LAUSR

A right-sided ventriculoperitoneal (VP) shunt was placed in patient with congenital hydrocephalous in the first month of life. Three-month review visit showed no improvement and after evaluation and computerised tomogram (CT) scan brain, another VP shunt was placed on the left side without handling the previous right sided VP shunt. Patient did not improve and again presented with fever and fits. CT scan brain with and without contrast was repeated, which showed bilateral subdural empyema and right-sided cranially migrated VP shunt. Cerebrospinal fluid (CSF) analysis demonstrated infection. Bilateral burr hole drainage of subdural empyema with subsequent removal of right-sided migrated VP shunt was done. Cranial end of left-sided VP shunt was converted into external ventricular drain (EVD) and its abdominal end removed. Patient was placed on intravenous as well as intraventricular antibiotics through the EVD. Later, right-sided VP shunt was placed after clearance of infection. Regular follow-up showed that the patient is doing well.