Levy Zachary D, Du Victor, Chiluwal Amrit, Chalif David J, Ledoux David E
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.
Department of Neurosugery, Hofstra Northwell School of Medicine, Hempstead, New York, USA.
World Neurosurg. 2016 Feb;86:510.e1-4. doi: 10.1016/j.wneu.2015.10.068. Epub 2015 Nov 10.
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.
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.
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.
脓肿分枝杆菌是一种快速生长的非结核分枝杆菌，与慢性肺部疾病、中耳炎、手术部位感染及播散性皮肤疾病有关。它通常见于有一定程度免疫抑制的患者。此前仅有1例关于脑室腹腔（VP）分流感染的报道。我们报告1例免疫功能正常的成年人VP分流感染，脓肿分枝杆菌为致病原。
一名67岁女性在动脉瘤性蛛网膜下腔出血并发脑积水后需要放置VP分流管。她的病程因两次分流感染而反复住院，第二次感染对标准抗生素治疗无反应。培养物多次培养出脓肿分枝杆菌。患者病情持续恶化，转至姑息治疗服务后最终死亡。
非结核分枝杆菌在VP分流感染中是罕见的非典型病原体。非典型分枝杆菌所致脑室炎患者在接受标准抗生素治疗时可能出现耐药性脑脊液细胞增多。
