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Central Nervous System Device Infections.

Rodrigo Hasbun1

  • 1Department of Medicine, Section of Infectious Diseases, The University of Texas Health Science Center at Houston, 6431 Fannin St. MSB 2.112, Houston, TX, 77030, USA. Rodrigo.Hasbun@uth.tmc.edu.

Current Infectious Disease Reports
|October 1, 2016
PubMed
Summary
This summary is machine-generated.

Nosocomial meningitis associated with central nervous system (CNS) devices presents diagnostic challenges. Device removal and repeat cultures are crucial for successful treatment outcomes in these complex infections.

Keywords:
Cerebrospinal fluid shunt or drainsDeep brain stimulatorsIntrathecal pumpsNosocomial meningitis

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Area of Science:

  • Neuroscience
  • Infectious Diseases
  • Neurosurgery

Background:

  • Nosocomial meningitis linked to central nervous system (CNS) devices like shunts, pumps, and stimulators leads to significant patient morbidity and mortality.
  • Diagnosing CNS device-associated meningitis is challenging due to potential negative cerebrospinal fluid cultures from prior antibiotics and confounding cerebrospinal abnormalities.

Purpose of the Study:

  • To highlight the diagnostic and therapeutic challenges of nosocomial meningitis in patients with CNS devices.
  • To emphasize the critical role of device management in achieving successful treatment outcomes.

Main Methods:

  • Review of clinical presentations and diagnostic difficulties in CNS device-associated meningitis.
  • Discussion of therapeutic strategies including antibiotic administration and device management.

Main Results:

  • Cerebrospinal fluid cultures may be falsely negative, complicating diagnosis.
  • Cerebrospinal abnormalities can be attributed to the underlying neurosurgical condition rather than infection.
  • Device removal with repeat cultures is a key factor for successful treatment.

Conclusions:

  • Effective management of nosocomial meningitis in CNS device patients requires a multifaceted approach.
  • Surgical intervention, including device removal and re-implantation after negative cultures, is paramount for infection eradication and patient recovery.