Ventricular shunt infection

From IDWiki

Background

Microbiology

Pathophysiology

  • Four mechanisms of infection:
    • Colonization at time of surgery progressing to infection
    • Retrograde infection from distal end (for ventriculoperitoneal shunts)
    • Transcutaneous (erosion or manipulation)
    • Hematogenous spread (especially for ventriculoatrial shunts)

Clinical Manifestations

  • Headache, nausea, lethargy, and altered mental status
  • May have erythema and tenderness over the tubing
  • May have abdominal pain if peritoneal source for VP shunt
  • Can present with isolated fever

Further Reading

  • 2017 Infectious Diseases Society of America's Clinical Practice Guidelines for Healthcare-Associated Ventriculitis and Meningitis. Clin Infect Dis. 2017;64(6):e34-e65. doi: 10.1093/cid/ciw861