Cerebrospinal fluid shunt colonization and obstruction by Paecilomyces variotii

A 57-year-old woman underwent ventriculoperitoneal shunt placement for noncommunicating hydrocephalus. She required several shunt revisions over a 2-year period for recurrent hydrocephalus. The shunt was subsequently found to be obstructed by growth of the saprophytic fungus, Paecilomyces variotii, an infrequent human pathogen. Paecilomyces infections have caused complications associated with prosthetic cardiac valves and synthetic lens implantation; this is the first reported association with a cerebrospinal fluid shunt.