by EBSCO Medical Review Board
(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 before
  • People who have a gastrostomy (feeding) tube

Other things that can increase the risk of infection 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

People with a CSF shunt infection may have:

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

Rarely, some people will not have symptoms.

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

The goal of treatment is to get rid of the infection. How that is done will depend on your overall health and infection. Options are:

  • Antimicrobial medicine to help your body kill the bacteria.
  • Surgery to remove the shunt. 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 get 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. Accessed April 15, 2022.

Complications of shunt systems. Hydrocephalus Association website. Available at: https://www.hydroassoc.org/complications-of-shunt-systems/. Accessed April 15, 2022.

Hanak, B.W., Bonow, R.H., et al. Cerebrospinal fluid shunting complications in children. Pediatric Neurosurgery, 2017; 52(6): 381-400.

Shunt infections. About Kids Health—The Hospital for Sick Children website. Available at: https://www.aboutkidshealth.ca/Article?contentid=954&language=English. Accessed April 15, 2022.

Revision Information