VP-shunt dysfunction caused by malaria CNS infection

• Published in: Child's nervous system Vol. 32; no. 4; pp. 759 - 760
• Main Authors: Fehrenbach, Michael Karl, Bernhard, Matthias, Siekmeyer, Manuela, Lippmann, Norman, Kiess, Wieland, Nestler, Ulf, Meixensberger, Jürgen, Preuss, Matthias
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.04.2016
• Subjects: Case Report; Central Nervous System Infections - complications; Central Nervous System Infections - etiology; Central Nervous System Infections - parasitology; Cerebral Ventricles - surgery; Child, Preschool; Humans; Malaria - complications; Malaria - pathology; Male; Medicine; Medicine & Public Health; Neurosciences; Neurosurgery; Ventriculoperitoneal Shunt - adverse effects; Hydrocephalus; Malaria CNS infection; VP-shunt dysfunction
• ISSN: 0256-7040; 1433-0350
• DOI: 10.1007/s00381-015-2912-2

Introduction Malaria is a widespread mosquito-borne infectious disease with over 300 million cases and roughly 900 thousand deaths in 2013. Cerebral involvement of malaria causes 50 % of all infection-associated deaths, especially in children below the age of 5 years. Hydrocephalus is a medical condition with abnormal accumulation of cerebrospinal fluid in physiological cavities and ventricles. Standard treatment is the implantation of a cerebrospinal fluid shunt device. A common problem associated with shunt treatment especially in pediatric patients is infection and consecutive shunt dysfunction caused by bacteriae or high protein levels clogging the valve. In these cases, Staphylococcus aureus and Staphylococcus epidermidis are predominantly found in CSF cultures. Case Presentation We present a case of a 2-year old boy from Saudi Arabia with a ventriculoperitoneal (VP)-shunt-dependent congenital hydrocephalus who suffered from cerebral malaria and developed consecutive shunt failure. Conclusion To the best of our knowledge, shunt failure caused by malaria CNS infection with Plasmodium falciparum has not yet been reported in the literature and should be considered as a rare cause of VP-shunt failure in patients with atypical VP-shunt infections living in or traveling from endemic areas.