Cerebrospinal fluid eosinophilia and sterile shunt malfunction

Traynelis, Vincent C.; Powell, R G; Koss, William; Schochet, Sydney S.; Kaufman, Howard H.

doi:10.1097/00006123-198811000-00019

Cited by 4 publications

(5 citation statements)

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“…When the resolution of symptoms and disappearance of CSF eosinophils follow the discontinuation of these drugs, the association of the eosinophilic meningitis with the underlying condition requiring the drug treatment can be ruled out (232). CSF eosinophilia may indicate malfunction of a plastic implant or any nonorganic materials coming in contact with the meninges (278). Eosinophilia has also been associated with catheters impregnated with rifampin and minocycline (18).…”

Section: Drugs Reagents and Plastic Devicesmentioning

confidence: 99%

Update on Eosinophilic Meningoencephalitis and Its Clinical Relevance

2009

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SUMMARY Eosinophilic meningoencephalitis is caused by a variety of helminthic infections. These worm-specific infections are named after the causative worm genera, the most common being angiostrongyliasis, gnathostomiasis, toxocariasis, cysticercosis, schistosomiasis, baylisascariasis, and paragonimiasis. Worm parasites enter an organism through ingestion of contaminated water or an intermediate host and can eventually affect the central nervous system (CNS). These infections are potentially serious events leading to sequelae or death, and diagnosis depends on currently limited molecular methods. Identification of parasites in fluids and tissues is rarely possible, while images and clinical examinations do not lead to a definitive diagnosis. Treatment usually requires the concomitant administration of corticoids and anthelminthic drugs, yet new compounds and their extensive and detailed clinical evaluation are much needed. Eosinophilia in fluids may be detected in other infectious and noninfectious conditions, such as neoplastic disease, drug use, and prosthesis reactions. Thus, distinctive identification of eosinophils in fluids is a necessary component in the etiologic diagnosis of CNS infections.

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Section: Drugs Reagents and Plastic Devicesmentioning

confidence: 99%

Update on Eosinophilic Meningoencephalitis and Its Clinical Relevance

2009

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“…Underlying CSF eosinophilia has been reported as both an incidental and benign finding in neurosurgical patinets [8,9,13,14,[16][17][18]. However, when CSF eosinophilia is present, it may be an indicator of an underlying pathology associated with, or possible cause of shunt malfunction.…”

Section: Discussionmentioning

confidence: 99%

“…However, when CSF eosinophilia is present, it may be an indicator of an underlying pathology associated with, or possible cause of shunt malfunction. In patients presenting with concern of shunt malfunction in the setting of elevated CSF eosinophil count, clinicians should consider workup of infection, benign underlying inflammatory reaction, or both [1,2,4,6,7,9,10,[12][13][14]18]. CSF eosinophilia has been reported in association with infection such as parasitic, bacterial, or mycotic infection of the central nervous system [1,7,9,12,13,15,16,19].…”

Section: Discussionmentioning

confidence: 99%

Cystoperitoneal Shunt Malfunction in Setting of Rifampin Allergy Presenting as Cerebrospinal Fluid Eosinophilia

Behbahani¹,

Chaudhry²,

Kwasnicki³

et al. 2019

Arch Clin Med Case Rep

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Background: Cerebral spinal fluid eosinophilia (CSFe) is correlated with increased risk of cranial shunt malfunctions. Although antibiotics coated shunt catheters have significantly reduced the incidence of infections and associated shunt malfunction, on rare occasion they may contribute to a shunt allergy and become the source of subsequent malfunction.Objective: We present a very rare case of a patient with an arachnoid cyst treated with cysto-peritoneal shunt (CPS), complicated by rifampin allergy manifesting as sterile CSFe and subsequent shunt malfunction.Case Report: A 17-months-old-male with symptomatic arachnoid cyst underwent uneventful craniotomy for cyst fenestration and CPS placement. At 2-month follow up he was neurologically stable; however, he developed an expanding pseudomeningocele that was palpable at the site of the prior craniotomy. Although shunt and pseudomeningocele taps were both negative for infectious etiology, the CSF analysis was notable for isolated CSFe.Given the persistence of symptoms, and well as subsequent emergency room visits for abdominal swelling, lowgrade fevers, and intermittent presence of pseudomeningocele, patient was admitted for further workup. Radio-Allergosorbent testing (RAST) was performed and revealed newly diagnosed rifampin allergy. CPS was then removed and patient was treated with a course of steroids until resolution of CSFe, and underwent placemen of a new CPS with non-antibiotics coated catheter. One week after discharge, patient returned with Staphylococcus Aureus related shunt malfunction, for which the shunt was externalized. He underwent a course of antibiotics treatment and was subsequently trialed to be weaned off the CPS, in light of recent cyst fenestration. A

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“…(Bosch and Oehmichen 1978) The finding of CSF eosinophils has been associated with allergy, intrathecal antibiotic administration, parasitic infestation, neurosyphilis, and fungal or tuberculosis infection. (Kessler and Cheek 1959;Bosch and Oehmichen 1978;Traynelis, Powell et al 1988;Snow and Kossovsky 1989;Vinchon, Vallee et al 1992;Niggemann, Bauer et al 1997; Lo Re www.intechopen.com…”

Section: Csf Eosinophiliamentioning

confidence: 99%

“…(Traynelis, Powell et al 1988;Jimenez, Keating et al 1994) While eosinophils are normally absent in patients without shunts, their presence is relatively common after shunt placement. We followed CSF samples after initial shunt placement in 300 children.…”

Section: Csf Eosinophiliamentioning

confidence: 99%

Interpretation of Cerebrospinal Fluid Parameters in Children with Hydrocephalus

Fulkerson¹

2012

Hydrocephalus

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Cerebrospinal fluid eosinophilia and sterile shunt malfunction

Cited by 4 publications

References 0 publications

Update on Eosinophilic Meningoencephalitis and Its Clinical Relevance

Update on Eosinophilic Meningoencephalitis and Its Clinical Relevance

Cystoperitoneal Shunt Malfunction in Setting of Rifampin Allergy Presenting as Cerebrospinal Fluid Eosinophilia

Interpretation of Cerebrospinal Fluid Parameters in Children with Hydrocephalus

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