Infective Endocarditis as a Complication of a Ventriculoatrial Shunt.

A 31-year-old man with a medical history of congenital hydrocephalus with a ventriculoatrial shunt presented with sepsis despite being treated with oxacillin for a recent bacteremia. His blood cultures grew methicillin-sensitive Staphylococcus aureus, and a transesophageal echocardiogram revealed small vegetations on the tricuspid valve and at the tip of the ventriculoatrial shunt. He underwent removal of the shunt and was treated with a 6-week course of oxacillin and rifampin for endocarditis. Our case highlights the importance of having a high index of suspicion for endocarditis in patients with a ventriculoatrial shunt. Similar to the management of other cardiac device-related infective endocarditis, removal of the shunt is required in addition to antibiotic therapy.