[Treatment of cerebrospinal fluid shunt infections using the Perrin and McLaurin technique. Analysis of 11 cases].

Eleven patients with shunt infection (SI) of the cerebrospinal fluid in whom the SI was withdrawn and replaced by a new SI system with reservoir and intraventricular and parenteral antibiotic treatment were reported. The diagnosis was made by culture of the components of the SI and, or, the cerebrospinal fluid. In 9 cases the agent was a staphylococcus. The different therapeutic trials to treat SI infections can be summarized as follows: a) replacement of the SI by an external drainage, antibiotics, and reinsertion of the SI when the cerebrospinal fluid was sterilized; b) withdrawal of the SI and placement of a new SI in the same surgical procedure associated with intraventricular and systemic antibiotic treatment; and c) treatment with intraventricular and, or, systemic antibiotics. It has been demonstrated that the surgical approach (a and b) is more effective. In our series the procedure indicated in B was followed by the control of the infection in all cases. The follow-up of the surgical treatment was 1-3 years. The most currently used SI was the ventriculoperitoneal bypass. Their main complications are pseudocysts which are easily recognized by of abdominal echography and frequently revealed SI infection. Diagnosis and treatment of SI infections should take into account the type of complications and the most appropriate collaboration with other clinical departments.