A Case of Recurrent Bacterial Meningitis Due to Retained 54-Year-Old Ureterodural Anastomosis

• Published in: JIM - high impact case reports Vol. 6; p. 2324709618795293
• Main Authors: D’Assumpcao, Carlos, Sandhu, Ahana, Heidari, Arash, Froush, Arman G., Hillyer, Shahab, Chen, Joseph, Ragland, Alan
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.01.2018; Sage Publications Ltd; SAGE Publishing
• Subjects: Case Report; Case reports; Meningitis; Urinary tract infections; uretero-arachnoid anastomosis; ventriculomegaly; ureterodural anastomosis; hydrocephalus; increased intracranial pressure; lumbar ureteral shunt; urinary retention; computed tomography myelogram; recurrent meningitis; lumboureteral shunt; congenital hydrocephalus; subarachnoid-ureteral shunt; urinary tract infection; arachnoid-ureterostomy
• ISSN: 2324-7096; 2324-7096
• DOI: 10.1177/2324709618795293

Ventriculoperitoneal shunts are the current treatment of choice for congenital hydrocephalus. It is rare for physicians to see patients with alternative types of shunting devices. Lumboureteral shunts, once popular from the 1940s to 1960s, decompress via the genitourinary system. Immediate complications were dehydration, electrolyte imbalances, infection, and the sacrifice of a functional kidney. Long-term complications include retrograde meningitis due to urinary tract infections. Three shunt types have been documented: polyethylene, silicone rubber, and ureterodural anastomosis. Routine imaging cannot detect a ureterodural anastomosis, and if suspected, computed tomography myelogram is needed for confirmation. This article presents the case of a man with long-standing ureterodural anastomosis that required ligation after recurrent episodes of acute meningitis secondary to urinary retention.