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Colon Ascendens Stent Peritonitis (CASP) - a Standardized Model for Polymicrobial Abdominal Sepsis
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Spontaneous bacterial peritonitis in patients with ventriculoperitoneal shunts

S J Gaskill1, A E Marlin

  • 1Pediatric Neurosurgery of South Texas, PA, San Antonio, USA.

Pediatric Neurosurgery
|March 1, 1997
PubMed

Insights

Spontaneous bacterial peritonitis (SBP) is a serious infection. This study describes 7 cases of SBP in patients with ventriculoperitoneal shunts, a previously undocumented association, suggesting a potential link between shunt function and infection risk.

Area of Science:

  • Infectious Diseases
  • Neurosurgery
  • Gastroenterology

Background:

  • Spontaneous bacterial peritonitis (SBP) is a peritoneal fluid infection without a clear intra-abdominal source, often seen in cirrhotic ascites.
  • While intestinal flora are common culprits, culture-negative SBP occurs.
  • Ventriculoperitoneal shunts are used to manage cerebrospinal fluid imbalances.

Purpose of the Study:

  • To describe the novel occurrence of spontaneous bacterial peritonitis (SBP) in patients with ventriculoperitoneal (VP) shunts.
  • To investigate the clinical features and potential etiologies of SBP in this unique patient population.
  • To provide recommendations for the recognition and management of SBP in patients with VP shunts.

Main Methods:

  • Case series review of 7 patients with ventriculoperitoneal shunts diagnosed with spontaneous bacterial peritonitis.
  • Analysis of patient histories, including shunt revision history, and microbiological cultures (peritoneal fluid and cerebrospinal fluid).
  • Review of existing literature and proposed theories regarding SBP etiology in shunted patients.

Main Results:

  • Seven cases of SBP were identified in patients with VP shunts, a previously undescribed association.
  • Patients typically had a remote history of shunt revision (mean 3.4 years) and cultures consistent with intestinal flora.
  • Cerebrospinal fluid cultures were often negative, but positive results suggested an ascending shunt infection.

Conclusions:

  • Ventriculoperitoneal shunts may predispose patients to SBP, potentially due to cerebrospinal fluid acting similarly to ascitic fluid.
  • SBP in shunted patients may represent a continuum of intra-abdominal processes, even without peritoneal fluid accumulation.
  • Early recognition and appropriate management are crucial for SBP in patients with VP shunts.

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