Turkish Neurosurgery
Shunt tapping versus lumbar puncture for evaluating cerebrospinal fluid infections in pediatric population.
Cagatay OZDOL1, Tolga GEDIZ1, Ahmet Tulgar BASAK2, Nazlı BASAK2, Kamran AGHAYEV3
1Antalya Education and Research Hospital, Neurosugery, Antalya,
2Medipol University, Neurosurgery, Istanbul,
3Biruni University, Neurosurgery, Istanbul,
DOI: 10.5137/1019-5149.JTN.24714-18.1

Aim:There is no consensus in the literature regarding the optimal method of obtaining cerebrospinal fluid sample in patients with suspected shunt infections. The most frequently used method is tapping shunt reservoir. Lumbar puncture is an alternative method yet it used far less frequently. Material and Methods:Medical records of pediatric patients with suspected shunt infections were retrospectively analyzed. All patients had cerebrospinal fluid samples obtained either via shunt tapping, lumbar puncture or both. The diagnosis of infection was made when at least one cerebrospinal fluid had positive culture results. The patients with negative cerebrospinal fluid culture results were followed up for at least 6 months to monitor the occurrence of central nervous system infection.Results:There were 20 patients in the study (12 males, 8 females). Cerebrospinal fluid was obtained by shunt tapping in 11, by lumbar puncture in 9 and by both methods in one patient. 13 patients (5 shunt tapping group - 45%, 7 lumbar puncture group -78%, one patient both shunt tapping and lumbar puncture) were diagnosed with shunt infection on the basis of cerebrospinal fluid culture. 7 patients with negative cerebrospinal fluid culture were found to have infections unrelated to shunts and did not show evidence of cerebrospinal fluid infection during the follow-up period. Although the percentage of infection detection was higher in Lumbar puncture group both groups showed negative predictive value of 100%. Conclusion:Both shunt tapping and LP are effective in establishing the diagnosis of shunt infection in suspected patients.

Corresponding author : Cagatay OZDOL