Multiple recurrent gram-negative cerebrospinal fluid shunt infections associated with a patient with a retained ventricular foreign body

A 3-year-old boy experienced 10 recurrent gram-negative ventriculoperitonea l shunt (VPS) infections with identical strains over a 17-month period. Mul tiple cranial MRI and CT scans to identify a retained foreign body were neg ative. CT myelography and pressure infusion radionuclide cisternography wer e also unhelpful. Ventriculoscopy revealed a small retained foreign body wh ich was successfully removed, and cultures subsequently yielded gram-negati ve organisms identical to the previously identified bacteria by pulsed fiel d gel electrophoresis, No further infections were noted after removal of th e retained fragment. Exploratory ventriculostomy should be considered in pa tients with recurrent VPS infections where other techniques fail to reveal a cause. Copyright (C) 1999 S. Karger AG, Basel.