{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T22:35:34Z","timestamp":1769726134102,"version":"3.49.0"},"reference-count":38,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"17","license":[{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2025,10,27]]},"abstract":"\n BACKGROUND<\/jats:title>\n Brain abscesses represent a focal intracranial infection characterized by the localized accumulation of pus within a vascularized capsule. While typically occurring in immunocompromised patients, they may also present in otherwise healthy individuals. CSF shunt-related infections commonly manifest as meningitis or ventriculitis; however, brain abscess formation remains rare, particularly with unusual pathogens and extended latency.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n \n The authors present the case of a 58-year-old female patient who developed a\n Streptococcus pneumoniae<\/jats:italic>\n brain abscess 7 years after cystoperitoneal shunt placement for an arachnoid cyst. She presented with headaches and altered consciousness, but without systemic infection signs. Radiological studies identified a left frontal abscess adjacent to the shunt catheter, which was initially considered either a tumor or an abscess due to the delayed onset. Surgical drainage, complete shunt removal, and targeted antibiotic therapy led to complete symptom resolution without residual neurological deficits. No subsequent shunt placement was required.\n <\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n Clinicians should be aware of the potential for late-onset brain abscesses associated with CSF shunts, even several years after placement. This case highlights the importance of careful consideration regarding the necessity of shunt placement in asymptomatic patients with arachnoid cysts and the need for vigilant monitoring for rare infectious complications.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE25547<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case25547","type":"journal-article","created":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:05:57Z","timestamp":1762214757000},"source":"Crossref","is-referenced-by-count":0,"title":["Late-onset Streptococcus pneumoniae brain abscess following cystoperitoneal shunt placement for an arachnoid cyst: illustrative case"],"prefix":"10.3171","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7889-3396","authenticated-orcid":true,"given":"Serdar","family":"Solmaz","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Hakkari State Hospital, Hakkari, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9246-1378","authenticated-orcid":true,"given":"Cafer Ikbal","family":"Gulsever","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hakkari State Hospital, Hakkari, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Onur","family":"Ozg\u00fcral","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ibni Sina Hospital, Ankara University School of Medicine, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hasan \u00c7a\u011flar","family":"U\u011fur","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ibni Sina Hospital, Ankara University School of Medicine, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"5","key":"bib1","series-title":"Clin Infect Dis","first-page":"1108","article-title":"Pyogenic brain abscess caused by Streptococcus pneumoniae: case report and review","volume":"25","author":"Grigoriadis","year":"1997","unstructured":"Grigoriadis EGold WL.Pyogenic brain abscess caused by Streptococcus pneumoniae: case report and review. Clin Infect Dis. 1997;25(5):1108-1112."},{"issue":"3","key":"bib2","series-title":"Jpn J Infect Dis","first-page":"191","article-title":"Surgically treated community-acquired brain abscess: bacteriological analysis based on predisposing infections","volume":"71","author":"Lee","year":"2018","unstructured":"Lee HSKim JHKim YHLee S.Surgically treated community-acquired brain abscess: bacteriological analysis based on predisposing infections. Jpn J Infect Dis. 2018;71(3):191-196."},{"issue":"9","key":"bib3","series-title":"Pediatr Infect Dis J","first-page":"e338","article-title":"Brain abscess developing after lobar pneumonia: a rare complication in unvaccinated child caused by Streptococcus pneumoniae serotype 14","volume":"43","author":"Ku\u015f","year":"2024","unstructured":"Ku\u015f SElvan-Tuz AAslan-Saritas UYilmaz D.Brain abscess developing after lobar pneumonia: a rare complication in unvaccinated child caused by Streptococcus pneumoniae serotype 14. Pediatr Infect Dis J. 2024;43(9):e338-e339."},{"key":"bib4","series-title":"Handb Clin Neurol","first-page":"349","article-title":"Management of bacterial central nervous system infections","volume":"140","author":"Brouwer","year":"2017","unstructured":"Brouwer MCvan de Beek D.Management of bacterial central nervous system infections. Handb Clin Neurol. 2017;140:349-364."},{"issue":"10","key":"bib5","series-title":"Indian J Pediatr","first-page":"833","article-title":"Brain abscess\u2014an unusual complication of ventriculo-peritoneal shunt","volume":"70","author":"Pandey","year":"2003","unstructured":"Pandey PSuri ASingh AKMahapatra AK.Brain abscess\u2014an unusual complication of ventriculo-peritoneal shunt. Indian J Pediatr. 2003;70(10):833-834."},{"issue":"2","key":"bib6","series-title":"Childs Nerv Syst","first-page":"119","article-title":"Latent abscess formation adjacent to a non-functioning intraventricular catheter","volume":"19","author":"Vougioukas","year":"2003","unstructured":"Vougioukas VIFeuerhake FHubbe UReinacher PVan Velthoven V.Latent abscess formation adjacent to a non-functioning intraventricular catheter. Childs Nerv Syst. 2003;19(2):119-121."},{"issue":"1","key":"bib7","series-title":"Neurosurgery","first-page":"1","article-title":"Fifteen-year review of the mortality of brain abscess","volume":"8","author":"Alderson","year":"1981","unstructured":"Alderson DStrong AJIngham HRSelkon JB.Fifteen-year review of the mortality of brain abscess. Neurosurgery. 1981;8(1):1-6."},{"issue":"4","key":"bib8","series-title":"Ann Intern Med","first-page":"571","article-title":"Brain abscess: a review of recent experience","volume":"82","author":"Brewer","year":"1975","unstructured":"Brewer NSMacCarty CSWellman WE.Brain abscess: a review of recent experience. Ann Intern Med. 1975;82(4):571-576."},{"issue":"9","key":"bib9","series-title":"J Pediatr Infect Dis Soc","first-page":"504","article-title":"Associations of standard care, intrathecal antibiotics, and antibiotic-impregnated catheters with cerebrospinal fluid shunt infection organisms and resistance","volume":"12","author":"Sedano","year":"2023","unstructured":"Sedano SKronman MPWhitlock KBAssociations of standard care, intrathecal antibiotics, and antibiotic-impregnated catheters with cerebrospinal fluid shunt infection organisms and resistance. J Pediatr Infect Dis Soc. 2023;12(9):504-512."},{"issue":"1","key":"bib10","series-title":"Cases J","first-page":"110","article-title":"Brain abscess formation as a CSF shunt complication: a case report","volume":"2","author":"Jamjoom","year":"2009","unstructured":"Jamjoom AABWaliuddin ARJamjoom AB.Brain abscess formation as a CSF shunt complication: a case report. Cases J. 2009;2(1):110."},{"issue":"4","key":"bib11","series-title":"Neurol India","first-page":"489","article-title":"Brain abscess and granuloma formation as late complications of retained ventricular catheter","volume":"57","author":"Khan","year":"2009","unstructured":"Khan SAGretchel AGovender HHartzenberg B.Brain abscess and granuloma formation as late complications of retained ventricular catheter. Neurol India. 2009;57(4):489-492."},{"issue":"4","key":"bib12","series-title":"Neurosurgery","first-page":"451","article-title":"Trends in the management of bacterial brain abscesses: a review of 102 cases over 17 years","volume":"23","author":"Mampalam","year":"1988","unstructured":"Mampalam TJRosenblum ML.Trends in the management of bacterial brain abscesses: a review of 102 cases over 17 years. Neurosurgery. 1988;23(4):451-458."},{"issue":"suppl 2","key":"bib13","series-title":"Neurosurgery","first-page":"519","article-title":"The surgical management of infections involving the cerebrum","volume":"62","author":"Hall","year":"2008","unstructured":"Hall WATruwit CL.The surgical management of infections involving the cerebrum. Neurosurgery. 2008;62(suppl 2):519-530."},{"issue":"6","key":"bib14","series-title":"Surg Infect (Larchmt)","first-page":"509","article-title":"Multiple brain abscesses caused by Streptococcus pneumoniae: rare complication of lobar pneumonia","volume":"12","author":"El Asri","year":"2011","unstructured":"El Asri ACAkhaddar AGazzaz MMultiple brain abscesses caused by Streptococcus pneumoniae: rare complication of lobar pneumonia. Surg Infect (Larchmt). 2011;12(6):509-510."},{"issue":"1","key":"bib15","series-title":"Arch Intern Med","first-page":"25","article-title":"Metastatic brain abscesses. A retrospective appraisal of 29 patients","volume":"119","author":"Gregory","year":"1967","unstructured":"Gregory DHMessner RZinneman HH.Metastatic brain abscesses. A retrospective appraisal of 29 patients. Arch Intern Med. 1967;119(1):25-31."},{"issue":"1-2","key":"bib16","series-title":"Acta Neurochir (Wien)","first-page":"15","article-title":"Stereotactic aspiration of brain abscesses: is this the treatment of choice?","volume":"121","author":"Stapleton","year":"1993","unstructured":"Stapleton SRBell BAUttley D.Stereotactic aspiration of brain abscesses: is this the treatment of choice? Acta Neurochir (Wien). 1993;121(1-2):15-19."},{"issue":"11","key":"bib17","series-title":"J Int Med Res","first-page":"3000605221137470","article-title":"Healthy adults with Streptococcus pneumoniae meningitis and Streptococcus pneumoniae subdural abscess: two case reports and a literature review","volume":"50","author":"Kong","year":"2022","unstructured":"Kong FLi LZhang DHealthy adults with Streptococcus pneumoniae meningitis and Streptococcus pneumoniae subdural abscess: two case reports and a literature review. J Int Med Res. 2022;50(11):3000605221137470."},{"issue":"6","key":"bib18","series-title":"J Korean Neurosurg Soc","first-page":"300","article-title":"Delayed cerebral abscess as a shunt complication and endoscopic removal of the ventricular catheter and abscess","volume":"43","author":"Shin","year":"2008","unstructured":"Shin DSHwang SCKim BTShin WH.Delayed cerebral abscess as a shunt complication and endoscopic removal of the ventricular catheter and abscess. J Korean Neurosurg Soc. 2008;43(6):300-303."},{"issue":"8","key":"bib19","series-title":"J Clin Diagn Res","first-page":"1694","article-title":"A pneumococcal brain abscess: a case report","volume":"7","author":"Belodu","year":"2013","unstructured":"Belodu RNagarathna SRavikumar RKumar RChandramouli BA.A pneumococcal brain abscess: a case report. J Clin Diagn Res. 2013;7(8):1694-1695."},{"issue":"5","key":"bib1","series-title":"Clin Infect Dis","first-page":"1108","article-title":"Pyogenic brain abscess caused by Streptococcus pneumoniae: case report and review","volume":"25","author":"Grigoriadis","year":"1997","unstructured":"Grigoriadis EGold WL.Pyogenic brain abscess caused by Streptococcus pneumoniae: case report and review. Clin Infect Dis. 1997;25(5):1108-1112."},{"issue":"3","key":"bib2","series-title":"Jpn J Infect Dis","first-page":"191","article-title":"Surgically treated community-acquired brain abscess: bacteriological analysis based on predisposing infections","volume":"71","author":"Lee","year":"2018","unstructured":"Lee HSKim JHKim YHLee S.Surgically treated community-acquired brain abscess: bacteriological analysis based on predisposing infections. Jpn J Infect Dis. 2018;71(3):191-196."},{"issue":"9","key":"bib3","series-title":"Pediatr Infect Dis J","first-page":"e338","article-title":"Brain abscess developing after lobar pneumonia: a rare complication in unvaccinated child caused by Streptococcus pneumoniae serotype 14","volume":"43","author":"Ku\u015f","year":"2024","unstructured":"Ku\u015f SElvan-Tuz AAslan-Saritas UYilmaz D.Brain abscess developing after lobar pneumonia: a rare complication in unvaccinated child caused by Streptococcus pneumoniae serotype 14. Pediatr Infect Dis J. 2024;43(9):e338-e339."},{"key":"bib4","series-title":"Handb Clin Neurol","first-page":"349","article-title":"Management of bacterial central nervous system infections","volume":"140","author":"Brouwer","year":"2017","unstructured":"Brouwer MCvan de Beek D.Management of bacterial central nervous system infections. Handb Clin Neurol. 2017;140:349-364."},{"issue":"10","key":"bib5","series-title":"Indian J Pediatr","first-page":"833","article-title":"Brain abscess\u2014an unusual complication of ventriculo-peritoneal shunt","volume":"70","author":"Pandey","year":"2003","unstructured":"Pandey PSuri ASingh AKMahapatra AK.Brain abscess\u2014an unusual complication of ventriculo-peritoneal shunt. Indian J Pediatr. 2003;70(10):833-834."},{"issue":"2","key":"bib6","series-title":"Childs Nerv Syst","first-page":"119","article-title":"Latent abscess formation adjacent to a non-functioning intraventricular catheter","volume":"19","author":"Vougioukas","year":"2003","unstructured":"Vougioukas VIFeuerhake FHubbe UReinacher PVan Velthoven V.Latent abscess formation adjacent to a non-functioning intraventricular catheter. Childs Nerv Syst. 2003;19(2):119-121."},{"issue":"1","key":"bib7","series-title":"Neurosurgery","first-page":"1","article-title":"Fifteen-year review of the mortality of brain abscess","volume":"8","author":"Alderson","year":"1981","unstructured":"Alderson DStrong AJIngham HRSelkon JB.Fifteen-year review of the mortality of brain abscess. Neurosurgery. 1981;8(1):1-6."},{"issue":"4","key":"bib8","series-title":"Ann Intern Med","first-page":"571","article-title":"Brain abscess: a review of recent experience","volume":"82","author":"Brewer","year":"1975","unstructured":"Brewer NSMacCarty CSWellman WE.Brain abscess: a review of recent experience. Ann Intern Med. 1975;82(4):571-576."},{"issue":"9","key":"bib9","series-title":"J Pediatr Infect Dis Soc","first-page":"504","article-title":"Associations of standard care, intrathecal antibiotics, and antibiotic-impregnated catheters with cerebrospinal fluid shunt infection organisms and resistance","volume":"12","author":"Sedano","year":"2023","unstructured":"Sedano SKronman MPWhitlock KBAssociations of standard care, intrathecal antibiotics, and antibiotic-impregnated catheters with cerebrospinal fluid shunt infection organisms and resistance. J Pediatr Infect Dis Soc. 2023;12(9):504-512."},{"issue":"1","key":"bib10","series-title":"Cases J","first-page":"110","article-title":"Brain abscess formation as a CSF shunt complication: a case report","volume":"2","author":"Jamjoom","year":"2009","unstructured":"Jamjoom AABWaliuddin ARJamjoom AB.Brain abscess formation as a CSF shunt complication: a case report. Cases J. 2009;2(1):110."},{"issue":"4","key":"bib11","series-title":"Neurol India","first-page":"489","article-title":"Brain abscess and granuloma formation as late complications of retained ventricular catheter","volume":"57","author":"Khan","year":"2009","unstructured":"Khan SAGretchel AGovender HHartzenberg B.Brain abscess and granuloma formation as late complications of retained ventricular catheter. Neurol India. 2009;57(4):489-492."},{"issue":"4","key":"bib12","series-title":"Neurosurgery","first-page":"451","article-title":"Trends in the management of bacterial brain abscesses: a review of 102 cases over 17 years","volume":"23","author":"Mampalam","year":"1988","unstructured":"Mampalam TJRosenblum ML.Trends in the management of bacterial brain abscesses: a review of 102 cases over 17 years. Neurosurgery. 1988;23(4):451-458."},{"issue":"suppl 2","key":"bib13","series-title":"Neurosurgery","first-page":"519","article-title":"The surgical management of infections involving the cerebrum","volume":"62","author":"Hall","year":"2008","unstructured":"Hall WATruwit CL.The surgical management of infections involving the cerebrum. Neurosurgery. 2008;62(suppl 2):519-530."},{"issue":"6","key":"bib14","series-title":"Surg Infect (Larchmt)","first-page":"509","article-title":"Multiple brain abscesses caused by Streptococcus pneumoniae: rare complication of lobar pneumonia","volume":"12","author":"El Asri","year":"2011","unstructured":"El Asri ACAkhaddar AGazzaz MMultiple brain abscesses caused by Streptococcus pneumoniae: rare complication of lobar pneumonia. Surg Infect (Larchmt). 2011;12(6):509-510."},{"issue":"1","key":"bib15","series-title":"Arch Intern Med","first-page":"25","article-title":"Metastatic brain abscesses. A retrospective appraisal of 29 patients","volume":"119","author":"Gregory","year":"1967","unstructured":"Gregory DHMessner RZinneman HH.Metastatic brain abscesses. A retrospective appraisal of 29 patients. Arch Intern Med. 1967;119(1):25-31."},{"issue":"1-2","key":"bib16","series-title":"Acta Neurochir (Wien)","first-page":"15","article-title":"Stereotactic aspiration of brain abscesses: is this the treatment of choice?","volume":"121","author":"Stapleton","year":"1993","unstructured":"Stapleton SRBell BAUttley D.Stereotactic aspiration of brain abscesses: is this the treatment of choice? Acta Neurochir (Wien). 1993;121(1-2):15-19."},{"issue":"11","key":"bib17","series-title":"J Int Med Res","first-page":"3000605221137470","article-title":"Healthy adults with Streptococcus pneumoniae meningitis and Streptococcus pneumoniae subdural abscess: two case reports and a literature review","volume":"50","author":"Kong","year":"2022","unstructured":"Kong FLi LZhang DHealthy adults with Streptococcus pneumoniae meningitis and Streptococcus pneumoniae subdural abscess: two case reports and a literature review. J Int Med Res. 2022;50(11):3000605221137470."},{"issue":"6","key":"bib18","series-title":"J Korean Neurosurg Soc","first-page":"300","article-title":"Delayed cerebral abscess as a shunt complication and endoscopic removal of the ventricular catheter and abscess","volume":"43","author":"Shin","year":"2008","unstructured":"Shin DSHwang SCKim BTShin WH.Delayed cerebral abscess as a shunt complication and endoscopic removal of the ventricular catheter and abscess. J Korean Neurosurg Soc. 2008;43(6):300-303."},{"issue":"8","key":"bib19","series-title":"J Clin Diagn Res","first-page":"1694","article-title":"A pneumococcal brain abscess: a case report","volume":"7","author":"Belodu","year":"2013","unstructured":"Belodu RNagarathna SRavikumar RKumar RChandramouli BA.A pneumococcal brain abscess: a case report. 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