Differential Diagnosis for Infected VP Shunt
- Single Most Likely Diagnosis
- Ventriculoperitoneal (VP) shunt infection: This is the most direct and likely diagnosis given the context of the question. Infection of a VP shunt can occur due to contamination during surgery, hematogenous spread, or direct infection from the skin. Symptoms may include fever, headache, nausea, vomiting, and signs of increased intracranial pressure.
- Other Likely Diagnoses
- Meningitis: Infection can spread to the meninges, causing meningitis, which presents with symptoms such as fever, headache, stiff neck, and altered mental status.
- Cerebral abscess: A collection of pus in the brain tissue, which can be a complication of VP shunt infection, presenting with focal neurological deficits, seizures, and signs of increased intracranial pressure.
- Peritonitis: Infection can spread to the peritoneal cavity, causing peritonitis, which presents with abdominal pain, fever, and guarding.
- Do Not Miss Diagnoses
- Brain abscess or empyema: These conditions can arise from the spread of infection and are critical to identify due to their high morbidity and mortality if not promptly treated.
- Sepsis: Systemic infection can lead to sepsis, a life-threatening condition that requires immediate recognition and treatment.
- Hydrocephalus: Obstruction or malfunction of the VP shunt due to infection can lead to hydrocephalus, which necessitates urgent intervention to prevent brain damage.
- Rare Diagnoses
- Echovirus or Coxsackievirus infection: Rarely, these viruses can cause central nervous system infections, including meningitis, which might be considered in the differential diagnosis of an infected VP shunt, especially in immunocompromised patients.
- Fungal infection: Fungal infections, such as candidiasis, can occur, especially in patients with prolonged hospital stays or immunocompromised states, and can infect VP shunts, though this is less common than bacterial infections.