Shunt Nephritis: An Increasingly Unfamiliar Diagnosis.
World Neurosurg
; 111: 346-348, 2018 Mar.
Article
in En
| MEDLINE
| ID: mdl-29325951
ABSTRACT
BACKGROUND:
Shunt nephritis is a rare, reversible immune-complex mediated complication of cerebrospinal fluid (CSF) shunt infection that can progress to end-stage renal disease and even death if diagnosis is delayed. CASE DESCRIPTION The present case report details the manifestation and clinical course of shunt nephritis in a 50-year-old patient who presented with symptoms of nephrotic syndrome 30 years after ventriculojugular shunt placement. Diagnosis was delayed due to initial negative CSF and blood cultures, but a later CSF culture was positive for Propionibacterium acnes. After treatment with intravenous antibiotics and complete removal of shunt with subsequent replacement with a new ventriculoperitoneal shunt, the nephritic symptoms resolved, but the patient continued to have reduced kidney function consistent with stage IIIa chronic kidney disease.CONCLUSION:
This case emphasizes the clinical importance of having a high index of suspicion in patients with a ventricular shunt who present with symptoms consistent with nephritis, even in the setting of negative cultures and delayed presentation.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Cerebrospinal Fluid Shunts
/
Prosthesis-Related Infections
/
Gram-Positive Bacterial Infections
/
Kidney Failure, Chronic
/
Nephritis
Type of study:
Diagnostic_studies
Limits:
Humans
/
Male
/
Middle aged
Language:
En
Journal:
World Neurosurg
Journal subject:
NEUROCIRURGIA
Year:
2018
Document type:
Article
Affiliation country:
Estados Unidos