[Infection of the valves of CSF shunts. Results of local and general antibiotic treatment in 6 cases]

Abstract

Infection of six cerebro-spinal fluid shunts in six patients were treated with daily intrashunt injections of antibiotics plus combination of intravenous or oral systemic antibiotic therapy. Three organisms were involved in the shunt infection: staphylococcus epidermidis in five, staphylococcus capitis and micrococcus varians. One patient had mixed shunt infection with micrococcus varians and staphylococcus épidermidis. All six patients received daily intrashunt injections of vancomycin and oral rifampin with a combination of trimethoprim/sulfamethoxazole (three patients), or intravenous fosfomycin (two patients), or intravenous vancomycin (one patient). Four of six cases were considered cured of their infection without shunt surgery. Their hydrocephalus will be well controlled during antibiotic therapy. Surgery was necessary for two patients with associated shunt malfunction, one of them was considered a treatment failure of antibiotic therapy.