{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:04:51Z","timestamp":1792022691611,"version":"4.4.0"},"reference-count":11,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground<\/jats:title>\n<\/jats:sec>\n\n: <\/jats:title>\nHepatitis C virus (HCV) is the most common blood\u2013borne virus, affecting tens of millions of people worldwide. Neurologic manifestations of chronic HCV are rare and may be overlooked during workup of central nervous system (CNS) infections. We report on a patient who was diagnosed with hepatitis C meningoencephalitis after a protracted treatment course for presumed methicillin-resistant Staphylococcus aureus<\/jats:italic> (MRSA) ventriculitis.<\/jats:p>\n<\/jats:sec>\n\nCase Description: <\/jats:title>\nThis was a 34-year-old male with a history of intravenous drug use and ventriculoperitoneal shunt placement for hydrocephalus secondary to post-traumatic intracranial hemorrhage, who presented 1 week following shunt surgery with worsening dizziness, with initial assessment demonstrating shunt infection with positive MRSA on cerebrospinal fluid (CSF) cultures. Over his hospital course, the patient demonstrated worsening ventriculomegaly on imaging, with pleocytosis and hyperproteinosis on CSF analyses despite aggressive antibiotic treatment, ventricular irrigation, and negative bacterial and fungal cultures. His symptoms resolved within 1 week of antiviral therapy for HCV with sofosbuvir-velpatasvir.<\/jats:p>\n<\/jats:sec>\n\nConclusion: <\/jats:title>\nIn patients with chronic HCV, viral reactivation may manifest as protracted ventriculitis in the setting of low-to-normal pressure ventriculomegaly. Providers should be cognizant of serologically covert viral etiologies for post-operative infections and consider preemptive antiviral treatment in patients with aseptic CSF profiles when refractory to empiric antibiotic regimens for more common CNS pathogens.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_708_2025","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T08:14:55Z","timestamp":1756455295000},"page":"370","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Hepatitis C ventriculitis obscured by concurrent methicillin-resistant Staphylococcus aureus<\/i> infection after ventriculoperitoneal shunt placement: An illustrative case"],"prefix":"10.25259","volume":"16","author":[{"given":"Chiemeka David","family":"Uwakwe","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Stony Brook University Hospital, Stony Brook, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Racheed","family":"Mani","sequence":"additional","affiliation":[{"name":"Department of Neurology, Stony Brook University Hospital, Stony Brook, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujith","family":"Swarna","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Stony Brook University Hospital, Stony Brook, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Blaszczyk","sequence":"additional","affiliation":[{"name":"Department of Medicine, Stony Brook University Hospital, Stony Brook, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen","family":"Calandra","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Stony Brook University Hospital, Stony Brook, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Egnor","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Stony Brook University Hospital, Stony Brook, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2025,8,29]]},"reference":[{"key":"10.25259\/SNI_708_2025\/ref-1","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1007\/978-3-319-60086-4_10","article-title":"Pyogenic ventriculitis","volume-title":"Atlas of infections in neurosurgery and spinal surgery","author":"Akhaddar","year":"2017","edition":"1st ed"},{"key":"10.25259\/SNI_708_2025\/ref-2","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1007\/s004280050380","article-title":"Hepatitis C virus infection of peripheral nerves in type II cryoglobulinaemia","volume":"434","author":"Bonetti","year":"1999","journal-title":"Virchows 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nella crioglobulinemia mista HCV-correlata [Peripheral nervous system involvement in HCV-related mixed cryoglobulinemia]","volume":"53","author":"Migliaresi","year":"2001","journal-title":"Reumatismo"},{"key":"10.25259\/SNI_708_2025\/ref-7","doi-asserted-by":"crossref","first-page":"236148","DOI":"10.1155\/2012\/236148","article-title":"HCV-related nervous system disorders","volume":"2012","author":"Monaco","year":"2012","journal-title":"Clin Dev Immunol"},{"key":"10.25259\/SNI_708_2025\/ref-8","first-page":"208","article-title":"Central nervous system involvement in patients with HCV-related cryoglobulinemia","volume":"315","author":"Origgi","year":"1998","journal-title":"Am J Med Sci"},{"key":"10.25259\/SNI_708_2025\/ref-9","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1056\/NEJMc2106143","article-title":"Extrahepatic manifestations of chronic HCV infection","volume":"385","author":"Rinc\u00f3n-Choles","year":"2021","journal-title":"N Engl J 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