CASE HISTORY 4

A 14 month old boy was referred from another hospital for an infected ventriculo-peritoneal shunt. The baby was born prematurely and had meningomyelocele and hydrocephalus. He underwent surgery for his first shunt when he was 7 weeks old. One week prior to transfer, he was admitted to the hospital for fever. Needle aspiration of the shunt revealed a cloudy fluid which had Gram positive cocci in clusters seen on Gram stain.

QUESTIONS

 1. What is meningomyelocele?  Answer

2. What is Hydrocephalus?  Answer

3. What is the purpose of ventriculo-peritoneal shunt?  Answer

4.What is the most likely pathogen to be recovered from his fluid culture?  Answer

5. What kind of pathogen is S. epidermidis ?  Answer

6.What virulence factors does Staphylococcus epidermidis possess which allows it to be an opportunistic pathogen?  Answer

 7. What is the most appropriate management for line infections with S. epidermidis?  Answer

8. Where are these organisms normally found in nature and how do they gain access to the bloodstream?  Answer