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Infection-Related Glomerulonephritis Revealed as Shunt Nephritis: A Case Report
Nathalie Hammer1, Antonio Rodriguez-Calero2, Philipp Zens2,3
1Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, Bern, Switzerland.
Biomedicine Hub
|December 1, 2025
Summary
Shunt nephritis, a kidney disease linked to infected shunts, can be challenging to diagnose. Prompt treatment involving antibiotics and shunt removal is vital for kidney recovery.
Area of Science:
- Nephrology
- Infectious Diseases
- Immunology
Background:
- Shunt nephritis is a rare immune complex-mediated glomerulonephritis associated with infected ventriculoatrial (VAS) or ventriculoperitoneal shunts (VPS).
- Incidence has decreased due to improved infection management, but low-grade bacteremia can still occur, often involving Cutibacterium acnes.
- Immune complex deposition in kidneys causes glomerulonephritis and nephrotic syndrome.
Purpose of the Study:
- To highlight the diagnostic challenges of shunt nephritis, especially when overt infection is absent.
- To emphasize the importance of early diagnosis and multidisciplinary management for preventing progressive kidney damage.
Main Methods:
- Case presentation of a 35-year-old male with a history of traumatic brain injury and VAS placement.
- Diagnostic workup included renal biopsy, cerebrospinal fluid (CSF) analysis, and blood/CSF cultures.
- Treatment involved targeted antibiotics, shunt externalization, removal, and eventual VPS re-implantation.
Main Results:
- Patient presented with nephrotic syndrome, hypertension, and neurological decline.
- Renal biopsy showed diffuse membranoproliferative glomerulonephritis.
- Cutibacterium acnes was identified in blood and CSF cultures.
- Post-treatment, complement levels normalized, albuminuria decreased, and renal function stabilized.
Conclusions:
- Early recognition and prompt intervention, including antibiotics and shunt removal, are crucial for resolving shunt nephritis and nephrotic syndrome.
- Multidisciplinary management is essential for complex cases of shunt nephritis.
- This case underscores the need for vigilance in diagnosing shunt nephritis even without obvious signs of infection.
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