Tanıl KENDİRLİ, Suat FİTÖZ, Ülker DOĞRU, Haluk GÜRİZ, Ağahan ÜNLÜ, Erdal İNCE, Ergin ÇİFTÇİ

Pseudomonas aeruginosa'ya bağlı ventrikülitli bir olgu

Ventriküloperitoneal şant, hidrosefalisi olan hastaların intrakranial basıncını azaltmak amacıyla sıklıkla kullanılır. Şant enfeksiyonları ventriküloperitoneal şantı olan hastaların %7-9'unda görülür ve mortalite oranı %10-13'tür. En sık etken koagülaz-negatif stafilokoklardır. Ventrikülit ise vent-riküllerin enfeksiyonu olup, şant enfeksiyonlarının en ciddi, morbidite ve mortalitesi en yüksek komplikasyonudur. Burada meningosel ve hidrosefali nedeniyle ventriküloperitoneal şant konulan bir hastada gelişen Pseudomonas aeruginosa'nm neden olduğu ventrikülit olgusu sunulmaktadır.

A case with ventriculitis due to Pseudomanas aeruginasa

Ventriculoperitoneal shunt is frequently used to decrease intracranial pressure in patients with hydrocephaly. Shunt infections are seen in 7-9% of patients with ventriculoperitoneal shunt, and the mortality rate is 10-13%. The most common agent is coagulase-negative Staphylococcus in these patients. Ventriculitis, infection of ventricules, is the most severe, and being have the highest morbidity and mortality in complications of shunt infections. Here, a case with ventriculoperitoneal shunt for meningocele and hydrocephaly who has Pseudomonas aeruginosa ventriculitis is presented.

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1. Ammirati M, Raimondi AJ. Cerebrospinal fluid shunt infections in children. A study on the relationship between the etiology of hydrocephalus, age at the time of shunt placement and infection rate. Child's Nerv Sys 1987; 3:106-109.
2. Bafeltowska JJ, Buszman E, Mandat KM et al. Therapeutic vancomycin monitoring in children with hydrocephalus during treatment of shunt infections. Surg Neurol 2004; 62:142-150.
3. Bremer AA, Darouiche RO. Ventriculoperitoneal shunt infection due to Serratia marcescens. J Infect (baskıda)
4. Gill CJ, Murphy MA, Hamer DH. Treatment of Staphylococcus epidermidis ventriculo-peritoneal shunt infection with Linezolid. J Infect 2000; 45:129-132.
5. Enger PO, Svendsen F, "Wester K. CSF shunt infections in children: experiences from a population-based study. Acta Neurochir 2003; 145:243-248.
6. Korinek AM, Reina M, Boach AL et al: Prevention of external ventricular drain-related ventriculitis. Acta Neurochir 2005; 147:39-46.
7. Pfausler B, Spiss H, Dittrich P et al: Concentrations of fosfomycin in the cerebrospinal fluid of neurointensive care patients with ventriculostomy-associated ventriculitis. J Antimicrob Chemother 2004; 53:848-852.
8. Martinez R, Gaul C, Buchfelder M et al: Serum procalcitonin monitoring for differential diagnosis of ventriculitis in adult intensive care patients. Intensive Care Med 2002; 28:208-210.
9. Lyke KE, Obasanjo OO, Williams MA et al: Ventriculitis complicating use of intraventricular catheters in adult Neurosurgical patients. Clin Infect Dis 2001; 33:2028-2033.
10. Machado HR, de Oliveira RS: Simultaneous repair of myelomeningocele and shunt insertion. Childs Nerv Syst 2004; 20:107-109.
11. Tuli S, Drake J, Lamberti-Pasculli M: Long-term outcome of hydrocephalus management in myelomeningoceles. Childs Nerv Syst 2003; 19:286-291.
12. Thompson TP, Albright AL. Proprionibacterium acnes infections of cerebrospinal fluid shunts. Child's Nerv Syst 1998; 14:378-380.
13. Wang KC, Lee HJ, Sung JN et al: Cerebrospinal fluid shunt infection in children: efficiency of management protocol, rate of persistent shunt colonization, and significance of 'off-antibiotics' trial. Child's Nerv Syst 1999; 15:38-44.
14. Murphy K, Bradley J, James HE. The treatment of Candida albicans shunt infections. Child's Nerv Syst 2000; 16:4-7.