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(CSF Shunt Infection)

Definition

Cerebrospinal fluid (CSF) is a clear fluid that protects the brain and spinal cord. A CSF shunt drains excess fluid from the brain into another part of the body.

An infection can develop in the shunt. It needs to be treated quickly to keep it from spreading.

Causes

It can be easier for germs to stick to medical devices like shunts. Bacteria that sticks to the shunt can grow into an infection.

Risk Factors

Infection is more common in:

  • Babies who are born too early
  • Older adults
  • People who have had a shunt infection in the past

Other factors are:

  • Problems during surgery, such as a long surgery or infection
  • Problems after surgery, such as CSF leaking
  • Need for a second surgery to replace part or all of the shunt

Symptoms

The infection may cause:

  • Fever
  • Redness, discharge, swelling, and pain
  • Headache
  • Nausea and vomiting
  • Fatigue
  • Irritability
  • Change in mental status or behavior
  • Seizures

Some will not have symptoms but it is rare.

Diagnosis

Your doctor will check the area around the shunt. Blood and CSF fluid may be tested. It will show signs of infection and the specific germ that caused it.

Images may be taken to find the source of the infection. This can be done with:

Treatment

Treatment will depend on your overall health and infection. Options include:

  • Medicine—antimicrobial medicine. It will help your body kill the bacteria.
  • Surgery—the shunt may need to be removed. An external shunt will be placed until the infection clears. The internal shunt may be placed again once the infection has cleared.

Prevention

When you are getting a shunt, your care team will take steps to lower your chances of infection. This may mean:

  • Using tubes that are treated with antibiotics
  • Giving you antimicrobial medicine before surgery

RESOURCES

Family Doctor—American Academy of Family Physicians  http://www.familydoctor.org 

Hydrocephalus Association  https://www.hydroassoc.org 

CANADIAN RESOURCES

Canadian Patient Safety Institute  http://www.patientsafetyinstitute.ca 

Health Canada  https://www.canada.ca 

References

Central nervous system device infections. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/central-nervous-system-device-infections . Updated August 12, 2019. Accessed October 25, 2019.

Complications of shunt systems. Hydrocephalus Association website. Available at: https://www.hydroassoc.org/complications-of-shunt-systems/. Accessed October 25, 2019.

Schreffler RT, Schreffler AJ, et al. Treatment of cerebrospinal fluid shunt infections: a decision analysis. Pediatr Infect Dis J. 2002 Jul;21(7):632-636.

Shunt infections. About Kids Health—The Hospital for Sick Children website. Available at: https://www.aboutkidshealth.ca/Article?contentid=954&language=English. Updated November 10, 2009. Accessed October 25, 2019.

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