Biomaterial Database

Haemophilus influenzae B meningitis in a patient with a ventriculoperitoneal shunt and meningomyelocele. 1990

Y Brandstetter, and M Melzer-Lange, and M J Chusid

Department of Pediatrics, Medical College of Wisconsin, Milwaukee.

A child with an implanted ventriculoperitoneal (VP) shunt and meningomyelocele had an infection of his cerebrospinal fluid (CSF). The organism cultured from the VP shunt apparatus and the meningomyelocele repair site was Haemophilus influenzae B (HIB), a very unusual pathogen in this setting. The patient was treated with the appropriate antibiotics, administered intravenously in accordance with accepted practice and available literature, with no improvement. The site of the persistent infection was finally determined to be within the meningomyelocele repair tissue. The patient's clinical status improved dramatically following the removal and replacement of the total shunt apparatus. The three-part apparatus tip was cultured according to the standard laboratory practice, but did not yield any organism. We conclude that the management of HIB meningitis in the presence of a VP shunt should include prompt removal of the apparatus. Recovery of the organism may be enhanced by separating the apparatus components and culture of the connections, instead of merely the indwelling tip.

UI	MeSH Term	Description	Entries
D007223	Infant	A child between 1 and 23 months of age.	Infants
D008297	Male		Males
D008591	Meningomyelocele	Congenital, or rarely acquired, herniation of meningeal and spinal cord tissue through a bony defect in the vertebral column. The majority of these defects occur in the lumbosacral region. Clinical features include PARAPLEGIA, loss of sensation in the lower body, and incontinence. This condition may be associated with the ARNOLD-CHIARI MALFORMATION and HYDROCEPHALUS. (From Joynt, Clinical Neurology, 1992, Ch55, pp35-6)	Myelocele,Myelomeningocele,Acquired Meningomyelocele,Myelomeningocele, Acquired,Acquired Meningomyeloceles,Acquired Myelomeningocele,Acquired Myelomeningoceles,Meningomyelocele, Acquired,Meningomyeloceles,Meningomyeloceles, Acquired,Myeloceles,Myelomeningoceles,Myelomeningoceles, Acquired
D010529	Peritoneal Cavity	The space enclosed by the peritoneum. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the STOMACH. The two sacs are connected by the foramen of Winslow, or epiploic foramen.	Greater Sac,Lesser Sac,Omental Bursa,Bursa, Omental,Cavity, Peritoneal,Sac, Greater,Sac, Lesser
D002557	Cerebrospinal Fluid Shunts	Tubes inserted to create communication between a cerebral ventricle and the internal jugular vein. Their emplacement permits draining of cerebrospinal fluid for relief of hydrocephalus or other condition leading to fluid accumulation in the ventricles.	Cerebrospinal Fluid Shunt,Shunt, Cerebrospinal Fluid,Shunts, Cerebrospinal Fluid
D006192	Haemophilus Infections	Infections with bacteria of the genus HAEMOPHILUS.	Hemophilus Infections,Haemophilus influenzae Infection,Haemophilus influenzae Type b Infection,Hib Infection,Infections, Haemophilus,Infections, Hemophilus,Haemophilus Infection,Haemophilus influenzae Infections,Hemophilus Infection,Hib Infections,Infection, Haemophilus,Infection, Haemophilus influenzae,Infection, Hemophilus,Infection, Hib
D006193	Haemophilus influenzae	A species of HAEMOPHILUS found on the mucous membranes of humans and a variety of animals. The species is further divided into biotypes I through VIII.	Bacterium influenzae,Coccobacillus pfeifferi,Haemophilus meningitidis,Hemophilus influenzae,Influenza-bacillus,Mycobacterium influenzae
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man