STUDY OF EARLY VENTRICULO-PERITONEAL (VP) SHUNT INFECTION FOLLOWING SHUNT PLACEMENT FOR HYDROCEPHALOUS IN CHILDREN

Swapan Kumar Paul*, Rakibul Islam, Ashim Kumar Sarker, Durlav Kanti Paul, Delwar Hossain and Mm Aminur Rashid

ABSTRACT

Background: Ventriculo peritoneal (VP) shunt placement is a common procedure for hydrocephalus in all age group. VP shunt infection is a major concern for treating surgeons and physicians. Malfunctioning of the shunt is a common consequences following shunt infection. Hydrocephalus is a common neurosurgical problem and treated commonly with ventriculo-peritoneal shunt. Hydrocephalus was diagnosed clinically by history, sign and symptoms and was confirmed by CT scan or MRI of brain. In this study we have diagnosed early shunt infection by analyzing the signs and symptoms following shunt placement that will help in early detection of shunt infection and faster management. Methods: This is a prospective interventional study. The study was done from January 2019 to December 2021 in Bangladesh Shishu Hospital & Institute (BSH&I). Sixty patients were underwent VP shunt placement for hydrocephalus (HCP). They were followed up to 30 days after surgery. They were evaluated with presence of undue continuous fever, signs of infection along the shunt on the absence of other causes, indication of infection along the shunt tract or incision site and signs of meningeal irritation or peritonitis. Results: Out of sixty patients underwent for VP shunt placement, fourteen (23.33%) patients had VP shunt infection. This is more in the neonatal and early infant age group (up to 2 months) and young child age group. Higher incidence of shunt infection also in the lower socioeconomic group. Most patients had fever, headache and neck rigidity. Conclusion: VP shunt placement is a common and popular procedure for CSF diversion for hydrocephalousin children Shunt infection reduces the success of this surgery.

Keywords: Hydrocephalus, VP shunt infection, signs and symptoms of meningitis and ventriculo-meningitis.