- Shunt Blockage
- CSF Overdrainage
- The Slit Ventricle Syndrome
- Abdominal Complications
- Intra-abdominal Fluid Collections
- Shunt Infection
- The Presentation of Shunt Infection
- Organisms Responsible for Shunt Infection
- Treatment of Shunt Infection
- The Role of Antibiotic Prophylaxis in Shunt Surgery
Shunt infection is one of the most common complications encountered and one that carries significant morbidity and even mortality. Shunt infections result in prolonged hospitalization, they increase the risk of subsequent shunt malfunction and can lead to physical disability and impaired intellectual development. Reported shunt infection rates in some instances exceed 20%, although a range of 5-15% would be a more realistic figure, examining larger series of pediatric patients. Rates as low as 1% have been achieved in some centers .
The subject of shunt infection is a complex one, and beyond the differences between individual neurosurgical units, there are important variations relating to the heterogeneity of the hydrocephalic population. Whilst shunt infection may afﬂict adults as well as children, it is in the pediatric population that shunt infection rates tend to be greater and the majority of studies have been performed in this group.
Although there are many factors that appear to contribute to shunt infection, it is generally assumed that contamination of the shunt system occurs at or around the time of shunt surgery. Poor surgical technique, excessive handling of the shunt hardware and inadequate operative environment are among some of the general risk factors frequently cited. Specific factors that appear to have particularly strong correlations with shunt infection are post- operative wound infection and CSF leakage; strenuous measures should be taken to avoid these complications.
Within the pediatric age group, patient age also appears to play a significant role. Pople et al.  report an incidence of infection of 15.7% in children less than 6 months of age in contrast to a rate of 5.6% in those older than 6 months. Immunological immaturity, different microbiological ﬂora and physical properties of the skin are among the possible factors increasing the risk of shunt infection in the neonate.
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