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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 73-year-old man with a ventriculoperitoneal shunt implanted 4 months earlier due to normal pressure hydrocephalus was admitted for a fever of 39&#46;6<span class="elsevierStyleHsp" style=""></span>&#176;<span class="elsevierStyleSmallCaps">C</span> that started 48<span class="elsevierStyleHsp" style=""></span>h earlier and presented generalized tonic&#8211;clonic seizures on the day of admission&#46; Cranial computed tomography showed a hypodense space-occupying lesion in the white matter of the right frontal lobe&#44; measuring 43<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>34<span class="elsevierStyleHsp" style=""></span>mm&#44; with peripheral contrast uptake&#44; located on the shunt &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#44; with associated perilesional vasogenic edema and compression of the right lateral ventricle&#44; with no midline deviation &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; We drained the abscess and withdrew the entire device&#46; The various cultures were positive for methicillin-resistant <span class="elsevierStyleItalic">Staphylococcus aureus</span>&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">A cerebrospinal fluid shunt is one of the most common neurosurgical procedures and can be external &#40;temporary&#41; or internal&#46; Infections occur in 5&#8211;15&#37; of these procedures&#44; representing 45&#8211;52&#37; of cases of nosocomial meningitis&#47;ventriculitis in adults&#44; with most infections appearing in the first month after placement&#46; The associated factors are patient-related &#40;extreme age&#44; main process&#44; comorbidities&#44; skin lesions&#41;&#44; surgery-related &#40;duration&#44; neurosurgeon&#39;s experience&#41; and shunt-related &#40;previous neurosurgery&#44; checks&#44; previous shunt infection&#41;&#46; The biomaterial&#39;s properties&#44; the host&#39;s defense mechanisms and bacterial virulence factors also play a role&#46; Infections occur after the colonization of the shunt with skin flora during surgery or by skin lesions adjacent to the shunt&#46; Infections can also occur through hematogenous pathways and by retrograde infection from the catheter&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The predominant agents are staphylococci&#44; with Gram-negative bacilli isolated in devices that drain the cerebrospinal fluid to the peritoneal cavity&#46; Treatment includes withdrawing the entire system&#44; as well as antibiotherapy&#46;</p></span>"
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April 2019 Brain abscess in relation to infection of the ventriculoperitoneal shunt system
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Vol. 219. Issue 3.
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Vol. 219. Issue 3.
Pages 161 (April 2019)
Medicine in Images
DOI: 10.1016/j.rceng.2018.11.002
Brain abscess in relation to infection of the ventriculoperitoneal shunt system
Absceso cerebral secundario a infección del sistema de derivación ventrículo-peritoneal
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S.M. Santos-Seoane
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smsspulp@yahoo.es

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, R. Cabo-Madagán, A. Rodriguez-Guardado
Servicio de Medicina Interna, Hospital de Cabueñes, Gijón, Asturias, Spain
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