Department of Neurosurgery, General Hospital Bamberg, Bamberg, Germany.
Department of Neurosurgery, University Hospital Tuebingen, Tuebingen, Germany.
J Neurol Surg A Cent Eur Neurosurg. 2024 Nov;85(6):622-624. doi: 10.1055/a-2156-5520. Epub 2023 Aug 18.
Ventriculoperitoneal (VP) shunt infections are a fairly common complication in both the early and late postoperative periods. Sometimes diagnosis is difficult despite the fact that infection is often accompanied by clinical symptoms. Furthermore, pathogenic bacteria can be detected in the cerebrospinal fluid.
We describe a case of chronic VP shunt infection in a 24-year-old female patient who was operated on for posterior fossa pilocytic astrocytoma and needed a VP shunt. The infection revealed itself 5 years after shunt implantation with nonspecific symptoms, and it took approximately 2 years to make a correct diagnosis. Meanwhile, the patient's condition became critical. The infection was caused by , which is capable of forming biofilms on implants, and which is difficult to identify due to the peculiarity of its cultivation.
When the bacterium was identified, the shunt was replaced and antimicrobial therapy was performed, after which the patient's condition improved dramatically and she got back to her normal life.
This case shows how difficult the diagnosis of VP shunt infection can be and what clinical significance it can have for the patient.
脑室-腹腔(VP)分流感染是早期和晚期术后相当常见的并发症。尽管感染通常伴有临床症状,但有时诊断仍很困难。此外,脑脊液中可检测到病原菌。
我们描述了一例 24 岁女性患者慢性 VP 分流感染的病例,该患者因后颅窝毛细胞星形细胞瘤而接受手术,并需要 VP 分流。分流植入 5 年后出现非特异性症状,大约 2 年后才做出正确诊断。在此期间,患者病情危急。感染是由 引起的,这种细菌能够在植入物上形成生物膜,由于其培养的特殊性,很难识别。
当鉴定出细菌时,更换了分流管并进行了抗菌治疗,此后患者的病情显著改善,恢复了正常生活。
本病例表明 VP 分流感染的诊断有多么困难,以及对患者的临床意义有多大。