An unusual case of recurrent pneumonia.

A gentleman, aged 54, with shunted hydrocephalus presented with recurrent chest infections. He had a ventriculoperitoneal (VP) shunt inserted when he was 38 years old for obstructive hydrocephalus due to a cerebellar tumour, with no subsequent shunt revisions since. Over a 2-year period, he presented with three episodes of pneumonia, which, on each occasion, responded well to antibiotics but then subsequently recurred. A chest x-ray identified the distal end of the VP shunt above the level of the diaphragm. CT scan found the distal end of the shunt tubing to be within a pulmonary bronchus. The VP shunt was revised and the patient had no subsequent recurrences of his chest infections. The authors review the complications of VP shunt placement including the more common sites of shunt tubing migration.