Treatment of Infections of Cerebrospinal Fluid Shunts

医学 脑脊液 脑膜炎 内科学 外科
作者
R. L. McLaurin,Peter T. Frame
出处
期刊:Clinical Infectious Diseases [Oxford University Press]
卷期号:9 (3): 595-603 被引量:50
标识
DOI:10.1093/clinids/9.3.595
摘要

There is no unanimity at present concerning the best method of treatment of cerebrospinal fluid shunt-related infections. The most frequently used method includes removal of the shunt followed by antibiotic therapy and later replacement of the shunt. The experience at the University of Cincinnati during the past 15 years indicates that many shunt infections can be effectively treated without shunt removal. This report summarizes experiences with 11 consecutive ventriculoperitoneal shunt infections. These were treated by externalization of the peritoneal catheter followed by intraventricular and systemic antimicrobial therapy and by later replacement of the peritoneal catheter. The advantages of this method include the avoidance of two major operative procedures and the elimination of a period in which the intracranial pressure is not controlled. The need for externalization of the peritoneal catheter relates to the occurrence of localized peritoneal infection and pseudocyst formation, which preventscure of the infection in many instances if the catheter is left in place. After follow-up periods of four months to five years, 10 of the 11 patients have apparently been cured of their infection.

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