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Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
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Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such...
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Gonococcal Infection and Ventriculoperitoneal Shunts.

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Neisseria gonorrhoeae, a common cause of pelvic inflammatory disease, can rarely infect ventriculoperitoneal shunts. Two adolescent cases of Neisseria gonorrhoeae shunt infection required externalization for treatment.

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Area of Science:

  • Infectious Diseases
  • Neisseria gonorrhoeae Infections
  • Pediatric Neurosurgery

Background:

  • Pelvic inflammatory disease (PID) is frequently caused by Neisseria gonorrhoeae and Chlamydia trachomatis.
  • Disseminated Neisseria gonorrhoeae infections outside the genitourinary tract are uncommon.
  • Ventriculoperitoneal shunts are used to treat hydrocephalus in pediatric patients.

Purpose of the Study:

  • To report two cases of ventriculoperitoneal shunt infection caused by Neisseria gonorrhoeae in adolescents.
  • To highlight the rare extra-genital manifestation of Neisseria gonorrhoeae infection.
  • To discuss the management of such complex shunt infections.

Main Methods:

  • Case report of two adolescent patients with ventriculoperitoneal shunt infection.
  • Identification of Neisseria gonorrhoeae as the causative agent.
  • Description of the clinical course and treatment, including shunt externalization.

Main Results:

  • Both patients presented with ventriculoperitoneal shunt infection due to Neisseria gonorrhoeae.
  • The infection necessitated externalization of the ventriculoperitoneal shunt for effective management.
  • Successful treatment outcomes were achieved following appropriate interventions.

Conclusions:

  • Neisseria gonorrhoeae should be considered in the differential diagnosis of shunt infections, even in the absence of typical genitourinary symptoms.
  • Prompt recognition and management, including shunt externalization, are crucial for favorable outcomes in ventriculoperitoneal shunt infections caused by Neisseria gonorrhoeae.
  • This presentation underscores the importance of considering rare pathogens in complex pediatric neurosurgical infections.