{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T10:25:10Z","timestamp":1770114310970,"version":"3.49.0"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"10","license":[{"start":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T00:00:00Z","timestamp":1741564800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2025,3,10]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Shunt nephritis, although rare, should be high in the differential diagnoses for patients with gross or microscopic hematuria and a history of a ventriculoatrial\/cystoatrial shunt.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>\n                      The authors present the case of a 31-year-old female with a history of a resected posterior fossa hemangioblastoma and hydrocephalus, who presented to the nephrology clinic with night sweats and tea-colored urine for 3 months after being hospitalized for a saddle pulmonary embolism; kidney biopsy was contraindicated. The patient had hypocomplementemia, nephrotic-range proteinuria, positive proteinase 3\u2013specific antineutrophil cytoplasmic antibody, and dysmorphic red blood cells in the urine sediment. CSF culture grew\n                      <jats:italic>Propionibacterium acnes<\/jats:italic>\n                      . The patient was diagnosed with shunt nephritis without the need for a kidney biopsy. The patient was treated with ceftriaxone and surgical shunt removal. Hematuria, proteinuria, and night sweats resolved 3 weeks later. A ventriculoperitoneal shunt was placed 4 months later for persistent hydrocephalus.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Shunt nephritis is a rare type of glomerulonephritis that can progress to end-stage renal disease or death if the diagnosis is delayed or not established. Definitive treatment involves antibiotic therapy and surgical shunt removal. This case highlights that a kidney biopsy is not necessary for diagnosis in all cases, and aspiration of shunt fluid could be all that is required to determine a diagnosis.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE24546\">https:\/\/thejns.org\/doi\/10.3171\/CASE24546<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case24546","type":"journal-article","created":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T02:59:54Z","timestamp":1741575594000},"source":"Crossref","is-referenced-by-count":0,"title":["Diagnosis of shunt nephritis through cerebrospinal fluid culture: avoiding the need for kidney biopsy. Illustrative case"],"prefix":"10.3171","volume":"9","author":[{"given":"Ilgizar","family":"Hart","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Nephrology, Medical University of South Carolina, Charleston, South Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1862-8640","authenticated-orcid":true,"given":"Keisuke","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Deparment of Nephrology, Nara Medical University, Kashihara, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5491-8226","authenticated-orcid":true,"given":"Benjamin R.","family":"Teruel","sequence":"additional","affiliation":[{"name":"Department of Medicine, Medical University of South Carolina, Charleston, South Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Blaithin A.","family":"McMahon","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Nephrology, Medical University of South Carolina, Charleston, South Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"bib1","series-title":"Comprehensive Clinical Nephrology","first-page":"669","author":"Johnson","year":"2019","unstructured":"Johnson RJFeehally JFloege J.Comprehensive Clinical Nephrology. Elsevier; 2019:669-670."},{"issue":"7419","key":"bib2","series-title":"Lancet","first-page":"921","article-title":"Nephrotic syndrome associated with bacter\u00e6mia after shunt operations for hydrocephalus","volume":"2","author":"Black","year":"1965","unstructured":"Black JAChallacombe DNOckenden BG.Nephrotic syndrome associated with bacter\u00e6mia after shunt operations for hydrocephalus. Lancet. 1965;2(7419):921-924."},{"issue":"6","key":"bib3","series-title":"Nephrol Dial Transplant","first-page":"1143","article-title":"The clinical spectrum of shunt nephritis","volume":"12","author":"Haffner","year":"1997","unstructured":"Haffner DPSchindera FAschoff AJMatthias SWaldherr RSch\u00e4rer K.The clinical spectrum of shunt nephritis. Nephrol Dial Transplant. 1997;12(6):1143-1148."},{"key":"bib4","series-title":"Case Rep Nephrol","first-page":"1867349","article-title":"Delayed manifestation of shunt nephritis: a case report and review of the literature","volume":"2017","author":"Babigumira","year":"2017","unstructured":"Babigumira MHuang BWerner SQunibi W.Delayed manifestation of shunt nephritis: a case report and review of the literature. Case Rep Nephrol. 2017;2017:1867349."},{"key":"bib5","series-title":"World Neurosurg","first-page":"346","article-title":"Shunt nephritis: an increasingly unfamiliar diagnosis","volume":"111","author":"Harland","year":"2018","unstructured":"Harland TAWinston KRJovanovich AJJohnson RJ.Shunt nephritis: an increasingly unfamiliar diagnosis. World Neurosurg. 2018;111:346-348."},{"issue":"5","key":"bib6","series-title":"Am J Kidney Dis","first-page":"e11","article-title":"Shunt nephritis with positive titers for ANCA specific for proteinase 3","volume":"43","author":"Iwata","year":"2004","unstructured":"Iwata YOhta SKawai KShunt nephritis with positive titers for ANCA specific for proteinase 3. Am J Kidney Dis. 2004;43(5):e20.1-e20.6:e11-e16."},{"issue":"9","key":"bib7","series-title":"J Pediatr Surg","first-page":"839","article-title":"Shunt nephritis","volume":"23","author":"Narchi","year":"1988","unstructured":"Narchi HTaylor RAzmy AFMurphy AVBeattie TJ.Shunt nephritis. J Pediatr Surg. 1988;23(9):839-841."},{"issue":"5","key":"bib8","series-title":"Kidney Int","first-page":"792","article-title":"Bacterial infection\u2013related glomerulonephritis in adults","volume":"83","author":"Nasr","year":"2013","unstructured":"Nasr SHRadhakrishnan JD\u2019Agati VD.Bacterial infection\u2013related glomerulonephritis in adults. Kidney Int. 2013;83(5):792-803."},{"issue":"3","key":"bib9","series-title":"Cent Eur J Urol","first-page":"330","article-title":"Macroscopic hematuria in patients on anticoagulation therapy","volume":"68","author":"Mladenov","year":"2015","unstructured":"Mladenov BSMariyanovski VHadzhiyska V.Macroscopic hematuria in patients on anticoagulation therapy. Cent Eur J Urol. 2015;68(3):330-333."},{"issue":"3","key":"bib10","series-title":"Autoimmun Rev","first-page":"201","article-title":"Infections and antineutrophil cytoplasmic antibodies: triggering mechanisms","volume":"14","author":"Konstantinov","year":"2015","unstructured":"Konstantinov KNUlff-M\u00f8ller CJTzamaloukas AH.Infections and antineutrophil cytoplasmic antibodies: triggering mechanisms. Autoimmun Rev. 2015;14(3):201-203."},{"issue":"4","key":"bib11","series-title":"Kidney Int Rep","first-page":"774","article-title":"Shunt nephritis and pyogenic spondylitis with a positive PR3-ANCA associated with chronically infected ventriculoatrial shunt","volume":"2","author":"Ono","year":"2017","unstructured":"Ono HKishi SInagaki TShunt nephritis and pyogenic spondylitis with a positive PR3-ANCA associated with chronically infected ventriculoatrial shunt. Kidney Int Rep. 2017;2(4):774-778."},{"issue":"12","key":"bib12","series-title":"Kidney Int","first-page":"1434","article-title":"A young man with Propionibacterium acnes-induced shunt nephritis","volume":"73","author":"Kiryluk","year":"2008","unstructured":"Kiryluk KPreddie DCD\u2019Agati VDIsom R.A young man with Propionibacterium acnes-induced shunt nephritis. 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Nephrol Dial Transplant. 1997;12(6):1143-1148."},{"key":"bib4","series-title":"Case Rep Nephrol","first-page":"1867349","article-title":"Delayed manifestation of shunt nephritis: a case report and review of the literature","volume":"2017","author":"Babigumira","year":"2017","unstructured":"Babigumira MHuang BWerner SQunibi W.Delayed manifestation of shunt nephritis: a case report and review of the literature. Case Rep Nephrol. 2017;2017:1867349."},{"key":"bib5","series-title":"World Neurosurg","first-page":"346","article-title":"Shunt nephritis: an increasingly unfamiliar diagnosis","volume":"111","author":"Harland","year":"2018","unstructured":"Harland TAWinston KRJovanovich AJJohnson RJ.Shunt nephritis: an increasingly unfamiliar diagnosis. 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Kidney Int. 2013;83(5):792-803."},{"issue":"3","key":"bib9","series-title":"Cent Eur J Urol","first-page":"330","article-title":"Macroscopic hematuria in patients on anticoagulation therapy","volume":"68","author":"Mladenov","year":"2015","unstructured":"Mladenov BSMariyanovski VHadzhiyska V.Macroscopic hematuria in patients on anticoagulation therapy. Cent Eur J Urol. 2015;68(3):330-333."},{"issue":"3","key":"bib10","series-title":"Autoimmun Rev","first-page":"201","article-title":"Infections and antineutrophil cytoplasmic antibodies: triggering mechanisms","volume":"14","author":"Konstantinov","year":"2015","unstructured":"Konstantinov KNUlff-M\u00f8ller CJTzamaloukas AH.Infections and antineutrophil cytoplasmic antibodies: triggering mechanisms. Autoimmun Rev. 2015;14(3):201-203."},{"issue":"4","key":"bib11","series-title":"Kidney Int Rep","first-page":"774","article-title":"Shunt nephritis and pyogenic spondylitis with a positive PR3-ANCA associated with chronically infected ventriculoatrial shunt","volume":"2","author":"Ono","year":"2017","unstructured":"Ono HKishi SInagaki TShunt nephritis and pyogenic spondylitis with a positive PR3-ANCA associated with chronically infected ventriculoatrial shunt. Kidney Int Rep. 2017;2(4):774-778."},{"issue":"12","key":"bib12","series-title":"Kidney Int","first-page":"1434","article-title":"A young man with Propionibacterium acnes-induced shunt nephritis","volume":"73","author":"Kiryluk","year":"2008","unstructured":"Kiryluk KPreddie DCD\u2019Agati VDIsom R.A young man with Propionibacterium acnes-induced shunt nephritis. Kidney Int. 2008;73(12):1434-1440."}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/9\/10\/article-CASE24546.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/9\/10\/article-CASE24546.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/9\/10\/article-CASE24546.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T23:36:59Z","timestamp":1770075419000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/9\/10\/article-CASE24546.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,10]]},"references-count":24,"journal-issue":{"issue":"10"},"URL":"https:\/\/doi.org\/10.3171\/case24546","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,10]]}}}