Kumar Vikas, Loomba Poonam Sood, Singh Daljit, Saran Ravindra Kumar
Department of Neurosurgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India.
Department of Microbiology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India.
J Pediatr Neurosci. 2017 Jan-Mar;12(1):83-84. doi: 10.4103/jpn.JPN_149_16.
Cerebrospinal fluid (CSF) shunt failure is commonly associated with infection or mechanical obstruction of the shunt system. A 4-year-old male child who had undergone multiple shunt revisions at another hospital for congenital hydrocephalus and later for shunt obstruction, presented with exposed shunt at the supraclavicular region. Shunt revision was performed. The CSF culture showed no growth; however, the histopathological examination of shunt tube showed growth inside the lumen of silicone tube well away from the tip of ventriculoperitoneal shunt. The skin biopsy from the exposed site revealed foreign body giant cell granulomatous reaction. The patient was discharged on postoperative day 6 without any complications. At 3 months follow-up, the patient is doing well. A growth of within the shunt tube prompted us to think of how the hardware can get infected and may remain a source of constant infection.
脑脊液（CSF）分流失败通常与分流系统的感染或机械性梗阻有关。一名4岁男童因先天性脑积水在另一家医院接受了多次分流修复手术，后来又因分流梗阻接受手术，其锁骨上区域出现分流管外露。进行了分流修复手术。脑脊液培养无细菌生长；然而，分流管的组织病理学检查显示，在硅胶管腔内远离脑室腹腔分流管尖端处有生长物。外露部位的皮肤活检显示有异物巨细胞肉芽肿反应。患者术后第6天出院，无任何并发症。在3个月的随访中，患者情况良好。分流管内的生长物促使我们思考硬件如何会被感染，以及如何可能一直是持续感染的源头。
