Yotam D. Eshel MD, Emily H. Kestenbaum MD, Keren B. Rochwerger MD, Mickey Gideon MD MBA, Aya Khalaila MD, Lior Carmon MD
Ventriculoperitoneal shunt (VPS) placement is a standard treatment for pediatric hydrocephalus. However, infection remains a significant complication, occurring in 5–27% of cases, with coagulase-negative staphylococci (CONS) and Staphylococcus aureus being the most common pathogens [1]. Current guidelines recommend empirical antibiotic treatment and surgical removal of the infected shunt [2]. While shunt removal and replacement are recommended for managing shunt infections, these procedures subject the child to the risks associated with multiple surgeries. However, recent approaches have suggested that in certain cases antibiotics alone may suffice, thus avoiding the risks of surgery [3].
We describe two children with VPS infections caused by CONS who were successfully treated with vancomycin and rifampicin alone, without the need for shunt removal.