P.acnes CNS shunt infections are not well characterized. We retrospectively analyzed the clinical features and microbiological data on all adult patients who had a positive CSF culture for P. acnes since 1990. Patients who did not have CNS shunts were excluded. Patients were divided into 3 groups: 1)Infected patients had signs and symptoms of CNS infection and either: (A) 2 positive CSF and/or shunt component cultures OR (B) 1 positive CSF gram stain and 1 positive CSF and/or shunt component culture. 2)Non-infected patients were with or without signs and symptoms of CNS infection but lacked supportive microbiological data as described above. 3)Co-infected patients met the infected group criteria but had other organisms isolated from the CSF in addition to P.acnes. 30 patients(aged 21-77 yrs) with CNS shunts had P. acnes isolated from their CSF. Of these, 11 were deemed infected, 13 were non-infected, and 6 were co-infected. Chronic headache was the most frequent symptom in all three groups. Abdominal complaints were more common in the infected group. There were no risk factors that differentiated the 3 groups. 2 patients in the infected group had > 500/mm3 in the CSF with PMN predominance and one had hypoglycorrhachia. All patients in the non-infected and co-infected groups had CSF WBC <100/mm3. 5 patients in the infected group did not have pleocytosis. Other organisms isolated from the co-infected group were coagulase-negative staphylococci and Candida parapsilosis. In conclusion, P. acnes may be a more common cause of CNS shunt infection than previously recognized. The signs and symptoms of P.acnes CNS shunt infections are nonspecific. These infections may be associated with a marked pleocytosis and hypoglycorrhachia, although normal CSF parameters are common.
|Original language||English (US)|
|Number of pages||1|
|Journal||Clinical Infectious Diseases|
|State||Published - Dec 1 1997|
ASJC Scopus subject areas
- Microbiology (medical)
- Infectious Diseases