[Treatment of infected ventriculo-atrial shunts]

The paper presents the incidence of infection observed in 108 patients subjected to ventriculoatrial shunting at the Department of Neurosurgery, University Medical Centre of Ljubljana. Infection was established in 17 (15.8%) Pudenz's shunts. It is most likely to develop within the first year following the shunt implantation. The most common clinical symptom associated with the shunt infection is an obscure, moderately elevated body temperature (about 38 degrees C) of several weeks duration. The infected shunt should be removed without delay and replaced by external ventricular drainage with an uniflow valve and an added piece for the intraventricular administration of the antibiotic. Before the results of the cerebrospinal fluid and drainage system cultures are known, the Methicillin therapy of 200 mg/kg daily should be initiated and followed by the adequate antibiotic therapy consistent with the culture findings. Should the antibiotic therapy administered by this route fail to control the infection, additional intraventricular instillation is to be instituted.