• World Neurosurg · Apr 2016

    Case Reports

    Intraventricular bone wax as cause of recurrent CSF infection: a neuroradiological pitfall.

    • Pietro Spennato, Inti Enrique Escamilla-Rodrìguez, Giuliana Di Martino, Alessia Imperato, Giuseppe Mirone, and Giuseppe Cinalli.
    • Department of Neurosurgery, Santobono-Pausilipon Pediatric Hospital, Naples, Italy. Electronic address: pierospen@gmail.com.
    • World Neurosurg. 2016 Apr 1; 88: 690.e7-690.e9.

    BackgroundPersistent or recurrent shunt infections can be secondary to predisposing factors, such as isolated compartments, cerebrospinal fluid leaks, or foreign bodies.Case DescriptionA 5-year-old girl experienced several episodes of shunt infections. After careful reevaluation of all neuroradiologic records of the patient, a foreign body in the left frontal horn of the lateral ventricle was suspected. An endoscopic approach was used to identify and remove a small fragment of bone wax.ConclusionsTo our knowledge, this is the first report of intraventricular bone wax causing persistent CSF infection. The diagnosis was difficult because wax resembles air on computed tomography and on magnetic resonance imaging, and so it had been not noticed for months. Only its persistence on several images raised the suspicion of foreign body inside the ventricular system.Copyright © 2016 Elsevier Inc. All rights reserved.

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