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2014 ; 2014
(ä): ä Nephropedia Template TP
gab.com Text
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English Wikipedia
Subacute bacterial endocarditis and subsequent shunt nephritis from
ventriculoatrial shunting 14?years after shunt implantation
#MMPMID24962489
Burström G
; Andresen M
; Bartek J Jr
; Fytagoridis A
BMJ Case Rep
2014[Jun]; 2014
(ä): ä PMID24962489
show ga
Fourteen years after shunt implantation, a 26-year-old patient with
myelomeningocele, concomitant hydrocephalus and a ventriculoatrial cerebrospinal
fluid (CSF) shunt presented with brief but recurrent episodes of fever
predominantly when taking showers or during physical exertion. After 4?years of
inconclusive multidisciplinary investigations, the patient progressed into
end-stage renal disease before an echocardiogram revealed a vegetative plaque on
the tendinous chords of the tricuspid valve. CSF cultures were grown from the
shunt valve, confirming bacterial growth of Propionibacterium acnes suspected of
causing subacute bacterial endocarditis and subsequent shunt nephritis. The
patient was successfully treated with antibiotics combined with ventriculoatrial
shunt removal and endoscopic third ventriculocisternostomy (VCS). This case
illustrates the nowadays rare, but potentially severe complication of subacute
bacterial endocarditis and shunt nephritis. It also exemplifies the VCS as an
alternative to implanting foreign shunt systems for CSF diversion.