First Report of Ventriculoperitoneal Shunt Infection due to Cyberlindnera fabianii

Fungal infections in the central nervous system (CNS) are associated with significant morbidity and death. Transient fungemia in immunocompetent patients without any other risk factors for fungemia has been suggested as a possible mechanism that may lead to serious fungal ventriculoperitoneal (VP) s...

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Main Authors: Jonathan Baghdadi, Peera Hemarajata, Romney Humphries, Theodoros Kelesidis
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Infectious Diseases
Online Access:http://dx.doi.org/10.1155/2015/630816
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author Jonathan Baghdadi
Peera Hemarajata
Romney Humphries
Theodoros Kelesidis
author_facet Jonathan Baghdadi
Peera Hemarajata
Romney Humphries
Theodoros Kelesidis
author_sort Jonathan Baghdadi
collection DOAJ
description Fungal infections in the central nervous system (CNS) are associated with significant morbidity and death. Transient fungemia in immunocompetent patients without any other risk factors for fungemia has been suggested as a possible mechanism that may lead to serious fungal ventriculoperitoneal (VP) shunt infections, but evidence is lacking. The clinical spectrum, diagnosis, and optimal therapy of Cyberlindnera fabianii infections remain to be determined. We describe the first case of CNS infection due to C. fabianii that occurred in an immunocompetent adult with a VP shunt. Spontaneous translocation with yeast that is not part of the normal gastrointestinal flora in the setting of ingestion of multiple servings of a fermentation product was the likely source from which Cyberlindnera fabianii gained entrance into the VP shunt system, causing meningitis in this patient. The authors conclude that, in view of the high morbidity associated with yeast infection of the CNS, long-term antifungal therapy should be strongly considered in cases where the VP shunt cannot be completely removed. Transient fungemia may lead to invasive disease in an immunocompetent host with VP shunt, even in the absence of any other risk factors for fungemia and even after remote placement of the VP shunt.
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spelling doaj-art-cee4935d9f2141b7bca29a5cafbc2e602025-02-03T05:48:29ZengWileyCase Reports in Infectious Diseases2090-66252090-66332015-01-01201510.1155/2015/630816630816First Report of Ventriculoperitoneal Shunt Infection due to Cyberlindnera fabianiiJonathan Baghdadi0Peera Hemarajata1Romney Humphries2Theodoros Kelesidis3Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USADepartment of Pathology & Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USADepartment of Pathology & Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USADivision of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USAFungal infections in the central nervous system (CNS) are associated with significant morbidity and death. Transient fungemia in immunocompetent patients without any other risk factors for fungemia has been suggested as a possible mechanism that may lead to serious fungal ventriculoperitoneal (VP) shunt infections, but evidence is lacking. The clinical spectrum, diagnosis, and optimal therapy of Cyberlindnera fabianii infections remain to be determined. We describe the first case of CNS infection due to C. fabianii that occurred in an immunocompetent adult with a VP shunt. Spontaneous translocation with yeast that is not part of the normal gastrointestinal flora in the setting of ingestion of multiple servings of a fermentation product was the likely source from which Cyberlindnera fabianii gained entrance into the VP shunt system, causing meningitis in this patient. The authors conclude that, in view of the high morbidity associated with yeast infection of the CNS, long-term antifungal therapy should be strongly considered in cases where the VP shunt cannot be completely removed. Transient fungemia may lead to invasive disease in an immunocompetent host with VP shunt, even in the absence of any other risk factors for fungemia and even after remote placement of the VP shunt.http://dx.doi.org/10.1155/2015/630816
spellingShingle Jonathan Baghdadi
Peera Hemarajata
Romney Humphries
Theodoros Kelesidis
First Report of Ventriculoperitoneal Shunt Infection due to Cyberlindnera fabianii
Case Reports in Infectious Diseases
title First Report of Ventriculoperitoneal Shunt Infection due to Cyberlindnera fabianii
title_full First Report of Ventriculoperitoneal Shunt Infection due to Cyberlindnera fabianii
title_fullStr First Report of Ventriculoperitoneal Shunt Infection due to Cyberlindnera fabianii
title_full_unstemmed First Report of Ventriculoperitoneal Shunt Infection due to Cyberlindnera fabianii
title_short First Report of Ventriculoperitoneal Shunt Infection due to Cyberlindnera fabianii
title_sort first report of ventriculoperitoneal shunt infection due to cyberlindnera fabianii
url http://dx.doi.org/10.1155/2015/630816
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