the need to rule out a Cryptococcus infection in those cases of chronic meningitis with hydrocephalus.