# Distinct Clinical Phenotypes of Infection and Mechanical Dysfunction in Ventriculoperitoneal Shunt Complications

## TL;DR

The study identifies distinct clinical and lab differences between VP shunt infections and mechanical issues, aiding diagnosis and treatment decisions.

## Contribution

The study provides institution-specific clinical and biochemical markers to differentiate VP shunt infection from mechanical dysfunction.

## Key findings

- Shunt infections showed fever, elevated CRP/WBC, low CSF glucose, and high CSF protein.
- Mechanical dysfunction occurred later and lacked infection markers.
- Coagulase-negative staphylococci were the most common infection pathogens.

## Abstract

Introduction

Ventriculoperitoneal shunt complications, particularly infection and mechanical dysfunction, represent major causes of morbidity and revision surgery in patients with hydrocephalus.

Objective

This study aimed to evaluate our single-center experience with ventriculoperitoneal shunt revisions and to compare shunt infection and mechanical shunt dysfunction in order to identify institution-specific clinical, laboratory, and cerebrospinal fluid (CSF) characteristics that may facilitate differential diagnosis.

Results

Among the patients, 140 (35.9%) were diagnosed with ventriculoperitoneal shunt infection, while 250 (64.1%) had mechanical shunt dysfunction. Fever, elevated C-reactive protein (CRP) and white blood cell (WBC) levels, reduced CSF glucose, and increased CSF protein levels were significantly more frequent in the infection group (p<0.001). Shunt infections predominantly occurred in the early postoperative period, whereas mechanical shunt dysfunction was more commonly observed during the late postoperative period. Coagulase-negative staphylococci were the most frequently isolated pathogens in CSF cultures.

Conclusion

Ventriculoperitoneal shunt infection and mechanical shunt dysfunction demonstrate clearly distinct clinical and biochemical profiles. Early assessment of these parameters may facilitate more accurate differentiation and support rational clinical decision-making.