Sepsis Caused by Bacterial Colonization of Migrated Distal Ventriculoperitoneal Shunt Catheter into the Pulmonary Artery: A First Case Report and Literature Review
| Autor: | Adi Ahmetspahić, Ibrahim Omerhodžić, Almir Džurlić, Nevena Mahmutbegović, Salko Zahirovic, Kenan I. Arnautović, Edin Hajdarpašić |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Pulmonary Artery Ventriculoperitoneal Shunt Sepsis 03 medical and health sciences Postoperative Complications 0302 clinical medicine Bacterial colonization Foreign-Body Migration medicine.artery medicine Humans Intracranial pressure business.industry Middle Aged medicine.disease Klebsiella Infections Hydrocephalus Surgery Shunt (medical) Klebsiella pneumoniae Catheter Treatment Outcome 030220 oncology & carcinogenesis Pulmonary artery Neurology (clinical) Tomography X-Ray Computed Complication business 030217 neurology & neurosurgery |
| Zdroj: | World Neurosurgery. 126:172-180 |
| ISSN: | 1878-8750 |
| DOI: | 10.1016/j.wneu.2019.02.176 |
| Popis: | Background Migration of distal ventriculoperitoneal (VP) shunt catheter into another body part has been described as a potentially serious surgical complication. We present the first case of sepsis caused by transcardial and pulmonary migration of a distal catheter into the heart and pulmonary artery, which was subsequently colonized by Klebsiella pneumoniae. Case Report A 56-year-old man underwent VP shunt insertion for hydrocephalus that developed after the surgery for intracranial meningioma. Three years later, he was admitted to department for infectious diseases because of persistent fever. Klebsiella pneumoniae was isolated from the blood cultures. Computed tomography (CT) of the thorax showed migration of the distal catheter into the heart and pulmonary artery. The migrated shunt catheter was retrieved without any complication with the assistance of a cardiovascular surgeon; microbiologic analysis confirmed that the catheter was colonized with K. pneumoniae. We decided to delay new VP shunt placement because of the positive blood cultures, and 3 weeks after the surgery, the patient was without signs of increased intracranial pressure and without any heart problems. Conclusion Migration of a distal VP shunt catheter into the heart should be considered in patients with a previously placed VP shunt presenting with cardiopulmonary problems, arrhythmia, and/or fever. Neurosurgeons should be involved as soon as possible, and a multidisciplinary approach is warranted. |
| Databáze: | OpenAIRE |
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