Staphylococcus-associated glomerulonephritis in adults
- Samih H Nasr, MD
Samih H Nasr, MD
- Associate Professor of Laboratory Medicine and Pathology
- College of Medicine, Mayo Clinic
- Jai Radhakrishnan, MD, MS
Jai Radhakrishnan, MD, MS
- Professor of Medicine
- Columbia University Medical Center
- Vivette D D'Agati, MD
Vivette D D'Agati, MD
- Professor of Pathology
- Columbia University
- College of Physicians and Surgeons
- Section Editors
- Lee A Hebert, MD
Lee A Hebert, MD
- Section Editor — Glomerular Diseases
- Professor of Medicine
- Ohio State University
- Wexner College of Medicine and Public Health
- Richard J Glassock, MD, MACP
Richard J Glassock, MD, MACP
- Editor-in-Chief — Nephrology
- Section Editor — Glomerular Diseases
- Emeritus Professor
- The David Geffen School of Medicine at UCLA
The term postinfectious glomerulonephritis has primarily referred to poststreptococcal glomerulonephritis. This is still appropriate in children, but in adults, as described below, Staphylococcus-associated glomerulonephritis (previously referred to as post-staphylococcal glomerulonephritis) may be as or more common.
This topic will review Staphylococcus-associated glomerulonephritis in adults. Other causes of infection-related glomerulonephritis, including poststreptococcal glomerulonephritis and glomerulonephritis associated with endocarditis or with viral, fungal, protozoal, or parasitic infections, are discussed elsewhere. (See "Poststreptococcal glomerulonephritis" and "Renal disease in the setting of infective endocarditis or an infected ventriculoatrial shunt" and "Overview of renal disease associated with hepatitis C virus infection" and "Renal disease associated with hepatitis B virus infection" and "Overview of kidney disease in HIV-positive patients" and "Clinical presentation, classification, and causes of membranoproliferative glomerulonephritis", section on 'Infections' and "Schistosomiasis and glomerular disease" and "Clinical manifestations and diagnosis of echinococcosis", section on 'Other organs'.)
Proposed general terms for glomerulonephritis induced by infections mentioned in the preceding section are infection-associated or infection-related glomerulonephritis . The most commonly used term for Streptococcus-related disease is poststreptococcal glomerulonephritis because the renal disease typically begins after the usually pharyngeal or skin infection has either resolved spontaneously or has been effectively treated.
By contrast, most of the other causes of bacterial infection-associated glomerulonephritis, including that due to Staphylococcus infection, occur when the patient is still infected. Thus, we prefer the term Staphylococcus-associated glomerulonephritis to distinguish it from glomerulonephritis that can develop when the infection is no longer active (eg, poststreptococcal glomerulonephritis). (See "Poststreptococcal glomerulonephritis".)
Staphylococcus-associated glomerulonephritis is an immune complex-mediated disease . The antigen component of the immune complex is derived from the infective agent, similar to poststreptococcal glomerulonephritis. (See "Poststreptococcal glomerulonephritis", section on 'Pathogenesis'.)
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- CLINICAL MANIFESTATIONS
- Findings at presentation
- Most common sites of infection
- Laboratory tests
- - Bacterial cultures
- Diagnostic criteria
- Indications for kidney biopsy
- Histologic findings
- - Light microscopy
- - Immunofluorescence microscopy
- - Electron microscopy
- - IgA-dominant Staphylococcus-associated glomerulonephritis
- Distinction from IgA nephropathy
- DIFFERENTIAL DIAGNOSIS AND EVALUATION FOR OTHER CAUSES
- Distinction from C3 glomerulonephritis
- MONITORING AFTER DIAGNOSIS
- Eradicate the infection
- Control hypertension and edema
- Do not use immunosuppressive therapy
- Persistent or recurrent disease
- Renal prognosis
- SOCIETY GUIDELINE LINKS
- SUMMARY AND RECOMMENDATIONS