Fever in a child with cerebrospinal fluid access device or shunt: a pragmatic approach to management.

Children with shunts commonly present with fever, and often the focus of infection will be unrelated to their shunt. However, as shunt infections may present with few or even no specific symptoms, evaluation of a child with a shunt presenting with fever should be careful and comprehensive to ensure shunt infections are not missed. Treatment of an infected shunt involves removal of the shunt followed by a long course of antibiotics; missing or partially treating shunt infections can result in significant morbidity and potentially even mortality.

Complication of etanercept treatment for rheumatoid arthritis--purulent pericarditis caused by a commensal organism.

The patient presented with increasing fatigue and dyspnoea. The patient had medical history of rheumatoid arthritis for which she had been taking methotrexate for the past 15 years and etanercept for the past 6 years. Initial diagnosis was cardiac failure but further investigation by echocardiogram revealed a large pericardial effusion.

Microbiologically confirmed meningoencephalitis due to Enterococcus avium: a first report.

We describe an 80-year-old lady with a meningoencephalitic illness followed by vertebral discitis. Enterococcus avium was cultured from her cerebrospinal fluid. No other pathogen was incriminated in her illness.