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Candida Shunt Infection Causing Arachnoiditis and Hydrocephalus: A Case Report
Jason J Kim1, Chenxuan Li1, Simon G Ammanuel2
1Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, USA.
Cureus
|May 5, 2022
Summary
Fungal arachnoiditis, a rare complication of ventriculoperitoneal shunts, can cause debilitating symptoms. Early diagnosis and treatment are crucial for recovery from this serious infection.
Area of Science:
- Neuroscience
- Infectious Diseases
- Neurosurgery
Background:
- Arachnoiditis, a rare condition causing chronic debilitating complications, is infrequently diagnosed, with sparse knowledge on its causes.
- Known causes include infections, trauma, spinal tumors, and iatrogenic factors from neurological interventions.
- Ventriculoperitoneal (VP) shunts are used to treat hydrocephalus, but can be a source of infection.
Observation:
- A 65-year-old female presented with symptoms suggestive of arachnoiditis, including leg weakness, spasms, and bladder dysfunction, following VP shunt placement for hydrocephalus.
- Initial workup was inconclusive, but recurrent symptoms of fever and abdominal pain led to further investigation.
- Abdominal CT revealed shunt catheter abnormalities, and ultrasound-guided fluid aspiration confirmed *Candida albicans* infection.
Findings:
- The patient was diagnosed with fungal arachnoiditis secondary to a contaminated VP shunt.
- Cerebrospinal fluid (CSF) analysis confirmed *Candida albicans* growth.
- Prompt treatment with shunt removal and intravenous antifungals led to patient recovery.
Implications:
- This case highlights the importance of considering arachnoiditis in patients with characteristic symptoms, even with initially normal investigations.
- Fungal infections, particularly *Candida albicans*, should be suspected in shunt-related complications, even with atypical or progressive presentations.
- Extensive evaluation for infection, especially fungal, is critical for patients undergoing neurological interventions involving device placement.
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