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首页> 外文期刊>British journal of neurosurgery >Persistent and intractable ventriculitis due to retained ventricular catheters.
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Persistent and intractable ventriculitis due to retained ventricular catheters.

机译：由于保留了心室导管而导致的持久性和顽固性心室炎。

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摘要

It is generally recommended that, in cases of difficulty in removing a ventricular catheter during a shunt revision, it is best left alone to avoid intraventricular haemorrhage. Retained ventricular catheters (RVCs) are usually safe, although in the presence of ventriculitis they may become colonized by organisms and become a source of persistent or recurrent infection. The authors present a case of persistent and intractable ventriculitis due to an old retained ventricular catheter. A 23-year-old female, who had a RVC and a functioning shunt, was admitted for a suspected blocked shunt. At surgery the shunt was found to be infected and external drainage was instituted. Over the next 4 months, she developed intractable and persistent staphylococcal ventriculitis, despite undergoing 10 further surgical procedures, and appropriate intravenous and intrathecal antibiotic therapy. She responded rapidly only after surgical removal of the old RVC via a craniotomy. The staphylococcus cultured from the RVC had an identical antibiogram to the organism responsible for the intractable ventriculitis. This case emphasizes the point that, although RVC are generally considered safe, removal becomes imperative in the presence of concurrent CSF infection that fails to respond quickly to intrathecal antibiotic therapy.
机译：通常建议，在分流翻修期间难以拔除心室导管的情况下，最好单独放置以避免脑室内出血。保留性心室导管（RVC）通常是安全的，尽管在存在心室炎的情况下，它们可能会被生物定植，并成为持续或反复感染的来源。作者介绍了由于旧的保留的心室导管导致的持续性和顽固性心室炎的病例。一名具有RVC和有效分流器的23岁女性因涉嫌阻塞分流器而入院。在手术中，发现该分流器被感染，并进行了外部引流。在接下来的四个月中，尽管经历了十次进一步的手术程序以及适当的静脉内和鞘内抗生素治疗，她仍发展为顽固性和持续性葡萄球菌性心室炎。仅在通过开颅手术手术切除旧的RVC后，她才迅速做出反应。从RVC培养的葡萄球菌与引起顽固性心室炎的微生物具有相同的抗菌素。这个案例强调了这样一个观点，尽管通常认为RVC是安全的，但在并发CSF感染的情况下，清除仍势在必行，而CSF感染对鞘内抗生素治疗无法迅速做出反应。

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