To define the risk of multiloculated hydrocephalus (MLH) following gram negative organisms (GNO) shunt infection. Materials and Methods :
The authors carried out a retrospective study of 10 cases of GNO shunt infection that were treated at Zagazig University Hospital from 1994-1997. Results :
There were 6 males and 4 females with a median age of 3 months. Hydrocephalus followed an interventricular hemorrhage in 6 cases. The GNO shunt infection was diagnosed at a median of 30 days after the original shunting. Pseudomonas aeruginosa was the commonest organism. The median sterilization time of cerebrospinal fluid (CSF) was 15 days of external ventricular drainage. Eight (80%) cases developed MLH which was diagnosed at a median of 2 months after the shunt infection. This was significantly higher than the 10% of MLH following shunt infection by staphylococcus epidermidis at Zagazig University Hospital. At a median follow-up of 20 months the mean shunt revision ,rateof our GNO shunt infected patients was 0.22/year. One patient died of meningo-enceplzalitis and 5 remain severely disabled. Conclusion :
Clinicians sfwuld be aware of the increased risk of MLH following GNO shunt infection particularly in patients with posthemorrhagic hydrocephalus. Every effort should be made to diagnose the shunt infection early and to treat it aggressively. |
