The diagnostic importance of eosinophil granulocytes in the CSF of children with ventricular-peritoneal shunt systems.

Abstract

We investigated the occurrence of cerebrospinal fluid (CSF) eosinophilia in patients with ventriculo-abdominal shunt systems with regard to possible infection. For this purpose, we examined the CSF of 83 children at the time of shunt obstruction or malfunction. In 32 children (38.6%) we found more than 4% of eosinophil granulocytes in the CSF with a maximum of 76%. In 15 of these 32 children the CSF was sterile, whereas in 17 patients bacterial infection was present. In the CSF of 16 of those 17 children, Staph. epidermidis was cultivated. There was statistically significant correlation between positive Staph. epidermidis culture and the occurrence of CSF eosinophilia (P<0.05). The occurrence of CSF eosinophilia in patients with ventriculo-peritoneal shunts is well known and was mostly attributed to an allergic reaction. Our findings support the theory of an infectious etiology of the eosinophilia and are thus in line with new American and French studies. We believe that CSF eosinophilia indicates a persistent infection of the central nervous system by the contaminated shunt system. As the organism which is the most common cause we cultured Staph. epidermidis.