Propionibacterium acnes: A Difficult-to-Diagnose Ventriculoperitoneal Shunt Infection. Case Report

Abstract

Background Ventriculoperitoneal (VP) shunt infections are a fairly common complication in both the early and late postoperative periods. Sometimes diagnosis is difficult despite the fact that infection is often accompanied by clinical symptoms. Furthermore, pathogenic bacteria can be detected in the cerebrospinal fluid.

Method We describe a case of chronic VP shunt infection in a 24-year-old female patient who was operated on for posterior fossa pilocytic astrocytoma and needed a VP shunt. The infection revealed itself 5 years after shunt implantation with nonspecific symptoms, and it took approximately 2 years to make a correct diagnosis. Meanwhile, the patient's condition became critical. The infection was caused by Propionibacterium acnes, which is capable of forming biofilms on implants, and which is difficult to identify due to the peculiarity of its cultivation.

Result When the bacterium was identified, the shunt was replaced and antimicrobial therapy was performed, after which the patient's condition improved dramatically and she got back to her normal life.

Conclusions This case shows how difficult the diagnosis of VP shunt infection can be and what clinical significance it can have for the patient.

Keywords

Propionibacterium acnes - ventriculoperitoneal shunt infection

Submission Statement

This manuscript is original and has not been submitted elsewhere in part or in whole.

Consent

Written informed consent was obtained from the patient for publication of this case report.

Publikationsverlauf

Eingereicht: 15. Juni 2023

Angenommen: 14. August 2023

Accepted Manuscript online:
18. August 2023

Artikel online veröffentlicht:
17. Oktober 2023

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