Case Series: Pediatric Shunt Tunnel Catheter Infection

Shunt infections are common pediatric neurosurgical cases with high morbidity that almost always requires surgical removal of the shunt, external ventricular drain placement, and delayed shunt replacement. Tunnel infections are well-described clinical entities occurring with indwelling catheters, whereby the indwelling tunnel portion of a line becomes externally infected with a sterile central lumen. These infections are typically treated with line replacement or antibiotics depending on clinical circumstances. We describe 2 cases of shunt tunnel infection. Both cases presented as erythema over the thoracic portion of the shunt without signs of CNS infection, with only a remote history of shunt surgery and no recent systemic illness. One case was treated with a course of antibiotics, and the other with surgical removal and eventual replacement. Both children made full recoveries. Our case series juxtaposes 2 alternative successful strategies for treating the rare entity of shunt tunnel infection.