{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T12:58:15Z","timestamp":1779281895855,"version":"3.51.4"},"reference-count":14,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1983,9]]},"abstract":"<jats:p content-type=\"fine-print\">\u2713 The authors have reviewed the clinical manifestations and therapy of hydrocephalus shunt infections in 32 patients with a total of 35 shunt infections. These 35 infections accounted for 43 hospital admissions. First infections usually developed within 2 months following surgery. At the time of diagnosis, 89% of patients were febrile. Fever and cough as a symptom complex characterized the initial clinical presentation in six of 19 episodes of infection complicating ventriculoatrial (VA) shunts, as compared with none of 21 episodes in which infection complicated ventriculoperitoneal (VP) shunts. Seven of 21 infectious episodes occurring in patients with VP shunts <jats:italic>in situ<\/jats:italic> were associated with significant abdominal pain and tenderness. These patients usually had no other clinical features to suggest shunt infection. Both of these symptom complexes often led to delays in diagnosis and treatment. Causative organisms included <jats:italic>Staphylococcus epidermidis<\/jats:italic> in 21, <jats:italic>Staphylococcus aureus<\/jats:italic> in seven, Gram-negative aerobic bacilli in seven, diphtheroids in five, <jats:italic>Streptococcus<\/jats:italic> species in four, and anaerobes in three. Five infections were polymicrobial in nature. Positive blood cultures were seen in 13 of 17 infectious episodes complicating VA shunts, as compared with only three of 13 other infections. When the shunt was completely removed, with or without replacement, all 13 patients were cured. When intravenous antibiotics were administered in conjunction with incomplete shunt removal, only eight of 15 courses resulted in cure. Intraventricular antibiotics were administered in four patients and all were cured. Therapy of shunt infections with parenteral antibiotics and incomplete shunt removal is associated with an unacceptably high failure rate.<\/jats:p>","DOI":"10.3171\/jns.1983.59.3.0389","type":"journal-article","created":{"date-parts":[[2009,5,8]],"date-time":"2009-05-08T16:20:10Z","timestamp":1241799610000},"page":"389-394","source":"Crossref","is-referenced-by-count":91,"title":["Cerebrospinal fluid shunt infections"],"prefix":"10.3171","volume":"59","author":[{"given":"Kevin R.","family":"Forward","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. Derek","family":"Fewer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. Grant","family":"Stiver","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"JAMA","doi-asserted-by":"publisher","first-page":"751","DOI":"10.1001\/jama.1978.03290080041021","article-title":"Rifampin therapy of Staphylococcus epidermidis. Use in infections from indwelling artificial devices.","volume":"240","author":"Archer","year":"1978"},{"key":"b2","series-title":"Dev Med Child Neurol","first-page":"50","article-title":"Preliminary studies on the impregnation of Silastic elastomers with antimicrobial substances.","volume":"18","author":"Bayston","year":"1976"},{"key":"b3","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"506","DOI":"10.3171\/jns.1968.29.5.0506","article-title":"Complications of ventriculoatrial shunts. 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A 12-year study.","volume":"35","author":"Shurtleff","year":"1971"},{"key":"b12","series-title":"Pediatrics","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1542\/peds.53.1.55","article-title":"Therapy of Staphylococcus epidermidis infections associated with cerebrospinal fluid shunts.","volume":"53","author":"Shurtleff","year":"1974"},{"key":"b13","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"311","DOI":"10.3171\/jns.1976.45.3.0311","article-title":"Control of shunt infection. Report of 150 consecutive cases.","volume":"45","author":"Venes","year":"1976"},{"key":"b14","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"41","DOI":"10.3171\/jns.1980.52.1.0041","article-title":"Cerebrospinal fluid antibiotic levels during treatment of shunt infections.","volume":"52","author":"Wald","year":"1980"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/59\/3\/article-p389.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/59\/3\/article-p389.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/59\/3\/article-p389.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,13]],"date-time":"2022-11-13T03:59:14Z","timestamp":1668311954000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/59\/3\/article-p389.xml"}},"subtitle":["A review of 35 infections in 32 patients"],"short-title":[],"issued":{"date-parts":[[1983,9]]},"references-count":14,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/jns.1983.59.3.0389","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[1983,9]]}}}