title: Ventriculoperitoneal shunt infection following uterine instrumentation for dysfunctional uterine bleeding.
abstract: Shunt infections are most common within the first 6 months following implantation. A shunt infection 19 years after implantation secondary to uterine ablation has not been reported to our knowledge. Office hysteroscopic procedures have become commonplace in gynecologic practice. Infectious complication rates are low, but peritonitis has been described. We present a patient with a ventriculoperitoneal shunt infection following a uterine ablation for dysfunctional uterine bleeding. Three days following the ablation she developed abdominal pain. CT scan of the abdomen 5 months after the procedure revealed a pseudocyst. She then underwent removal of her shunt with intra-operative cultures revealing Streptococcus agalactiae. Definitive treatment consisted of shunt explantation and antibiotic treatment with complete resolution of her pain and pseudocyst. Consideration for prophylactic antibiotics should be made when a patient with a ventriculoperitoneal shunt undergoes any transvaginal procedure.
authors.affiliation: Wexner Medical Center, Department of Neurological Surgery, Ohio State University, 410 W 10th Avenue, 1014 N Doan Hall, Columbus, OH 43210, USA. Electronic address: Andrew.Shaw@osumc.edu.
authors.forename: Andrew B
authors.initials: AB
authors.lastname: Shaw
authors.affiliation: Wexner Medical Center, Department of Neurological Surgery, Ohio State University, 410 W 10th Avenue, 1014 N Doan Hall, Columbus, OH 43210, USA.
authors.forename: Evan S
authors.initials: ES
authors.lastname: Marlin
authors.affiliation: Wexner Medical Center, Department of Neurological Surgery, Ohio State University, 410 W 10th Avenue, 1014 N Doan Hall, Columbus, OH 43210, USA.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Ikeda
authors.affiliation: Wexner Medical Center, Department of Neurological Surgery, Ohio State University, 410 W 10th Avenue, 1014 N Doan Hall, Columbus, OH 43210, USA.
authors.forename: Mario
authors.initials: M
authors.lastname: Ammirati
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging / Q000209:etiology; D000328:Adult; D020878:Device Removal; D003937:Diagnosis, Differential; D055356:Endometrial Ablation Techniques; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D008796:Metrorrhagia / Q000601:surgery*; D010149:Postoperative Pain / Q000000981:diagnostic imaging; D011860:Radiography, Abdominal; D013290:Streptococcal Infections / Q000188:drug therapy / Q000209:etiology*; D013292:Streptococcus agalactiae; D014057:Tomography, X-Ray Computed; D017287:Ventriculoperitoneal Shunt / Q000295:instrumentation*
keywords: Hysteroscopy; Infection; Pseudocyst; Ventriculoperitoneal shunt