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Typical Symptoms and Signs
Cerebrospinal Fluid (CSF) Shunts and Drains
➤ New headache, nausea, lethargy and/or change in mental status are
suggestive of CSF shunt infection (S-M).
➤ Erythema and tenderness over the subcutaneous shunt tubing are
suggestive of CSF shunt infection (S-M).
➤ Fever, in the absence of another clear source of infection, could be
suggestive of CSF shunt infection (W-L).
➤ Symptoms and signs of peritonitis or abdominal tenderness in
patients with ventriculoperitoneal shunts, in the absence of another
clear etiology, are indicative of CSF shunt infection (S-M).
➤ Symptoms and signs of pleuritis in patients with ventriculopleural
shunts, in the absence of another clear etiology, are indicative of CSF
shunt infection (S-M).
➤ Demonstration of bacteremia in a patient with a ventriculoatrial
shunt, in the absence of another clear source of bacteremia, is
evidence of CSF shunt infection (S-M).
➤ Demonstration of glomerulonephritis in a patient with a
ventriculoatrial shunt is suggestive of CSF shunt infection (W-L).
➤ New or worsening altered mental status in patients with external
ventricular drains is suggestive of infection (W-L).
➤ New fever and increased CSF white blood cell count in patients with
external ventricular drains could be suggestive of infection (W-L).
Neurosurgery or Head Trauma
➤ New headache, fever, evidence of meningeal irritation, seizures
and/or worsening mental status are suggestive of ventriculitis or
meningitis in the setting of recent trauma or neurosurgery (S-M).
➤ Fever, in the absence of another clear source of infection, is
suggestive of central nervous system (CNS) infection in the setting of
recent head trauma or neurosurgery (W-L).
Intrathecal Infusion Pumps
➤ New fever and drainage from the surgical site in patients with
intrathecal infusion pumps are suggestive of wound infection (W-L).
Diagnosis
