A 3-year-old child with a ventriculoperitoneal shunt placed 2 months ago for obstructive hydrocephalus presents with fever, abdominal pain along the shunt tract, and wound dehiscence over the shunt valve with purulent discharge. CSF from shunt tap shows WBC 200/mm3 and glucose 30 mg/dL. Which organism is most likely responsible?

• A Staphylococcus epidermidis ✓
• B Streptococcus pneumoniae
• C Escherichia coli
• D Pseudomonas aeruginosa

Explanation

VP shunt infections occur in 5 to 15 percent of procedures, most commonly within the first 2 months. Coagulase-negative staphylococci, particularly Staphylococcus epidermidis, account for nearly half of cases due to skin flora contamination and biofilm formation on the hardware. Treatment requires IV antibiotics plus shunt exteriorization or removal, as antibiotics alone rarely eradicate biofilm organisms.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.