HIGH RATE
VENTRICULOPERITONEAL CSF SHUNT INFECTIONS IN INFANTS AND CHILDREN
AHMED K.
MANSOUR, NABIL MANSOUR ALI
The Departments of Pediatrics
Neurosurgery
Faculty of
Mrdicine, Mansoura University- Mansoura, Egypt
This study was can ducted on ventriculo
peritoneal (V.P) shunt procedures performed for infants and childern (up to
15 years old) in Mansoura University Hospital and Mansoura Emergency
Hospital during 6 years period (1993 to 1999). A total of 247 patients
underwent V.P. shunt procedures during this time period. Excluding produres
done for infection, the former patients underwent 275 procedures (231 new
implantations and 44 revisions). Of these infections occurred in 54
patients (22% per patient and 19.6 % perper procedure ) during a median follow-up
period of 3.9 years (6 months to 6.5 years) The infection rate in our in
ststitution was 22%. Infants comprise 65% of this group. In our material,
she highest risk of CSF shunt infection was infants 6 months or less of
age, in postmeningitic cases and in shunt revision performed within 6
months of the primary shunting. Various protocols of management have been
compared as to their efficacy. The highest cure rate was achieved when the
shunt was removed followed by a period of intravenous antibiotics (Without
intraventricular siliastic tubing) and later by delayed shunt replacement.
Externalization of the shunt and external ventricular drainage (EVD) Were
associated with high incidence of relapse. The dismal outcome of CSF shunt
infection in this age group calls for prevention, early diagnosis and
aggressive management of this serious illness