Surgical Management of Infection of the Central Nervous System, Skull, and Spine

Silva, Harley Brito da; Coimbra, P.; Rocha, R. P.; Filho, Flávio Leitão; Deinsberger, Wolfgang

doi:10.1016/b978-0-323-43140-8.00059-7

Cited by 1 publication

(3 citation statements)

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“…Interestingly, abdominal tenderness, guarding and rigidity may develop in patients with VP shunt who develop peritonitis [ 10 ]. Abdominal pseudocysts at the distal end of the shunt can cause partial or complete shunt obstruction [ 11 ]. These patients usually present with an unexplained occlusion of the peritoneal catheter or failure of peritoneal CSF absorption.…”

Section: Reviewmentioning

confidence: 99%

“…Local symptoms, such as erythema, pain, and purulence, may be present along the course of the shunt, although this is an inconsistent finding, and were present in 49% of cases in the retrospective analysis and 26% in the review article [ 9 ]. Clinically, individual symptoms are not typically both sensitive and specific [ 10 - 11 ]. Because most shunt infections occur in the first few months after shunt surgery, the positive and negative predictive values of individual symptoms will depend on when the shunt procedure was performed [ 11 - 12 ].…”

Section: Reviewmentioning

confidence: 99%

“…Clinically, individual symptoms are not typically both sensitive and specific [ 10 - 11 ]. Because most shunt infections occur in the first few months after shunt surgery, the positive and negative predictive values of individual symptoms will depend on when the shunt procedure was performed [ 11 - 12 ].…”

Section: Reviewmentioning

confidence: 99%

See 2 more Smart Citations

Challenges in the Management of Gram-Negative Bacterial Infections in Patients With Ventriculoperitoneal Shunt

Ahmad¹,

Brubaker²,

Rajendraprasad³

et al. 2021

Cureus

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Gram-negative bacterial infections of the central nervous system (CNS) have worse clinical outcomes. The most common bacteria include Escherichia Coli , Citrobacter species, Enterobacter species, Serratia species, and Pseudomonas aeruginosa . There are multiple risk factors for CNS infection after shunt insertion, including younger age, obstructive hydrocephalus, shunt revision surgery, and trauma. The clinical presentation of a ventriculoperitoneal (VP) shunt infection includes the signs and symptoms of meningitis to fever with abdominal pain and peritonitis. Apart from cerebrospinal fluid (CSF) analysis, microbiological cultures and radiological studies are key diagnostic tools. Initial empirical intravenous antimicrobial therapy is preferably broad spectrum with appropriate coverage for resistant Gram-negative pathogens and the duration of treatment depends upon pathogenesis, host factors, and clinical response to the therapy. Considering the importance of this disease and associated clinical outcomes, in this review article, we have summarized the epidemiology, clinical features, management, and prevention of Gram-negative VP shunt infections in adults.

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Section: Reviewmentioning

confidence: 99%