Glomerulonephritis associated with acute pneumococcal pneumonia: a case report

Abstract

Streptococcus pyogenes is the most common cause of post-infectious glomerulonephritis. There have been isolated case reports of nephritis following infections with Streptococcus pneumoniae. We report here the case of a 6-year-old white female who presented with blood culture-confirmed pneumococcal pneumonia associated with glomerulonephritis. Her acute renal failure improved over several days, and renal function was normal by 8 weeks post-hospitalization. This case serves to reinforce the concept that other organisms besides Streptococcus pyogenes can trigger a similar post-infectious glomerulonephritis and should be considered in the differential diagnosis of any child who presents with acute glomerulonephritis and respiratory findings. Additionally, pneumococcus group 7 may be a nephritogenic strain and requires further investigation.

Pneumococcal glomerulonephritis in a healthy child: a case report and literature review

“…All patients, including ours, had microscopic haematuria, proteinuria and/ or oliguria on admission. Most patients developed high blood pressure (1)(2)(3)5) on presentation, but only two required diuretics, (1,5) and only one of these patients needed antihypertensive agents.…”

“…Patients were usually no longer febrile at the onset of AGN. In patients with pneumococcal AGN, the onset of nephritis was seen within 2-10 days (3,4,6,8) of the primary infection, manifesting as pneumonia, (1,2,(4)(5)(6)(7) submandibular suppurative adenitis (3) or leg cellulitis. (8) In our patient, who developed AGN one week after experiencing submandibular and cervical adenitis, the clinical condition improved although the fever remained unabated.…”

“…In most patients with post-infectious glomerulonephritis following pneumococcal pneumonia, (1,2,4,5) respiratory symptoms were the first to appear, followed by renal manifestations. In our patient, however, renal involvement was the first manifestation and pneumonia with pleural effusion only developed later.…”

“…Isolated reports of acute nephritis caused by S. pneumoniae infection, usually following respiratory symptoms, have rarely been described. (1,2) Herein, we present a previously healthy child who developed pneumococcal AGN following submandibular and cervical lymphadenitis complicated with respiratory problems, and in whom AGN was confirmed on blood culture. We also review the relevant literature.…”

Ūminis glomerulonefritas, susijęs su mikoplazmine pneumonija

“…Tačiau esama duomenų, kad panašų glomerulonefritą gali sukelti ir kiti mikroorganizmai. Palyginti nesenas pavyzdys iš literatūros -ūminis glomerulonefritas, pasireiškęs po pneumokokinės pneumonijos (1). Inkstus gali pažeisti ir mikoplazminė infekcija, tačiau tai gana retas reiškinys, o kliniškai šis pažeidimas pasireiškia įvairiai.…”