Ventricular shunt infection: Difference between revisions

Revision as of 21:52, 12 August 2020

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

@@ Line 1: / Line 1: @@
-== Background ==
+==Background==
-=== Microbiology ===
+===Microbiology===
-* [[Enterobacteriaceae]]
+*[[Enterobacteriaceae]]
-* [[Pseudomonas aeruginosa]]
+*[[Pseudomonas aeruginosa]]
-* [[Staphylococcus aureus]]
+*[[Staphylococcus aureus]]
-* [[Coagulase-negative staphylococci]]
+*[[Coagulase-negative staphylococci]]
-* [[Candida species]]
+*[[Candida species]]
-=== Pathophysiology ===
+===Pathophysiology===
-* Four mechanisms of infection:
+*Four mechanisms of infection:
-** Colonization at time of surgery progressing to infection
+**Colonization at time of surgery progressing to infection
-** Retrograde infection from distal end (for ventriculoperitoneal shunts)
+**Retrograde infection from distal end (for ventriculoperitoneal shunts)
-** Transcutaneous (erosion or manipulation)
+**Transcutaneous (erosion or manipulation)
-** Hematogenous spread (especially for ventriculoatrial shunts)
+**Hematogenous spread (especially for ventriculoatrial shunts)
-== Clinical Manifestations ==
+==Clinical Manifestations==
-* Headache, nausea, lethargy, and altered mental status
+*Headache, nausea, lethargy, and altered mental status
-* May have erythema and tenderness over the tubing
+*May have erythema and tenderness over the tubing
-* May have abdominal pain if peritoneal source for VP shunt
+*May have abdominal pain if peritoneal source for VP shunt
-* Can present with isolated fever
+*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: [https://doi.org/10.1093/cid/ciw861 10.1093/cid/ciw861]
 [[Category:Infectious diseases]]