Presentation
Shunt nephritis should be considered in patients with a ventriculoatrial shunt presenting with arthritis, and the arthritis may be an early indicator of an infected ventriculoatrial shunt. [ncbi.nlm.nih.gov]
A 23-year-old girl with a ventriculo-atrial shunt presented with hematuria, proteinuria and severe oedema. Diphtheroid organisms were cultured from blood, cerebrospinal fluid and the shunt valve. [ucdavis.pure.elsevier.com]
Transient arthritis with positive tests for rheumatoid factor as presenting sign of shunt nephritis. Ann Rheum Dis 1991 ; 50 : 182 –3. 2 Aelion JA, Pinals RS. Arthritis associated with ventriculo‐atrial shunt. [doi.org]
Entire Body System
- Chronic Infection
Nephritis associated with a chronically infected ventriculo-atrial (VA) or ventriculo-peritoneal (VP) shunt is known as shunt nephritis. [keio.pure.elsevier.com]
Nephritis associated with a chronically infected ventriculoatrial shunt is known as shunt nephritis. To our knowledge, we report the first case of shunt nephritis in a child with a ventriculoperitoneal shunt. [ncbi.nlm.nih.gov]
- Fishing
Am J Med. 1975 Sep; 59 (3):417–423. [ PubMed ] [ Google Scholar ] Dobrin RS, Day NK, Quie PG, Moore HL, Vernier HL, Michael AF, Fish AJ. [ncbi.nlm.nih.gov]
F., Fish, A. J. The role of complement, immunoglobulin and bacterial antigen in coagulase-negative staphylococcal shunt nephritis. Am. J. Med. 59 (1975) 660–673. Google Scholar 15. Bolton, W. K., Sande, M. A., Normansell, D. E., Sturgill, B. [link.springer.com]
- Leg Edema
A 60-year-old woman who had a VA shunt implanted for hydrocephalus began to show intermittent low-grade fever of an unknown origin, as well as hypertension and lower leg edema. [keio.pure.elsevier.com]
- Fever of Unknown Origin
He began to show intermittent fever of unknown origin from the 3rd postoperative day. Blood culture yielded a few colonies of Staphylococcus epidermidis. [kundoc.com]
- Recurrent Infection
Precautions to avoid new infections should be taken. If there is a high risk of new infection (e.g. immune deficiency, recurrent infections) or institutional infection rates are greater than 5%, consider using antibiotic-impregnated shunt catheters. [ispn.guide]
Liver, Gall & Pancreas
- Hepatosplenomegaly
All patients had signs of infection, i.e. recurrent fever, hepatosplenomegaly, anaemia, and cerebral symptoms. [doi.org]
Immune complex glomerulonephritis seen in ± 4% of infants with infected ventriculoatrial, ventriculojugular or ventriculoperitoneal shunts Clinical Weight loss, lethargy, fever, lymphadenopathy, hepatosplenomegaly, HTN, arthralgia, nephrotic syndrome, [medical-dictionary.thefreedictionary.com]
Workup
The diagnostic workup and management of this disease is discussed. [ncbi.nlm.nih.gov]
Workup often shows hypocomplementemia (↓ C3/C4), renal failure, eosinophilia and eosinophiluria. [medicalmediareview.com]
MD, University of Texas Health Sciences Center San Antonio Quick-brain MRI (also known as rapid-brain MRI, rapid-sequence MRI, fast-sequence MRI, single-shot fast-spin echo) is quickly replacing CT as the diagnostic imaging modality of choice in the workup [ahcmedia.com]
Diagnosis of Nephrotic Syndrome Because of these considerations, our recommendations for the initial workup of adults with nephrotic syndrome are outlined in Table 6. [jamanetwork.com]
Microbiology
- Blood Culture Positive
Blood cultures were positive for a coagulase‐negative staphylococcus and her cerebrospinal fluid was positive for a coagulase‐negative staphylococcus and Propionibacterium acnes. An echocardiogram did not reveal endocarditis. [doi.org]
- Gram-Positive Coccus
A gram-positive coccus, Gemella morbillorum, was recovered from her blood as well as cerebrospinal fluid, and the culture of the shunt catheter established the diagnosis of shunt nephritis. [ncbi.nlm.nih.gov]
Biopsy
- Liver Biopsy
Nowadays, most candidates awaiting orthotopic liver transplantation have an abnormal renal biopsy at the time of transplantation [ 7 ]. [academic.oup.com]
Treatment
Treatment of her shunt infection by shunt replacement and antibiotic therapy resulted in slow resolution of her nephritis. [ucdavis.pure.elsevier.com]
Abstract BACKGROUND: Shunt nephritis is an immune-complex-mediated glomerulonephritis (GN) associated with chronically infected ventriculoatrial shunts inserted for treatment of hydrocephalus. [doi.org]
The optimal treatment includes timely removal of the infected shunt in combination with aggressive antibiotic therapy. [degruyter.com]
The patient recovered completely after removal of the shunt and antibiotic treatment. [ncbi.nlm.nih.gov]
Prognosis
It generally has a good prognosis in the majority of early diagnosed and properly cured cases. Some cases of SN have a poor prognosis despite of a good therapeutical approach. Our patient was an 11-year old boy with two implanted shunts. [paedcro.com]
Treatment involves mandatory removal of the shunt and antibiotics; prognosis is variable. [ncbi.nlm.nih.gov]
A good prognosis of this pathology is achieved if an early antibiotic treatment is established, and the infected shunt is removed Real Time Impact Factor: Pending Author Name: Daniel Sebastián Contento*, Juan Esteban Muñoz, Carolina Cortés, Sebastián [citefactor.org]
S albus Treatment Antibiotics, high-dose prednisone Prognosis 1 ⁄ 2 resolve with therapy, 1 ⁄ 4 have persistent urine abnormalities; 1 ⁄ 4 die of the neurologic defects necessitating ventricular shunt [medical-dictionary.thefreedictionary.com]
Etiology
181 Temperature Regulation 182 Additional Nursing Care 183 Syndrome of Inappropriate Secretion of Antidiuretic Hormone 184 Preoperative Baseline 185 Postoperative Complications 186 Outcomes 187 References 188 Spine 191 Traumatic Spinal Cord Injuries Etiology [books.google.de]
These findings support the potential role of C. bovis as an etiologic agent in human renal disease and further define the immune complex nature of shunt nephritis. [ncbi.nlm.nih.gov]
Etiology of CSF Shunt Infections View Table | Favorite Table | Download (.pdf) Table 70–1. [mhmedical.com]
Epidemiology
Infections of cerebrospinal fluid shunts: epidemiology, clinical manifestations, and therapy. J Infect Dis. 1975 May; 131 (5):543–552. [ PubMed ] [ Google Scholar ] Sells CJ, Shurtleff DB, Loeser JD. [ncbi.nlm.nih.gov]
Death occurred in 9%.[1] Epidemiology[edit] Shunt nephritis is a rare condition affecting males and females of all ages. It occurs in approximately 0.7-2.3% of patients with shunt infections. [en.wikipedia.org]
Infections of cerebrospinal fluid shunts: epidemiology, clinical manifestations, and therapy. J. Infect. Dis. 131 : 543 – 552. 65. Sells, C. J., , D. B. Shurtleff, , and J. D. Loeser. 1977. [asmscience.org]
Infections of cerebrospinal fluid shunts: epidemiology, clinical manifestations and therapy. J. Infect. Dis. 131 (1975) 543–553. Google Scholar 19. McLaurin, R. L. Infected cerebrospinal shunts. Surg. Neurol. 1 (1973) 191–195. Google Scholar 20. [link.springer.com]
Currently, S aureus is the most common pathogen recognized. [10] Shunt nephritis may be associated with ventriculovascular, ventriculoperitoneal, peritoneovascular, or vascular shunts. [11] Epidemiology The various causes of infection-related GN have [emedicine.medscape.com]
Pathophysiology
This study of pathologic and laboratory changes following therapy suggests that the pathophysiology of the nephritis was based on an immunologic process, and that removal of antigen resulted in reversal of glomerular changes. [ncbi.nlm.nih.gov]
Nursing Care 200 Summary 202 KlippelFeil Syndrome 205 Outcomes 206 Summary 208 Neurovascular Disease 211 Arterial Supply 212 Venous Supply 213 Vein of Galen Aneurysmal Malformations 214 Diagnostic Tests 215 Treatment Options 216 Family Education 217 Pathophysiology [books.google.de]
Prevention
Prevention of bacterial endocarditis. [books.google.com]
Prevention of bacterial endocarditis. [books.google.de]
Endovascular retrieval of migrated shunts is less invasive, is feasible, and prevents further complications. [pediatricneurosciences.com]
The shunts divert CSF away from the ventricles, preventing increases in intracranial pressure that lead to neurologic sequelae. [mhmedical.com]