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Old 09-09-2012
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Bacteria VP Shunt Infection

A 4-year-old boy, who has a ventriculoperitoneal shunt for congenital hydrocephalus, develops fever, headache, irritability, lethargy, photophobia, and vomiting. His temperature is 39.6 C (103.2 F). He is noted to have nuchal rigidity, with the presence of both Kernig's and Brudzinski's signs. The shunt tract is erythematous on the surface. A lumbar puncture is performed and shows a WBC of 40,000/mm3 with 85% neutrophils, a glucose concentration of 48 mg/dL, and a protein concentration of 169 mg/dL. Which of the following is the most likely pathogen?

A. Haemophilus influenzae
B. Neisseria meningitidis
C. Pseudomonas aeruginosa
D. Staphylococcus epidermidis
E. Streptococcus pneumoniae
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Old 09-09-2012
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D. Staphylococcus epidermidis

Shunt associated meningitis is caused by it
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D..............
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D
S.epidermidis likes everything inert

VP shunts, prosthetic joints, prosthetic valves.. this little bug is a bitch
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Old 09-09-2012
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Quote:
Originally Posted by XpaezX View Post
D
S.epidermidis likes everything inert

VP shunts, prosthetic joints, prosthetic valves.. this little bug is a bitch
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Old 09-09-2012
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Yup correct answer is (D)
Most common causes of meningitis:
*MCC in adult= S.pneumonia
*2nd MCC in adult= N.meningitidis
*MCC in patient with penetrating skull injury or neurosurgery= S.aureus
*MCC in VP shunt related meningitis= S.epidermidis
*MCC in patient with acute neutropenia (Neutrophils <500)= Pseudomonas aeruginosa and other gram -ve
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