Transient arthritis with positive tests for rheumatoid factor as presenting sign of shunt nephritis.

Shunt nephritis is a rare complication of a chronically infected ventriculoatrial shunt. A 17 year old boy is described, with arthritis in both ankles and positive rheumatoid factor tests, who presented with symptoms of shunt nephritis. Blood cultures were positive for Staphylococcus epidermidis. The patient recovered completely after removal of the shunt and antibiotic treatment. 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.