Mycobacterium fortuitum Meningitis: Approach to Lumboperitoneal Shunt Infection.

Abstract:

:Mycobacterium fortuitum is a rare, opportunistic pathogen most frequently contracted through contact with a contaminated source. An immunocompetent 26-year-old female patient presented to our institution with an infected lumboperitoneal (LP) shunt presenting as continued nonhealing wounds. After multiple debridements, shunt revisions, and wound closure failures, infectious disease specialists were consulted. The wound cultures returned positive for M. fortuitum and the shunt was removed. Cerebrospinal fluid studies revealed significant pleocytosis with normal opening pressure, and the patient was diagnosed as having secondary meningitis. After shunt removal, the patient was treated with intravenous and oral antibiotics, resulting in infection resolution. Five months later, a new LP shunt was placed without infection recurrence. Although M. fortuitum was previously reported in neurosurgical patients with ventriculoperitoneal shunts, which are summarized here, to date this is the first case in the literature of M. fortuitum meningitis from an LP shunt. This case demonstrates the importance of clinicians considering uncommon and slow-growing pathogens, as well as consulting infectious disease specialists for patients with persistent, unexplained infections.

journal_name

South Med J

journal_title

Southern medical journal

authors

Zakrzewski J,Hu K,Neisewander BL,Esfahani DR,Bhimani AD,Shah HP,Haddadin DW,Mehta AI

doi

10.14423/SMJ.0000000000000955

subject

Has Abstract

pub_date

2019-04-01 00:00:00

pages

217-221

issue

4

eissn

0038-4348

issn

1541-8243

pii

SMJ50685

journal_volume

112

pub_type

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