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  • Title: Positron Emission Tomography Scan: A Good Way to Untie the Gordian Knot of Infection in Case of Multiple Ventriculoperitoneal Shunts.
    Author: Zanello M, Bozier E, Pallud J.
    Journal: World Neurosurg; 2022 Mar; 159():144-145. PubMed ID: 34999264.
    Abstract:
    Delayed infection from an implanted device can be challenging to diagnose. Here, we report a case of a 56-year-old male patient with history of congenital hydrocephalus and previous placement of a ventriculoperitoneal (VP) shunt who presented with sepsis without any evidence of shunt infection at follow-up 3 years after his most recent shunt implantation. The VP shunt contained 2 residual ventricular catheters and 2 residual peritoneal catheters, as the patient has had multiple VP shunt revisions since childhood. The patient was unresponsive to multiple antibiotic regimens. Of note, 2-[18]-fluoro-2-deoxy-D-glucose-positron emission tomography scan revealed hypermetabolism at the distal end of the latest implanted abdominal catheter without any abnormality of migrated cerebral catheters, highlighting the advantageous use of 2-[18]-fluoro-2-deoxy-D-glucose-positron emission tomography to identify the infected catheter when multiple devices are involved. Removal of abdominal catheters confirmed the localized infection, and follow-up was uneventful after shunt replacement.
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