Role of serological tests in the diagnosis of immune complex disease in infection of ventriculoatrial shunts for hydrocephalus.

Seven cases of ventriculoatrial shunt infection with immune complex disease are reported in order to demonstrate the usefulness of measurement of levels of specific antibody to Staphylococcus epidermidis in diagnosis. Blood and cerebrospinal fluid cultures gave misleading results, and there was initial doubt about the diagnosis in all seven cases. All showed grossly elevated titres of antibody to Staphylococcus epidermidis, with raised serum C-reactive protein levels and depressed complement levels. Measurement of antibody to Staphylococcus epidermidis enables the diagnosis of chronic ventriculoatrial shunt infection to be made rapidly and reliably.