Fungal infection of ventriculoperitoneal shunts in children

Chen Chia Chiou, Tai-Tong Wong, Hsi Hsun Lin, Betau Hwang, Ren Bin Tang, Keh Gong Wu, Bor Huey Lee

Research output: Contribution to journalArticlepeer-review

60 Citations (Scopus)

Abstract

Infection is still the most common complicationof shunt procedures in children. However, fungal infection is still considered to be rare. We found that fungi accounted for 17% of shunt infections (8 of 48) in a retrospective study. Allof the patients were premature babies and had received a ventriculoperitoneal shunt because ofhydrocephalus. The clinical manifestations were subtle and insidious. The time of onset of infection ranged from 1 month to 1 year after the insertion of the shunt. Examination of the cerebrospinal fluid of infected patients showed mild pleocytosis with an elevated protein concentration. Candida species (including Candida albicans, Candida parapsilosis, and Candida tropicalis) or Torulopsis glabrata were isolated. In all but one case, shunts were removed and systemic therapy with amphotericin B was administered. Amphotericin B was given intrathecally to two patients, who did not respond to systemic therapy. Treatment with fluconazole failed for one patient. We suggest performing fungal cultures in cases of shunt infection, especially those involving premature infants. Extraventricular drainage, systemic therapy with amphotericin B, and insertion of a new shunt remain the principal components of the treatment regimen for fungal shunt infections in children.

Original languageEnglish
Pages (from-to)1049-1053
Number of pages5
JournalClinical Infectious Diseases
Volume19
Issue number6
DOIs
Publication statusPublished - Jan 1 1994
Externally publishedYes

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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