Cryptococcal Infection of the Ventriculoperitoneal Shunt in an HIV-Infected Patient with an Excellent Immunovirologic Status.
BACKGROUND
Cryptococcus spp. is a rare cause of ventriculoperitoneal shunt (VPS) infection, with a variable clinical presentation. Diagnosis and treatment of this entity are challenging.


CASE DESCRIPTION
A cryptococcal VPS infection occurred in a human immunodeficiency virus-infected patient with an excellent immunovirologic status, with an abdominal mass as the only clinical sign at presentation. Microbiologic diagnosis was confirmed when Cryptococcus neoformans was isolated in 4 cerebrospinal fluid samples on different days. The patient was treated with dual antifungal therapy (liposomal amphotericin B plus flucytosine). The VPS was initially externalized and then removed. At 12-month follow-up, the patient remained asymptomatic, and no replacement VPS was required.


CONCLUSIONS
This is the first reported case of cryptococcal VPS infection in a patient with human immunodeficiency virus infection. Clinical outcome was excellent after dual antifungal therapy plus device withdrawal. Diagnosis and treatment of this entity remain a challenge for clinicians.
['Genebat|Miguel|M|', 'Mayorga-Buiza|María J|MJ|', 'Castillo-Ojeda|Esperanza|E|', 'Rivero-Garvía|Mónica|M|', 'Márquez-Rivas|Francisco J|FJ|', 'Jiménez-Mejías|Manuel E|ME|']
D018784:Abdominal Abscess D000328:Adult D000666:Amphotericin B D000935:Antifungal Agents D023241:Antiretroviral Therapy, Highly Active D055499:Catheter-Related Infections D020878:Device Removal D005437:Flucytosine D015658:HIV Infections D006801:Humans D008297:Male D016919:Meningitis, Cryptococcal D017287:Ventriculoperitoneal Shunt
Ventriculoperitoneal shunt Cryptococcus HIV