Shunt nephritis: demonstration of diphtheroid antigen in glomeruli.

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 shung valve. Immunoglobulin, complement components and diphtheroid antigenic material were demonstrated in the glomeruli by immunofluorescence microscopy. Treatment of her shunt infection by shunt replacement and antibiotic therapy resulted in slow resolution of her nephritis. The slow resolution of her nephritis suggests that prompt resolution of immune complex disease due to prolonged bacterial injection cannot always be anticipated, even after successful eradication of infection.