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Intracerebral sepsis due to intestinal perforation by ventriculo-peritoneal shunts: two cases
S Panagea1, T D Cartmill, H Panigrahi
1Department of Microbiology, North Manchester General Hospital, U.K.
Abstract:
Two cases of ventriculo-peritoneal (V-P) shunt infection attributable to intestinal perforation are reported. One patient developed a brain abscess, the other ventriculitis. Microbiology consisted of faecal flora and the peritoneal catheter was found to be faecally stained in both cases. There were no abdominal symptoms or signs. It is likely that infection developed via the ascending route.
Insights
Ventriculo-peritoneal shunt infections can occur from intestinal perforation, leading to brain abscess or ventriculitis. This occurs via an ascending route, even without abdominal symptoms.
Area of Science:
- Neurosurgery
- Infectious Diseases
- Gastroenterology
Background:
- Ventriculo-peritoneal shunts are crucial for managing hydrocephalus.
- Shunt infections are a significant complication, often requiring revision surgery.
- Intestinal perforation is a rare but serious cause of shunt infection.
Observation:
- Two cases of ventriculo-peritoneal shunt infection were identified.
- Infections were linked to intestinal perforation.
- Patients presented with brain abscess or ventriculitis.
- Microbiology revealed fecal flora, with stained peritoneal catheters.
Findings:
- The shunt infections were attributed to an ascending route from intestinal perforation.
- Absence of abdominal symptoms in both cases.
- Faecal staining of the peritoneal catheter confirmed the route of contamination.
Implications:
- Highlights a non-obvious pathway for shunt infection development.
- Emphasizes the need for vigilance in diagnosing shunt infections, even without typical gastrointestinal signs.
- Suggests potential diagnostic or preventative strategies targeting the gastrointestinal tract in specific patient populations.