Management of the colonised shunt

A system of management is described for colonised hydrocephalus shunts. If organisms have reached the lateral ventricles as well as the valve chamber, the shunt must be removed and the ventricles drained externally with instillation of a suitable antibiotic until the fluid is sterile. If the ventricular fluid is not infected the shunt can safely be replaced at the same operation, using a site on the opposite side of the head. The operation has been performed 12 times without reinfection.