[Case with large abdominal abscess associated with a ventriculoperitoneal shunt].
Abdominal abscess is a rare shunt-related complication with few reported cases. A 6-year-old female presented with a large staphylococcal abdominal abscess manifesting as abdominal distension without significant clinical signs or blood and cerebrospinal fluid findings of infection. The patient had undergone repeated surgeries for craniopharyngioma at 2 years of age and had suffered central pontine and extrapontine myelinolysis during the clinical course, had severely impaired hypothalamic function, and was in a vegetative state on presentation. In addition, she had previously suffered epidural, subdural, and cerebral parenchymal abscesses, which had resolved completely. She underwent percutaneous irrigation drainage of pus and removal of the shunt coupled with intense antibiotic administration, which cured the abscess without recurrence. Culture revealed methicillin-resistant Staphylococcus aureus. We thought that preexisting intracranial infection, which had extended down into the abdominal cavity through the peritoneal tube of the shunt, coupled with the patient's impaired immune function, had probably caused the abdominal abscess. Abdominal abscess is a potential complication of ventriculoperitoneal shunting, and timely diagnosis and treatment may achieve a good outcome.
Department of Neurosurgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu-shi, Chiba 279-0021, Japan.
Satoshi
S
Tsutsumi
Hidehiro
H
Okura
Yasuo
Y
Suga
Osamu
O
Akiyama
Yusuke
Y
Abe
Yukimasa
Y
Yasumoto
Masanori
M
Ito
D018784:Abdominal Abscess / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001922:Brain Abscess / Q000150:complications; D002648:Child; D003982:Dibekacin / Q000008:administration & dosage / Q000031:analogs & derivatives; D004322:Drainage; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D013203:Staphylococcal Infections / Q000209:etiology*; D014640:Vancomycin / Q000008:administration & dosage; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*
D000900:Anti-Bacterial Agents; D003982:Dibekacin; D014640:Vancomycin; C031986:arbekacin