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Updated: Mar 1, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Aspergillus Growth within Ventriculoperitoneal Shunt Tube
Vikas Kumar1, Poonam Sood Loomba2, Daljit Singh1
1Department of Neurosurgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India.
Insights
A child with hydrocephalus experienced shunt exposure and infection. Histopathology revealed Aspergillus fungus inside the cerebrospinal fluid (CSF) shunt tube, highlighting potential internal hardware contamination routes.
Area of Science:
- Neurology
- Infectious Diseases
- Biomedical Engineering
Background:
- Cerebrospinal fluid (CSF) shunts are critical for managing hydrocephalus.
- Shunt failure often results from infection or mechanical obstruction.
- Congenital hydrocephalus requires timely and effective management.
Observation:
- A 4-year-old male with congenital hydrocephalus presented with an exposed ventriculoperitoneal shunt.
- The patient had a history of multiple shunt revisions due to obstruction.
- An exposed shunt at the supraclavicular region necessitated surgical revision.
Findings:
- CSF cultures were negative for microbial growth.
- Histopathological examination of the shunt tube revealed Aspergillus fungal growth within the silicone lumen, distant from the shunt tip.
- Skin biopsy showed a foreign body giant cell granulomatous reaction.
Implications:
- Fungal contamination within the shunt lumen, independent of CSF culture results, presents a diagnostic challenge.
- This case suggests potential routes for internal shunt hardware infection.
- Understanding these infection pathways is crucial for preventing recurrent shunt dysfunction and improving patient outcomes.
Abstract:
Cerebrospinal fluid (CSF) shunt failure is commonly associated with infection or mechanical obstruction of the shunt system. A 4-year-old male child who had undergone multiple shunt revisions at another hospital for congenital hydrocephalus and later for shunt obstruction, presented with exposed shunt at the supraclavicular region. Shunt revision was performed. The CSF culture showed no growth; however, the histopathological examination of shunt tube showed Aspergillus growth inside the lumen of silicone tube well away from the tip of ventriculoperitoneal shunt. The skin biopsy from the exposed site revealed foreign body giant cell granulomatous reaction. The patient was discharged on postoperative day 6 without any complications. At 3 months follow-up, the patient is doing well. A growth of Aspergillus within the shunt tube prompted us to think of how the hardware can get infected and may remain a source of constant infection.
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