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Ventriculoperitoneal Shunt infections

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https://www.readbyqxmd.com/read/28344917/fatal-complications-after-pediatric-surgical-interventions-lessons-learned
#1
Willemijn M Klein, Mayke E Van der Putten, Benno Kusters, Bas H Verhoeven
Placement of catheters, drains, shunts, and tubes in children can lead to serious or even fatal complications at the moment of placement, such as hemorrhage at insertion, or in the longterm, such as infections and migration into adjacent organs. The clinician should always be aware of these potential complications, especially if the child is unwell. For postmortem diagnostic evaluation, either with a computed tomography scan or an invasive autopsy, all tubes, drains, shunts, and/or catheters should be left in situ...
January 2017: European Journal of Pediatric Surgery Reports
https://www.readbyqxmd.com/read/28329191/management-of-ventriculoperitoneal-shunt-infections-in-adults-analysis-of-risk-factors-associated-with-treatment-failure
#2
Iván Pelegrín, Jaime Lora-Tamayo, Joan Gómez-Junyent, Nuria Sabé, Dolors García-Somoza, Andreu Gabarrós, Javier Ariza, Pedro Fernández Viladrich, Carmen Cabellos
Background.: Little is known regarding the optimal treatment of ventriculoperitoneal (VP) shunt infections in adults. Our aim was to assess the efficacy of treatment strategies and to identify factors that predict failure. Methods.: Retrospective, observational study of patients aged ≥12 years with VP shunt infections (1980 -2014). Therapeutic approaches were classified under 4 headings: only antibiotics (OA), one-stage shunt replacement (OSSR), two-stage shunt replacement (TSSR), and shunt removal without replacement (SR)...
March 10, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28320186/neurological-complications-after-tuberculous-meningitis-in-a-multi-state-cohort-in-the-united-states
#3
Alexander E Merkler, Alexandra S Reynolds, Gino Gialdini, Nicholas A Morris, Santosh B Murthy, Kiran Thakur, Hooman Kamel
BACKGROUND AND PURPOSE: To assess the rate of neurological complications and mortality after tuberculous meningitis in the United States. METHODS: The authors performed a retrospective cohort study of all patients 18years or older hospitalized for tuberculous meningitis in California between 2005 and 2010, New York between 2006 and 2012, and Florida between 2005 and 2012. Outcomes of interest were mortality and the following neurological complications: stroke, seizure, hydrocephalus requiring a ventriculoperitoneal shunt, vision impairment, and hearing impairment...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28291426/case-report-of-a-6-year-old-girl-with-mycoplasma-hominis-ventriculoperitoneal-shunt-infection
#4
Masanori Sato, Noriko Kubota, Yoshihiko Katsuyama, Yota Suzuki, Yosuke Miyairi, Kisei Minami, Masashi Kasai
Mycoplasma hominis is a rare causative pathogen for surgical site infections after neurosurgical procedures. This organism lacks a cell wall, rendering it undetectable by Gram staining and making it resistant to beta-lactam antibiotics. In addition, some special techniques are required to identify this organism. Thus, it is very difficult to diagnose infections caused by this pathogen. Here, the authors report a pediatric case of M. hominis ventriculoperitoneal shunt (VPS) infection with central nervous system involvement for which beta-lactam antibiotics were not effective and Gram staining revealed no pathogens...
March 3, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28277297/prevention-of-ventriculoperitoneal-shunt-complications-after-intraperitoneal-urological-surgeries
#5
Takashi Ikeda, Sayaka Akiyama, Woo Jin Kim, Susumu Ito, Yuichiro Yamazaki
PURPOSE: To evaluate perioperative management for the prevention of postoperative shunt infection and malfunction after intraperitoneal urological surgery in patients with myelodysplasia and a ventriculoperitoneal shunt. METHODS: From 2005 to 2015, 20 consecutive patients with myelodysplasia and a ventriculoperitoneal shunt who underwent intraperitoneal urological surgeries were managed with the same perioperative regimen. Intraperitoneal surgeries involved opening gastrointestinal tracts, including bladder augmentation by enterocystoplasty, creating continent catheterizable channels and Malone antegrade continent enema...
October 14, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28249297/cerebrospinal-fluid-shunting-complications-in-children
#6
Brian W Hanak, Robert H Bonow, Carolyn A Harris, Samuel R Browd
Although cerebrospinal fluid (CSF) shunt placement is the most common procedure performed by pediatric neurosurgeons, shunts remain among the most failure-prone life-sustaining medical devices implanted in modern medical practice. This article provides an overview of the mechanisms of CSF shunt failure for the 3 most commonly employed definitive CSF shunts in the practice of pediatric neurosurgery: ventriculoperitoneal, ventriculopleural, and ventriculoatrial. The text has been partitioned into the broad modes of shunt failure: obstruction, infection, mechanical shunt failure, overdrainage, and distal catheter site-specific failures...
March 2, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28239499/a-dual-case-of-peritonitis-and-central-nervous-system-infection-caused-by-nutritionally-variant-streptococcal-species
#7
Sussi Vivar, Jennifer E Girotto, Thomas S Murray
Nutritional variant streptococci (NVS) are difficult to identify bacteria that can cause invasive infections such as endocarditis and meningitis. NVS as a cause of peritonitis has not been routinely described. This case of NVS as the etiology of peritonitis associated with previous neurosurgery and ventriculoperitoneal (VP) shunt revision demonstrates its potential role as a significant pathogen in patients with peritonitis and VP shunts. Therapy consists of vancomycin plus a second agent but since there are no standards for susceptibility testing, clinical response remains the standard for determining the efficacy of treatment...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28203330/risk-factors-for-health-care-associated-bloodstream-infections-in-a-neonatal-intensive-care-unit
#8
Sabahattin Ertugrul, Fesih Aktar, Ilyas Yolbas, Ahmet Yilmaz, Bilal Elbey, Ahmet Yildirim, Kamil Yilmaz, Recep Tekin
BACKGROUND: Healthcare-associated bloodstream infections (HCA-BSI) are a major cause of morbidity and mortality in neonatal intensive care units (NICUs). OBJECTIVES: We aimed to determine the causative organisms and risk factors of HCA-BSIs in NICUs. METHODS: This study was performed between January 2011 and December 2014 in the neonatal intensive care unit of Dicle university, Turkey. The study consisted of 126 patients (infected group) with positive blood culture and 126 randomly selected patients (uninfected control group) with negative blood culture after four days of hospitalization...
October 2016: Iranian Journal of Pediatrics
https://www.readbyqxmd.com/read/28192850/intramuscular-migration-of-venous-catheter-as-a-rare-complication-of-ventriculoatrial-shunt-case-report-and-literature-review
#9
Cheng-Che Hung, Hao-Yu Chuang, Hung-Lin Lin, Yen-Tse Chu, Cheng Hsin Cheng
The most common procedure to manage hydrocephalus is a ventriculoperitoneal shunt. Other alternatives include a ventriculoatrial (VA) shunt, ventriculopleural shunt, lumboperitoneal shunt, or ventriculocisternal shunt. The VA shunt is a relatively rare procedure for hydrocephalus. As reported, several complications of VA shunt include obstructions, malposition, shunt infections, endocarditis, heart failure, tricuspid regurgitation, intra-atrial thrombus, and pulmonary hypertension. In this case report and literature review, we discuss a rare case of intramuscular migration of a venous tube 1 year after VA shunt implantation...
February 13, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28186447/cranioplasty-with-autogenous-bone-flaps-cryopreserved-in-povidone-iodine-a-long-term-follow-up-study
#10
Jian Zhang, Fei Peng, Zhuang Liu, Jinli Luan, Xingming Liu, Chang Fei, Xueyuan Heng
OBJECTIVE The aim of this study was to investigate the long-term therapeutic efficacy of cranioplasty with autogenous bone flaps cryopreserved in povidone iodine and explore the risk factors for bone resorption. METHODS Clinical data and follow-up results of 188 patients (with 211 bone flaps) who underwent cranioplasty with autogenous bone flaps cryopreserved in povidone-iodine were retrospectively analyzed. Bone flap resorption was classified into 3 types according to CT features, including bone flap thinning (Type I), reduced bone density (Type II), and osteolysis within the flaps (Type III)...
February 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28180935/clinicopathological-features-and-microsurgical-outcomes-for-giant-pediatric-intracranial-tumor-in-60-consecutive-cases
#11
Ailing Guo, Vigneyshwar Suresh, Xianzhi Liu, Fuyou Guo
PURPOSE: Giant pediatric intracranial tumor (GPIT) remains to be a challenging disease with high morbidity and mortality. METHODS: The clinical data of 60 patients under 18 years of age operated on with GPIT (≥5 cm in diameter) were retrospectively analyzed. RESULTS: Gross total resection was achieved in 46 cases (77%) and subtotal resection was obtained in 14 cases (23%). Ninety percent (47/52) of the cases with obstructive hydrocephalus were resolved remarkably and only 10% (5/52) of the patients needed a ventriculoperitoneal shunt after tumor resection...
February 8, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28147383/incidence-of-secondary-hydrocephalus-after-excision-of-huge-encephaloceles-in-neonates-case-study
#12
Ehab Ahmed El Refaee, Mohamed Ibrahim Refaat, Mohamed Reda
Background Encephaloceles presents as a protrusion of the cranial contents through a defect in the cranium. The most common sites of occurrence are the occipital and frontonasal regions. The surgical outcome is reported to be satisfactory; however, the incidence of hydrocephalus in patients with encephaloceles is variable in the literature. This study investigated the relationship between the size of the encephaloceles and the occurrence of hydrocephalus. Patient and Methods Data of all neonates with encephaloceles who presented to our institution from September 2012 to September 2014 were collected...
February 1, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28106513/long-term-follow-up-of-superior-gluteal-artery-perforator-flap-closure-of-large-myelomeningoceles
#13
Brett A Whittemore, Dale M Swift, Bradley E Weprin, Frederick J Duffy
OBJECTIVE Large myelomeningocele defects and poor surrounding tissue quality make some defects particularly difficult to close primarily. This paper describes the superior gluteal artery perforator (SGAP) flap technique for defect closure and long-term clinical outcomes. METHODS The technique for closing a myelomeningocele with an SGAP flap is described. A retrospective chart review was performed on a cohort of 11 patients who underwent closure in this manner. RESULTS Between 1999 and 2015, 271 myelomeningoceles were closed, 11 of which were SGAP flap closures...
March 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28097382/ventriculoperitoneal-shunt-malfunction-caused-by-fractures-and-disconnections-over-10%C3%A2-years-of-follow-up
#14
Fatih Serhat Erol, Sait Ozturk, Bekir Akgun, Metin Kaplan
PURPOSE: We have discussed the diagnosis and treatment approaches in patients with discontinued (disconnected or fractured) ventriculoperitoneal (VP) shunts that caused mechanical dysfunction. METHODS: Between 2006 and 2016, VP shunt surgery was performed on 1357 pediatric patients in our clinic. In follow-up examinations, we retrospectively reviewed patients who underwent revision surgery. Except for diagnosis of discontinued VP shunt, by excluding revision-surgery patients, only those patients who underwent surgical treatment owing to discontinued (fracture or disconnection) catheter were included in the study...
January 17, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28087192/spontaneous-peritoneal-catheter-knot-formation-a-rare-cause-of-ventriculoperitoneal-shunt-malfunction
#15
Idrees Sher, Shanu Gambhir, Sarah Pinto, Asim Mujic, Jens Peters-Willke, Andrew Hunn
Ventriculoperitoneal (VP) shunting remains invaluable in the management of hydrocephalus. It is a common procedure that can be complicated by shunt malfunction due to infection, blockage and disconnection. Spontaneous peritoneal catheter knot formation causing CSF flow obstruction is a rare phenomenon. We present a case of a 12years old boy with spontaneous knot formation in the peritoneal catheter causing VP shunt obstruction and hydrocephalus.
April 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28050444/review-of-the-management-of-peroral-extrusion-of-ventriculoperitoneal-shunt-catheter
#16
REVIEW
Rajendra Kumar Ghritlaharey
INTRODUCTION: Peroral extrusion of peritoneal part of Ventriculoperitoneal Shunt (VPS) catheter is an extremely rare complication following VPS implantation. AIM: To review the options available for the management of peroral extrusion of VPS catheter. MATERIALS AND METHODS: PubMed, Medline, PMC (PubMed Central), Embase, Google scholar databases search was performed to retrieve the published/available data relating to the peroral extrusion of VPS catheter...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28049033/cryptococcal-infection-of-the-ventriculoperitoneal-shunt-in-an-hiv-infected-patient-with-an-excellent-immunovirologic-status
#17
Miguel Genebat, María J Mayorga-Buiza, Esperanza Castillo-Ojeda, Mónica Rivero-Garvía, Francisco J Márquez-Rivas, Manuel E Jiménez-Mejías
BACKGROUND: Cryptococcus spp. is a rare cause of ventriculoperitoneal shunt (VPS) infection, with a variable clinical presentation. Diagnosis and treatment of this entity are challenging. CASE DESCRIPTION: A cryptococcal VPS infection occurred in a human immunodeficiency virus-infected patient with an excellent immunovirologic status, with an abdominal mass as the only clinical sign at presentation. Microbiologic diagnosis was confirmed when Cryptococcus neoformans was isolated in 4 cerebrospinal fluid samples on different days...
March 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28018689/cryptococcus-gattii-in-an-immunocompetent-patient-in-the-southeastern-united-states
#18
John W Amburgy, Joseph H Miller, Benjamin J Ditty, Patrick Vande Lune, Shaaf Muhammad, Winfield S Fisher
Cryptococcal infections are seen throughout the United States in both immunocompromised and immunocompetent patients. The most common form is C. neoformans. In the Northwestern United States, C. gattii has received considerable attention secondary to increased virulence resulting in significant morbidity and mortality. There are no cases in the extant literature describing a patient with C. gattii requiring neurosurgical intervention in Alabama. A middle-aged immunocompetent male with no recent travel or identifiable exposure presented with meningitis secondary to C...
2016: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28018439/phelan-mcdermid-syndrome-presenting-with-developmental-delays-and-facial-dysmorphisms
#19
Yoon-Myung Kim, In-Hee Choi, Jun Suk Kim, Ja Hye Kim, Ja Hyang Cho, Beom Hee Lee, Gu-Hwan Kim, Jin-Ho Choi, Eul-Ju Seo, Han-Wook Yoo
Phelan-McDermid syndrome is a rare genetic disorder caused by the terminal or interstitial deletion of the chromosome 22q13.3. Patients with this syndrome usually have global developmental delay, hypotonia, and speech delays. Several putative genes such as the SHANK3, RAB, RABL2B, and IB2 are responsible for the neurological features. This study describes the clinical features and outcomes of Korean patients with Phelan-McDermid syndrome. Two patients showing global developmental delay, hypotonia, and speech delay were diagnosed with Phelan-McDermid syndrome via chromosome analysis, fluorescent in situ hybridization, and multiplex ligation-dependent probe amplification analysis...
November 2016: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/27994363/bilateral-abducens-and-facial-nerve-palsies-as-a-localizing-sign-due-to-reduction-in-intracranial-pressure-after-fourth-ventriculoperitoneal-shunting
#20
Boby Varkey Maramattom, Dilip Panikar
A trapped fourth ventricle often requires fourth ventriculoperitoneal shunting (4VP). Complications of this procedure include shunt blockage, infection, shunt migration, and overdrainage. Cranial nerve palsies are very rare after 4VP shunting and have been described with over drainage and brainstem distortion. We present an unusual case of bilateral abducens and facial nerve palsies after 4VP shunting after normalization of 4(th) ventricular parameters. Measurement of various brainstem angles presented us with a plausible hypothesis to explain the cranial nerve dysfunction...
October 2016: Annals of Indian Academy of Neurology
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