Fever as the initial sign of malfunction in non infected ventriculoperitoneal shunts

Sixty eight children were treated for ventriculoperitoneal shunt malfunction in our department during the years 1984-1989. Fifteen (22%) developed fever above 37.5 °C as a presenting sign of their shunt malfunction. Physical examination did not reveal any reason for the fever. Cerebrospinal fluid, urine and blood cultures were all negative. All the children were operated upon and the malfunction corrected. Fever subsided twenty four to thirty six hours after the operation in all the patients. Fever of unknown origin in children with shunted hydrocephalus might be the first sign of a developing shunt malfunction and a neurosurgical examination should be requested.