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The management of cerebrospinal fluid shunt infections

A clinical experience

  • Published:
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Summary

Fifty patients with infected cerebrospinal fluid shunts were treated by one of three forms of treatment:

  1. a)

    Twenty-two patients had shunt removal, systemic antibiotic treatment, and either external ventricular drainage or intermittent ventricular taps for decompression and antibiotic administration.

  2. b)

    Seventeen patients had removal and immediate replacement of the shunt with intrashunt and systemic antibiotics.

  3. c)

    Eleven patients received intrashunt and systemic antibiotics without shunt removal.

In the first group, antibiotics were given for a period of one week; in the second and third groups, intravenous antibiotics were administered for a minimum period of three weeks, and intraventricular antibiotics twice daily for two weeks. In all patients ventricular CSF was obtained and cultured 48 hours after cessation of antibiotic therapy, and cultures were repeated within four months after completion of therapy. Twenty-one of 22 patients in the first group, as well as 11 of 13 of the second group, were successfully treated. In the third group only four of the 11 patients responded to treatment.

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Author notes

  1. J. W. Walsh

    Present address: Division of Neurosurgery, University of Kentucky Medical Center, Lexington, Kentucky

  2. H. D. Wilson

    Present address: Department of Pediatrics, University of Kentucky Medical Center, Lexington, Kentucky

  3. H. E. James M.D. & J. D. Connor M.D.

    Present address: University of California Medical Center, 225 Dickinson Street, 92103, San Diego, CA, USA

Authors and Affiliations

  1. Division of Neurosurgery, University of California at San Diego, California

    H. E. James M.D.

  2. Department of Pediatrics, University of California at San Diego, California

    J. D. Connor M.D.

Authors
  1. H. E. James M.D.
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  2. J. W. Walsh
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  3. H. D. Wilson
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  4. J. D. Connor M.D.
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James, H.E., Walsh, J.W., Wilson, H.D. et al. The management of cerebrospinal fluid shunt infections. Acta neurochir 59, 157–166 (1981). https://doi.org/10.1007/BF01406345

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  • DOI: https://doi.org/10.1007/BF01406345

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