Quelltext der Seite DGI:ZNS-Infektionen/Nosokomiale Ventrikulitis und Meningitis/Klinisches Bild

==Klinisches Bild==

===<span class="ve-pasteProtect" style="font-size:13.5pt; mso-fareast-font-family:&quot;Times New Roman&quot;;mso-bidi-font-family:Calibri; mso-bidi-theme-font:minor-latin;mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;font-size:13.5pt;\nmso-fareast-font-family:\&quot;Times New Roman\&quot;;mso-bidi-font-family:Calibri;\nmso-bidi-theme-font:minor-latin;mso-ansi-language:DE&quot;}">Leitsymptome</span>===
<span class="ve-pasteProtect" style="font-size:12.0pt;
mso-fareast-font-family:&quot;Times New Roman&quot;;mso-bidi-font-family:Calibri;
mso-bidi-theme-font:minor-latin;mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;font-size:12.0pt;\nmso-fareast-font-family:\&quot;Times New Roman\&quot;;mso-bidi-font-family:Calibri;\nmso-bidi-theme-font:minor-latin;mso-ansi-language:DE&quot;}">Die initialen Symptome sind unspezifisch und bestehen typischerweise aus Kopfschmerzen, Übelkeit, Lethargie bzw. Vigilanzminderung, Fieber, Meningismus und Photo- und Phonophobie. Je nach Katheterlage kommen neben einem möglichen Erythem und Verhärtung über dem Kathetersystem weitere Symptome hinzu:</span>

<span class="ve-pasteProtect" style="font-size:12.0pt;mso-fareast-font-family:&quot;Times New Roman&quot;;mso-bidi-font-family:
Calibri;mso-bidi-theme-font:minor-latin;mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;font-size:12.0pt;mso-fareast-font-family:\&quot;Times New Roman\&quot;;mso-bidi-font-family:\nCalibri;mso-bidi-theme-font:minor-latin;mso-ansi-language:DE&quot;}">ventrikuloperitonealer (VP) Shunt</span>

*<span class="ve-pasteProtect" style="font-size:12.0pt;mso-fareast-font-family: &quot;Times New Roman&quot;;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin; mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;font-size:12.0pt;mso-fareast-font-family:\n\&quot;Times New Roman\&quot;;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;\nmso-ansi-language:DE&quot;}">Peritonitis</span>
*<span class="ve-pasteProtect" style="font-size:12.0pt;mso-fareast-font-family: &quot;Times New Roman&quot;;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin; mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;font-size:12.0pt;mso-fareast-font-family:\n\&quot;Times New Roman\&quot;;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;\nmso-ansi-language:DE&quot;}">abdominalen Druckempfindlichkeit</span>

<span class="ve-pasteProtect" style="font-size:12.0pt;mso-fareast-font-family:&quot;Times New Roman&quot;;mso-bidi-font-family:
Calibri;mso-bidi-theme-font:minor-latin;mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;font-size:12.0pt;mso-fareast-font-family:\&quot;Times New Roman\&quot;;mso-bidi-font-family:\nCalibri;mso-bidi-theme-font:minor-latin;mso-ansi-language:DE&quot;}">ventrikulopleuraler Shunt</span>

*<span class="ve-pasteProtect" style="font-size:12.0pt;mso-fareast-font-family: &quot;Times New Roman&quot;;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin; mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;font-size:12.0pt;mso-fareast-font-family:\n\&quot;Times New Roman\&quot;;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;\nmso-ansi-language:DE&quot;}">Pleuritis</span>

<span class="ve-pasteProtect" style="font-size:12.0pt;mso-fareast-font-family:&quot;Times New Roman&quot;;mso-bidi-font-family:
Calibri;mso-bidi-theme-font:minor-latin;mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;font-size:12.0pt;mso-fareast-font-family:\&quot;Times New Roman\&quot;;mso-bidi-font-family:\nCalibri;mso-bidi-theme-font:minor-latin;mso-ansi-language:DE&quot;}">ventrikuloatrialer (VA) Shunt</span>

*<span class="ve-pasteProtect" style="font-size:12.0pt;mso-fareast-font-family: &quot;Times New Roman&quot;;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin; mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;font-size:12.0pt;mso-fareast-font-family:\n\&quot;Times New Roman\&quot;;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;\nmso-ansi-language:DE&quot;}">Bakteriämie</span>
*<span class="ve-pasteProtect" style="font-size:12.0pt;mso-fareast-font-family: &quot;Times New Roman&quot;;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin; mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;font-size:12.0pt;mso-fareast-font-family:\n\&quot;Times New Roman\&quot;;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;\nmso-ansi-language:DE&quot;}">Glomerulonephritis</span>

===Epidemiologie===
<span class="ve-pasteProtect" style="font-size:12.0pt;
mso-fareast-font-family:&quot;Times New Roman&quot;;mso-bidi-font-family:Calibri;
mso-bidi-theme-font:minor-latin;mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;font-size:12.0pt;\nmso-fareast-font-family:\&quot;Times New Roman\&quot;;mso-bidi-font-family:Calibri;\nmso-bidi-theme-font:minor-latin;mso-ansi-language:DE&quot;}">Die Inzidenz von Shuntinfekten wird zwischen 5 und 41% angegeben, wobei die intraoperative Infektionsrate unter 4% beträgt. </span>

<span class="ve-pasteProtect" style="font-size:12.0pt;
mso-fareast-font-family:&quot;Times New Roman&quot;;mso-bidi-font-family:Calibri;
mso-bidi-theme-font:minor-latin;mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;font-size:12.0pt;\nmso-fareast-font-family:\&quot;Times New Roman\&quot;;mso-bidi-font-family:Calibri;\nmso-bidi-theme-font:minor-latin;mso-ansi-language:DE&quot;}">Die Infektinzidenz von externen Liquorableitungen wird mit ca. 11 / 1000 Kathetertage angegeben, dabei liegt die Inzidenz bei Kathetern, die bis zu 7 Tagen liegen, bei ca. 20 / 1000d, bei einer Liegedauer zwischen 7 und 10 Tagen bei ca. 13 / 1000d und ab 10 Tagen Liegedauer bei 8 / 1000d </span><span class="ve-pasteProtect" style="font-size:12.0pt;mso-fareast-font-family:&quot;Times New Roman&quot;;mso-bidi-font-family:
Calibri;mso-bidi-theme-font:minor-latin;mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;font-size:12.0pt;mso-fareast-font-family:\&quot;Times New Roman\&quot;;mso-bidi-font-family:\nCalibri;mso-bidi-theme-font:minor-latin;mso-ansi-language:DE&quot;}"><span class="ve-pasteProtect" style="mso-no-proof:yes" data-ve-attributes="{&quot;style&quot;:&quot;mso-no-proof:yes&quot;}"></span></span><ref><span style="color: rgb(51, 51, 51)">Tunkel AR, Hasbun R, Bhimraj A, Byers K, Kaplan SL, Michael Scheld W, van de Beek D, Bleck TP, Garton HJ, Zunt JR. 2017 Infectious Diseases Society of America's Clinical Practice Guidelines for Healthcare-Associated Ventriculitis and Meningitis. Clin Infect Dis 2017; 64: e34–e65</span></ref><span class="ve-pasteProtect" style="font-size:12.0pt;mso-fareast-font-family:&quot;Times New Roman&quot;;mso-bidi-font-family:
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&quot;Times New Roman&quot;;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;
mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;font-size:12.0pt;mso-fareast-font-family:\n\&quot;Times New Roman\&quot;;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;\nmso-ansi-language:DE&quot;}">.</span>
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