Cerebrospinal fluid shunt infections with anaerobic diphtheroids (Propionibacterium species)

Abstract

The clinical and laboratory findings in six cases of anaerobic diphtheroid infection of cerebrospinal fluid shunts are described. These organisms have been infrequently reported as a cause of shunt infections but our data indicate that such infections may be more common than currently appreciated. Propionibacterium species are common contaminants of cerebrospinal fluid specimens, but when isolated from the spinal fluid of a patient with a shunt who has symptoms and signs compatible with infection, the organism should not be dismissed as a contaminant. Fever was a constant finding frequently accompanied by signs of central nervous system dysfunction. Spinal fluid pleocytosis was usually limited to 1 to 200 cells and protein and sugar values were variable. The organisms grow slowly, therefore spinal fluid cultures should be held for at least 14 days before they are reported as negative.