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Cryptococcal peritonitis complicating a ventriculoperitoneal shunt in unsuspected cryptococcal meningitis
Human Pathology
|July 1, 1981
Summary
A rare case of cryptococcal meningitis complicated by cryptococcal peritonitis occurred in a patient with a ventriculoperitoneal shunt. The shunt likely facilitated the unusual spread of the fungus.
Area of Science:
- Neurology
- Infectious Diseases
- Medical Mycology
Background:
- Posterior fossa lesions can cause increased intracranial pressure, necessitating interventions like cerebrospinal fluid (CSF) diversion.
- Ventriculoperitoneal shunts are used to manage hydrocephalus but can be a conduit for infection.
Observation:
- A 34-year-old male presented with symptoms of increased intracranial pressure, likely due to a posterior fossa lesion.
- A ventriculoperitoneal shunt was placed, providing temporary symptom relief.
Findings:
- Cerebrospinal fluid cultures revealed *Cryptococcus neoformans*, confirming cryptococcal meningitis.
- Despite amphotericin B treatment, the patient's condition worsened, leading to death.
- Autopsy confirmed cryptococcal meningitis and cerebral edema, with an incidental finding of cryptococcal peritonitis.
Implications:
- This case highlights a rare presentation of cryptococcal meningitis with concurrent cryptococcal peritonitis.
- The ventriculoperitoneal shunt appears to have facilitated the unusual spread of *Cryptococcus neoformans* to the peritoneum.
- This case underscores the potential complications associated with cerebrospinal fluid shunts in the context of fungal infections.