Case Report of a V-P Shunt Dependent Child with Shunt Disconnection and Infection with Extended-Spectrum beta-Lactamase-Producing Klebsiella pneumoniae (ESBL-KP)

Abstract

Shunt malfunction superadded with infection in a shunt dependent child always lead to significant mortality and morbidity. Infections of central nervous system with Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae (ESBL-KP) are very atypical, only occurs in immunosuppressive state and inappropriate treatment increases mortality and morbidity. Use of central catheter or ‘ommaya reservoir’ is a very good method of C.S.F drainage and intraventricular administration of some antibiotics. Here we report a shunt dependent baby of three and half years with history of recurrent respiratory tract infections, gastroenteritis and UTIs as she presented to us with shunt disconnection and simultaneous meningitis with Extended-Spectrum β-Lactamase- Producing Klebsiella pneumoniae (ESBL-KP). This patient was treated with removal of infected shunt, reservoir implantation, parenteral antibiotics and lastly reintroduction of V-P shunt with removal of ‘ommaya reservoir’.