Ventricular Shunt Infection

Shunt infections are most common within 2 weeks of a shunt intervention; however, they can occur at any time. Shunt infection should be considered in any patient presenting with fever during the post-operative period or redness along the shunt tract. Brain imaging and shunt x-rays should be obtained to evaluate shunt function, and contrast MRI should be obtained to evaluate for intracranial ventriculitis or abscess. Cerebrospinal fluid cultures should be obtained prior to starting antibiotics by performing a shunt tap. Broad spectrum antibiotics should be started, and when infection is confirmed, surgery to remove the shunt components and place an external ventricular drain should be performed in a timely manner. Duration and choice of antibiotic regimen depends on the speciation of the infectious agent.