Recurrent Lymphocytic Pleural Effusion as a Complication of Ventriculopleural Shunt Meningitis Caused by Cutibacterium Acnes

Abstract

Cutibacterium acnes (C. acnes) is part of the normal flora and has been linked to many invasive and pleural infections. Though it is usually considered a contaminant bacterium, full antimicrobial therapy might result in the resolution of foreign body-related infections. In this report, we describe an infection that started as ventriculopleural shunt meningitis but was complicated by a recurrent lymphocytic pleural infection. Ultimately, there was a resolution of pleural effusions after treatment of C. acnes.

Characterization of cerebrospinal fluid (CSF) microbiota at the time of initial surgical intervention for children with hydrocephalus

“…Only one sample was found to have concordant results, where both WGAS and STGG detected S. epidermidis. As discussed previously, the detection of S. epidermidis is not surprising given its ubiquitous nature on human skin, but whether it is a true pathogen or a contaminant in this case is unclear [10,[26][27][28][29]. The other pathogens identified by WGAS included E. coli, K. variicola, and P. tolaasii-none of these pathogens had been found on STGG culture, though the former two are known to be pathogenic and could potentially cause CNS infection [36][37][38][39][40].…”

“…introduced into the CSF of children with CSF shunts. Therefore, the classification of these florae as "typical" skin commensals does not preclude them from causing significant morbidity [10,[26][27][28][29].…”