Gonococcal infection in cerebrospinal fluid and the presence of a ventriculoperitoneal shunt

Gonococcal Infection and Ventriculoperitoneal Shunts

ABSTRACT

Neisseria gonorrhoea e and Chlamydia trachomatis are pathogens commonly isolated in pelvic inflammatory disease. Neisseria gonorrhoea e may uncommonly spread outside the urogenital tract to cause complications. We present 2 cases of adolescents with ventriculoperitoneal shunt infection due to N. gonorrhoea e, requiring shunt externalization.

Gonococcal meningitis diagnosed by DNA amplification: case report and review of the literature

We report a case of gonococcal meningitis diagnosed by DNA amplification. A 47-year old man presented with a 4-day history of asymmetric painful swelling of his ankles and wrists, and skin rash. He had sex with men only but was HIV negative. Headache and photophobia led to a cerebrospinal fluid (CSF) examination that revealed meningitis. Cultures were negative but we detected Neisseria gonorrhoeae in his urine and CSF using a GC/chlamydia DNA amplification assay. The patient was discharged without sequela after 14 days of intravenous ceftriaxone.

Gonococcal meningitis and intra-abdominal abscess in the presence of a ventriculoperitoneal shunt

We report a case of gonococcal meningitis with an intraabdominal abscess in a 19-y-old woman, who had a ventriculoperitoneal shunt after craniotomy for astrocytoma. Percutaneous drainage was performed for the intraabdominal abscess. Ceftriaxone was administered with the ventriculoperitoneal shunt removal. The clinical course improved, but visual impairment last for 3 months following treatment.

Nosocomial bacterial meningitis, including central nervous system shunt infections

Nosocomial bacterial meningitis and CSF shunt infections result in considerable morbidity and mortality, necessitating an organized and thoughtful approach to prevention, diagnosis, and management. Prophylactic antibiotics appear to reduce the rate of postcraniotomy meningitis often caused by S. aureus. On the other hand, prophylactic antibiotics do not appear to reduce the risk of developing a CSF shunt infection. CSF shunt infections usually require shunt removal and antimicrobial chemotherapy to effect a successful outcome.