Cerebrospinal Fluid Shunt Infections

Shunt is the most common approach among medical and surgical treatment modalities for treating hydrocephalus. The main purpose of the shunt is to reduce intracranial pressure by draining the cerebrospinal fluid (CSF) from the ventricles. Infection is one of the serious complications and it develops in approximately 5-15% of the inserted devices. The microorganisms responsible for the shunt infection usually arise from the normal flora of the skin. During the surgical procedure and healing period, microorganisms residing in skin may adhere to the shunt and start the infection. The clinical symptoms may differ according to the type of shunt used. Abdominal pain is the most common complaint in patients with infected ventriculo-peritoneal (VP) shunt. On the other hand, fever is the leading symptom in ventriculo-atrial (VA) shunt infection. Other than clinical signs, biochemical and microbiological analysis of CSF are necessary to diagnose shunt infection. The gold standard of treatment is the usage of antibiotics with shunt revision. In addition to parenteral antibiotics, intraventricular administration of antibiotics may be an essential part of the treatment. The most efficient way to avoid shunt infection is to follow the strict rules for preventing surgical site infections.