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Ventriculitis and Meningitis

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2 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

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