Article Text

Download PDFPDF
Staphylococcus-induced glomerulonephritis: potential role for corticosteroids
  1. Rui Filipe Nogueira1,
  2. Nuno Oliveira1,2,
  3. Vítor Sousa2,3 and
  4. Rui Alves1,2
  1. 1Department of Nephrology, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
  2. 2Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
  3. 3Department of Pathology, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
  1. Correspondence to Dr Rui Filipe Nogueira; rui_filipe_10{at}live.com.pt

Abstract

Staphylococcus aureus is a troublesome pathogen, responsible for a broad range of clinical manifestations, ranging from benign skin infections to life-threatening conditions such as endocarditis and osteomyelitis. The kidney can be affected through a rapidly progressive glomerulonephritis mediated by an inflammatory reaction against a superantigen deposited in the glomerulus during the infection’s course. This glomerulopathy has a poor prognosis, often leading to chronically impaired kidney function, eventually progressing to end-stage renal disease. Treatment rests on antibiotherapy. Despite the inflammatory role in this disease’s pathophysiology, most authors discourage a simultaneous immunosuppressive approach given the concomitant infection. However, there are some reports of success after administration of systemic corticosteroids in these patients. We present a 66-year-old man with a staphylococcus-induced glomerulonephritis brought on by a vascular graft infection, with rapidly deteriorating kidney function despite extraction of the infected graft and 3 weeks of antibiotherapy with achievement of infection control. Kidney function improved after the introduction of corticosteroids. This case highlights the potential role of corticosteroids in selected cases of staphylococcus-induced glomerulonephritis, particularly those in which the infection is under control.

  • acute renal failure
  • contraindications and precautions
  • infectious diseases

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Footnotes

  • Contributors RFN (corresponding author) was responsible for writing the paper, was involved in the acquisition, analysis and interpretation of data as well as in the revision of the article for important intellectual content; was also involved in the final approval of the version published; and contributed to the patient's follow-up. NO was responsible for the patient's care as well as his follow-up and was involved in the revision of the article for important intellectual content and in the final approval of the version published. VS was responsible for analysing the kidney biopsy samples and provide the results, revised the work critically for important intellectual content and was involved in the final approval of the version published. RA was involved in conception and design of the paper as well as acquisition and interpretation of data and revised it critically for intellectual content and approved it for publication.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.