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Fever as the initial sign of malfunction in non infected ventriculoperitoneal shunts
E Ashkenazi1, F Umansky, S Constantini
1Department of Neurosurgery, Hadassah University Hospital, Jerusalem, Israel.
Insights
Fever in children with shunted hydrocephalus may indicate ventriculoperitoneal shunt malfunction. Prompt neurosurgical evaluation is crucial for diagnosis and treatment, leading to fever resolution post-correction.
Area of Science:
- Pediatric Neurosurgery
- Infectious Disease in Children
Background:
- Ventriculoperitoneal shunts are vital for managing hydrocephalus in children.
- Shunt malfunction is a common complication requiring timely intervention.
Observation:
- Fifteen of 68 pediatric patients (22%) presented with fever >37.5°C.
- Fever lacked an identifiable source on physical examination or via cultures (CSF, urine, blood).
Findings:
- All patients underwent surgery to correct shunt malfunction.
- Fever resolved within 24–36 hours postoperatively in all cases.
Implications:
- Fever of unknown origin in shunted hydrocephalus patients warrants consideration of shunt malfunction.
- Early neurosurgical consultation is recommended for prompt diagnosis and management.
Abstract:
Sixty eight children were treated for ventriculoperitoneal shunt malfunction in our department during the years 1984-1989. Fifteen (22%) developed fever above 37.5 degrees C as a presenting sign of their shunt malfunction. Physical examination did not reveal any reason for the fever. Cerebrospinal fluid, urine and blood cultures were all negative. All the children were operated upon and the malfunction corrected. Fever subsided twenty four to thirty six hours after the operation in all the patients. Fever of unknown origin in children with shunted hydrocephalus might be the first sign of a developing shunt malfunction and a neurosurgical examination should be requested.