Faculty Collaboration Database

Haemophilus influenzae B meningitis in a patient with a ventriculoperitoneal shunt and meningomyelocele. Wis Med J 1990 Aug;89(8):461-3

Date

08/01/1990

Pubmed ID

2396426

Scopus ID

2-s2.0-0025469567 (requires institutional sign-in at Scopus site)   2 Citations

Abstract

A child with an implanted ventriculoperitoneal (VP) shunt and meningomyelocele had an infection of his cerebrospinal fluid (CSF). The organism cultured from the VP shunt apparatus and the meningomyelocele repair site was Haemophilus influenzae B (HIB), a very unusual pathogen in this setting. The patient was treated with the appropriate antibiotics, administered intravenously in accordance with accepted practice and available literature, with no improvement. The site of the persistent infection was finally determined to be within the meningomyelocele repair tissue. The patient's clinical status improved dramatically following the removal and replacement of the total shunt apparatus. The three-part apparatus tip was cultured according to the standard laboratory practice, but did not yield any organism. We conclude that the management of HIB meningitis in the presence of a VP shunt should include prompt removal of the apparatus. Recovery of the organism may be enhanced by separating the apparatus components and culture of the connections, instead of merely the indwelling tip.

Author List

Brandstetter Y, Melzer-Lange M, Chusid MJ

Author

Marlene D. Melzer-Lange MD Adjunct Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Cerebrospinal Fluid Shunts
Haemophilus Infections
Haemophilus influenzae
Humans
Infant
Male
Meningomyelocele
Peritoneal Cavity