Multiple recurrent gram-negative cerebrospinal fluid shunt infections associated with a patient with a retained ventricular foreign body.
A 3-year-old boy experienced 10 recurrent gram-negative ventriculoperitoneal shunt (VPS) infections with identical strains over a 17-month period. Multiple cranial MRI and CT scans to identify a retained foreign body were negative. CT myelography and pressure infusion radionuclide cisternography were also unhelpful. Ventriculoscopy revealed a small retained foreign body which was successfully removed, and cultures subsequently yielded gram-negative organisms identical to the previously identified bacteria by pulsed field gel electrophoresis. No further infections were noted after removal of the retained fragment. Exploratory ventriculostomy should be considered in patients with recurrent VPS infections where other techniques fail to reveal a cause.
Shingadia
D
D
Division of Pediatric Infectious Diseases, Northwestern University Medical School, The Children's Memorial Hospital, Chicago, IL 60614, USA. dshingadia@nwu.edu
Grant
J
J
Bendet
M
M
Shulman
S T
ST
Yogev
R
R
D002552:Cerebral Ventricles / Q000601:surgery; D002675:Child, Preschool; D003952:Diagnostic Imaging; D004927:Escherichia coli Infections / Q000175:diagnosis / Q000601:surgery; D005500:Follow-Up Studies; D005547:Foreign Bodies / Q000601:surgery*; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery*; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation; D017287:Ventriculoperitoneal Shunt / Q000295:instrumentation*; D014696:Ventriculostomy