Radiologic evaluation of E. coli meningitis after a ventriculoperitoneal shunt.

A case of E. coli meningitis in a patient with a ventriculoperitoneal shunt was encountered recently at our institution . A shunt-induced bowel perforation was demonstrated by injecting contrast material percutaneously into the proximal end of the shunt. Apparently, retrograde spread of normal bowel flora via the shunt was responsible for his unusual Gram-negative meningitis. Because of the disastrous consequences of persistent bacterial seeding of his cerebrospinal fluid (CSF), the shunt was removed surgically. This unusual but potentially fatal complication of ventriculoperitoneal shunts has been reported in the nonradiologic literature. However, the radiologist 's role in documenting this condition has received little attention. A complete description of this case is provided .