Occult infections of ventriculoatrial shunts

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Abstract
✓ Organisms usually considered nonpathogens have been implicated with increasing frequency as the cause of infected ventriculoatrial shunts. Often the signs of infection are minimal, with no evidence of inflammation; but there may be low-grade fever, anemia, leukocystosis, and variably present hepatosplenomegaly. By routinely culturing all shunts electively revised, a form of infection completely unapparent clinically has been recognized. Coagulasenegative staphylococcus or diphthenoids were grown from the cardiac or ventricular catheters of each patient. Pre- and postoperative spinal fluid and blood cultures were sterile, and there was no other clinical or laboratory evidence of infection. Six such cases are discussed in detail. It is suggested that prophylactic use of appropriate antibiotics at the time of surgery may have a place in the control of the problem.