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Shunt infection

Brittany J Guest, Michael H Merjanian, Emily F Chiu, Caleb P Canders
Abdominal pseudocysts are rare complications of ventriculoperitoneal (VP) shunts characterized by accumulations of cerebrospinal fluid surrounded by fibrous layers in the intra-abdominal cavity or abdominal wall. We present a woman with bilateral VP shunts who presented with right-sided abdominal distension, pain, and tenderness and who was found to have an abdominal pseudocyst on point-of-care ultrasound and computed tomography. Given the potential to develop a secondary infection or VP shunt malfunction, it is important for emergency providers to consider intra-abdominal complications of VP shunts, including rare ones such as abdominal pseudocysts, in these patients who present with vague abdominal complaints...
February 2019: Clinical practice and cases in emergency medicine
Yuma Okamura, Keisuke Maruyama, Shin Fukuda, Hiroshi Horikawa, Nobuyoshi Sasaki, Akio Noguchi, Motoo Nagane, Yoshiaki Shiokawa
OBJECTIVEWhile cerebrospinal fluid (CSF) shunt surgery plays an essential role in the treatment of hydrocephalus, postoperative infection due to the implantation of foreign materials is still one of the most common and potentially serious complications of this procedure. Because no previously reported protocol has been proven to prevent postoperative infection after CSF shunt surgeries in adults, the authors investigated the effectiveness of a protocol introduced in their institution.METHODSA detailed standardized surgical protocol to prevent infection in patients undergoing CSF shunt surgeries was introduced in the authors' institution in December 2011...
February 15, 2019: Journal of Neurosurgery
Tamara D Simon, Matthew P Kronman, Kathryn B Whitlock, Samuel R Browd, Richard Holubkov, John R W Kestle, Abhaya V Kulkarni, Marcie Langley, David D Limbrick, Thomas G Luerssen, W Jerry Oakes, Jay Riva-Cambrin, Curtis Rozzelle, Chevis N Shannon, Mandeep Tamber, John C Wellons, William E Whitehead, Nicole Mayer-Hamblett
OBJECTIVECSF shunt infection treatment requires both surgical and antibiotic decisions. Using the Hydrocephalus Clinical Research Network (HCRN) Registry and 2004 Infectious Diseases Society of America (IDSA) guidelines that were not proactively distributed to HCRN providers, the authors previously found high adherence to surgical recommendations but poor adherence to intravenous (IV) antibiotic duration recommendations. In general, IV antibiotic duration was longer than recommended. In March 2017, new IDSA guidelines expanded upon the 2004 guidelines by including recommendations for selection of specific antibiotics...
February 15, 2019: Journal of Neurosurgery. Pediatrics
Gabriele Gradner, Rose Kaefinger, Gilles Dupré
BACKGROUND: Several case series and case reports have been published about idiopathic hydrocephalus treatment in dogs and cats using ventriculoperitoneal shunts (VPS). OBJECTIVES: To determine the risk and type of complications in dogs and cats after VPS placement. ANIMALS: Sixteen papers were included. Sixty dogs and 13 cats with idiopathic hydrocephalus treated by VPS placement were identified. METHODS: The databases CAB, Scopus, and Medline were used...
February 12, 2019: Journal of Veterinary Internal Medicine
Evgeni V Nikolaev, Andrew Zloza, Eduardo D Sontag
It was recently reported that acute influenza infection of the lung promoted distal melanoma growth in the dermis of mice. Melanoma-specific CD8+ T cells were shunted to the lung in the presence of the infection, where they expressed high levels of inflammation-induced cell-activation blocker PD-1, and became incapable of migrating back to the tumor site. At the same time, co-infection virus-specific CD8+ T cells remained functional while the infection was cleared. It was also unexpectedly found that PD-1 blockade immunotherapy reversed this effect...
2019: Frontiers in Immunology
Nimrah Abbasi, Greg Ryan
Fetal pleural effusions can be associated with significant perinatal morbidity and mortality. When diagnosed antenatally, referral to a tertiary fetal medicine center is recommended for a detailed ultrasound evaluation for additional structural abnormalities or features suggestive of congenital infections or fetal anemia. The effusions should be characterized as unilateral or bilateral, and presence of hydrops and/or mediastinal shift should be documented. Additional testing should include fetal echocardiography, maternal testing for blood group and screen, hemoglobinopathies, and congenital infections...
January 12, 2019: Best Practice & Research. Clinical Obstetrics & Gynaecology
Christopher A Latz, Richard P Cambria, Virendra I Patel, Jahan Mohebali, Emel A Ergul, R Todd Lancaster, Mark F Conrad, W Darrin Clouse
OBJECTIVE: Early outcomes and late mortality after open repair of extent I to III thoracoabdominal aortic aneurysms (TAAAs) are described, but late graft and aortic events are seldom detailed. This study investigated long-term aortic and graft outcomes as these data are increasingly important as endovascular repair matures. METHODS: During 28 years, 516 patients underwent repair (type I, n = 177 [34%]; type II, n = 100 [20%]; type III, n = 239 [46%]). Patients were monitored for late events...
February 5, 2019: Journal of Vascular Surgery
R Ved, E Bentley, A Amato-Watkins, J Lang, G Zilani, I Bhatti, P Leach
INTRODUCTION: Ventriculo-peritoneal shunts (VPS) are still the mainstay treatment for hydrocephalus in children. It is generally accepted that VPS failure and infection rates are higher for neonates than for older children. We compared our 1-year failure and infection rates in under 3-month-old children compared with older children in our department. RESULTS: We identified 58 children under 3 months of age who underwent VPS insertion between January 2007 and December 2016...
February 8, 2019: British Journal of Neurosurgery
FuMei Chen, Xianyu Deng, Zhanpeng Wang, Li Wang, Ke Wang, Liang Gao
Background: Severe ventriculitis (SV) caused by multidrug-resistant bacteria is associated with high morbidity and mortality in neurosurgical patients. This study assessed the outcomes of patients with SV caused by Acinetobacter baumannii who were treated by intraventricular (IVT) lavage and colistin administration. Methods: This retrospective study included consecutive patients with SV caused by A. baumannii who were admitted at the Neurosurgical Department of Shanghai Tenth People's Hospital from January 2014 to September 2017...
2019: Infection and Drug Resistance
John R W Kestle, Jay Riva-Cambrin
Prospective multicenter clinical research studies in pediatric hydrocephalus are relatively rare. They cover a broad spectrum of hydrocephalus topics, including management of intraventricular hemorrhage in premature infants, shunt techniques and equipment, shunt outcomes, endoscopic treatment of hydrocephalus, and prevention and treatment of infection. The research methodologies include randomized trials, cohort studies, and registry-based studies. This review describes prospective multicenter studies in pediatric hydrocephalus since 1990...
February 1, 2019: Journal of Neurosurgery. Pediatrics
Zhipeng Shen, Ning Wang, Wujie Shi, Peiliang Zhang, Jianbin Weng, Hanhai Zeng
RATIONALE: Brain magnetic resonance imaging (MRI) images of atypical teratoid rhabdoid tumor (ATRT) often present heterogeneous signals of various cells without remarkable features of the disease. We describe a unique case of atypical brain MRI images presenting as an type II neurofibromatosis and explore some diagnostic hints. PATIENT CONCERNS: A 1-year-and-7-month-old boy admitted to our department with a 7-day history of drowsiness and 2-day history of emesis, and his presenting complaint was repeated vomit...
February 2019: Medicine (Baltimore)
W Ji, Z F Zhang, J Shen, L J Fu, L Shi, Y W Chen, F Li
Objective: To access the feasibility, effectiveness and safety of transcatheter closure of ventricular septal defect (VSD) with right coronary cusp bulge. Methods: The study population consisted of 40 children (22 boys and 18 girls) undergoing transcatheter intervention for VSD with right coronary cusp bulge in Shanghai Children's Medical Center from August 2013 to June 2017. All patients were examined using transthoracic echocardiography and cardiovascular angiography before occlusion and received transcatheter closure of VSD by placing an occlude...
February 2, 2019: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Semih K Olguner, Bulent Boyar, Derya Alabaz, Tahsin Erman, Kadir Oktay, Ali Arslan, Emre Bilgin, Ali Ihsan Okten
PURPOSE: Ventriculitis is known to develop after chronic inflammation and bacterial invasion of the ventricular surface with a recurrence of shunt infections. The aim of this study is to evaluate the diagnostic value of elevation in cerebrospinal fluid (CSF) interleukin-1 beta (IL-1β) and tumor necrosis factor alpha (TNF-α) together with CSF culture and laboratory test results in the diagnosis of ventriculoperitoneal (VP) shunt-related ventriculitis, which is known to be more problematic than conventional shunt infection...
January 28, 2019: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Ayse Şahin, Nazan Dalgic
The rate of ventriculoperitoneal (VP) shunt infection is reported between 3% and 20%. Vancomycin-Resistant Enterococci (VRE) are increasingly prevalent nasocomial pathogens worldwide and they rarely cause infections to the central nervous system. Daptomycin is a cyclic lipopeptide effective antibiotic due to its rapid bactericidal effect. It is a life-saving treatment option for meningitis, bacteriemia, sepsis, endocarditis and urinary system infections caused by VRE. Here, we presented a 2.5-month-old male patient diagnosed with ventriculoperitoneal shunt infection caused by VRE faecium...
January 24, 2019: World Neurosurgery
Justin Z Lee, Pradyumna Agasthi, Ahmed K Pasha, Claudia Tarin, Andrew S Tseng, Nancy N Diehl, David O Hodge, Christopher V DeSimone, Ammar M Killu, Peter A Brady, Krishna Kancharla, Fred M Kusumoto, Komandoor Srivathsan, Michael J Osborn, Raul E Espinosa, Robert F Rea, Malini Madhavan, Christopher J McLeod, Win-Kuang Shen, Yong-Mei Cha, Paul A Friedman, Samuel J Asirvatham, Siva K Mulpuru
BACKGROUND: Stroke can be a devastating complication in patients with cardiovascular implantable electronic device (CIED) infection. Paradoxical septic embolism can occur in the presence of device leads and patent foramen ovale (PFO) via embolic dislodgment during transvenous lead removal (TLR). OBJECTIVE: The purpose of this study was to examine stroke and its associated factors in patients undergoing TLR for CIED infection. METHODS: We performed a retrospective analysis of all patients undergoing TLR for CIED infection from January 1, 2000, to July 30, 2017, from all 3 tertiary referral centers at the Mayo Clinic (Rochester, Phoenix, and Jacksonville)...
November 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
I-Chen Chen, Shih-Chia Yang, Kuan-Ting Liu, Yen-Hung Wu
RATIONALE: Double-lumen hemodialysis catheters are commonly used as temporary hemodialysis routes. Complications include infection, thrombosis, cardiac arrhythmia, entrapped guide wire, and malposition. We report a rare complication of delayed hemodialysis catheter malposition that caused retroperitoneal hemorrhage and hypovolemic shock during hemodialysis. PATIENT CONCERNS: A 72-year-old female patient who was receiving hemodialysis was referred to our emergency department because of general discomfort and decreased blood pressure (BP) after her regular hemodialysis...
January 2019: Medicine (Baltimore)
Cagatay Ozdol, Tolga Gediz, Ahmet Tulgar Basak, Nazlı Basak, Kamran Aghayev
AIM: There is no consensus in the literature regarding the optimal method of obtaining cerebrospinal fluid sample in patients with suspected shunt infections. The most frequently used method is tapping shunt reservoir. Lumbar puncture is an alternative method yet it used far less frequently. MATERIAL AND METHODS: Medical records of pediatric patients with suspected shunt infections were retrospectively analyzed. All patients had cerebrospinal fluid samples obtained either via shunt tapping, lumbar puncture or both...
October 2, 2018: Turkish Neurosurgery
P Y Lou, H Chen, Z H Wu, B Wang
Objective: To report a clinical protocol for the application of ventriculovesical shunts (VV shunts) in patient who may be unable to maintain or receive ventriculoperitoneal (VP) shunts. Methods: 25 patients underwent placement of VV shunts as an alternative to VP shunt therapy from March 2010 through March 2016. They all have malfunction of the VP shunt for the following reasons: peritoneal fluid inclusion(11 cases), failure of the peritoneum to absorb cerebrospinal fluid(7 cases), intra-abdominal infection(5 cases), peritoneal irritation pain(2 cases)...
January 1, 2019: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Philipp Krauss, Markus Florian Oertel, Lennart Henning Stieglitz
OBJECTIVE: Ventriculoperitoneal shunt implantation is a common procedure in general neurosurgery. The patient population is often fragile, ranging from elderly to pediatric patients, and avoidance of perioperative complication is of utmost importance. Abdominal catheter dislocation has been found to be a common cause for early shunt dysfunction and needs to be avoided by optimal visualization of the abdominal catheter insertion zone. Here, we introduce a self-holding wound retractor system Alexis® and demonstrate its use for abdominal shunt surgery in a series of patients...
January 11, 2019: Acta Neurochirurgica
Haider Ali Khattak, Nasim Gul, Shahbaz Ali Khan, Gul Muhammad, Ahsan Aurangzeb, Ibrahim Khan
BACKGROUND: Myelomeningocele is a congenital anomaly of Central Nervous System (CNS) leading to serious sequels related to various systems and organs of the affected patient. Hydrocephalus is a common condition associated with myelomeningocele. Hydrocephalus is seen in 11.8% of children with Myelomeningocele (MMC). This study was conducted to compare the simultaneous vs delayed ventriculoperitoneal shunting in children undergoing myelomeningocele in terms of infection. METHODS: This Randomized Control Trial was conducted at department of Neurosurgery, Ayub Medical College, Abbottabad from 7th March to 7th June 2016...
October 2018: Journal of Ayub Medical College, Abbottabad: JAMC
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