Cerebrospinal fluid shunt infections with anaerobic diphtheroids (Propionibacterium species)

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Abstract
The clinical and laboratory findings in 6 cases of anaerobic diphtheroid infection of CSF shunts are described. These organisms were infrequently reported as a cause of shunt infections but such infections may be more common than currently appreciated. Propionibacterium spp. are common contaminants of CSF 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 CNS dysfunction. Spinal fluid pleocytosis was usually limited to 1-200 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.