Cryptococcal peritonitis complicating a ventriculoperitoneal shunt in unsuspected cryptococcal meningitis.

A 34 year old male was hospitalized because of the probability of a posterior fossa lesion that had increased intracranial pressure. A ventriculoperitoneal shunt was implanted, resulting in partial resolution of symptoms. Subsequently Cryptococcus neoformans was cultured from the cerebrospinal fluid and a diagnosis of cryptococcal meningitis was made. Despite amphotericin B therapy, the patient continued to deteriorate and died on the eighty-fifth day of hospitalization. Autopsy demonstrated cryptococcal meningitis and cerebral edema. An unexpected finding was cryptococcal peritonitis, which was not associated with disseminated disease. The case is unique because cryptococcal peritonitis is rare, and the spread of the organism occurred through a ventriculoperitoneal shunt.