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Shuichi Ito - One of the best experts on this subject based on the ideXlab platform.
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Central venous catheter infection-related glomeruloNephritis under long-term parenteral nutrition: a report of two cases
BMC research notes, 2016Co-Authors: Mari Okada, Mai Sato, Masao Ogura, Koichi Kamei, Kentaro Matsuoka, Shuichi ItoAbstract:Advances in long-term parenteral nutrition via indwelling central venous catheter have improved the quality of life and mortality in patients with life-threatening gastrointestinal diseases complicated with severely impaired absorption. However, infection to central venous catheter is still a common and critical complication for such patients. We encountered two patients under long-term parenteral nutrition who developed glomeruloNephritis associated with central venous catheter infection. Persistent bacterial infection in indwelling medical devices placed in the blood-stream such as a ventricular-atrial Shunt is known to cause glomeruloNephritis, a condition termed Shunt Nephritis. We reported the clinical manifestations, treatment and their pathological findings in the two patients with glomeruloNephritis associated with central venous catheter infection. Both patients suffered from megacystis microcolon intestinal hypoperistalsis syndrome, a form of pseudo-Hirschsprung’s disease. They had been receiving home parenteral nutrition via central venous catheter because of severe malabsorption. They presented proteinuria, hematuria, hypocomplementemia and positive PR3-antineutrophilic cytoplasmic antibody accompanied by Staphylococcus epidermidis infection in the central venous catheter. Their renal biopsy revealed membranoproliferative glomeruloNephritis with positive C3 deposition. One of them recovered completely following the removal of catheter and administration of antibiotics, while another did not respond to the treatments. We then treated her with methylprednisolone pulse therapy followed by prednisolone. She responded well, and achieved complete remission. As central venous catheter infection-related glomeruloNephritis has a similar etiology to Shunt Nephritis, removal of the catheter and administration of antibiotics is fundamental to the treatment. If a patient is resistant to such conventional therapy, additional steroid and/or immunosuppressive agent could be considered. Although the number of patients with classical Shunt Nephritis is decreasing since the ventricular-peritoneal Shunt has become became the major procedure for hydrocephalus, central venous catheter infection-related glomeruloNephritis may increase in the future due to a marked increase in the number of patients receiving long-term parenteral nutrition. Routine urinalysis should be considered in such patients for early detection of central venous catheter infection-related glomeruloNephritis.
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Central venous catheter infection-related glomeruloNephritis under long-term parenteral nutrition: a report of two cases
BMC Research Notes, 2016Co-Authors: Mari Okada, Mai Sato, Masao Ogura, Koichi Kamei, Kentaro Matsuoka, Shuichi ItoAbstract:Background Advances in long-term parenteral nutrition via indwelling central venous catheter have improved the quality of life and mortality in patients with life-threatening gastrointestinal diseases complicated with severely impaired absorption. However, infection to central venous catheter is still a common and critical complication for such patients. We encountered two patients under long-term parenteral nutrition who developed glomeruloNephritis associated with central venous catheter infection. Persistent bacterial infection in indwelling medical devices placed in the blood-stream such as a ventricular-atrial Shunt is known to cause glomeruloNephritis, a condition termed Shunt Nephritis. We reported the clinical manifestations, treatment and their pathological findings in the two patients with glomeruloNephritis associated with central venous catheter infection. Case presentation Both patients suffered from megacystis microcolon intestinal hypoperistalsis syndrome, a form of pseudo-Hirschsprung’s disease. They had been receiving home parenteral nutrition via central venous catheter because of severe malabsorption. They presented proteinuria, hematuria, hypocomplementemia and positive PR3-antineutrophilic cytoplasmic antibody accompanied by Staphylococcus epidermidis infection in the central venous catheter. Their renal biopsy revealed membranoproliferative glomeruloNephritis with positive C3 deposition. One of them recovered completely following the removal of catheter and administration of antibiotics, while another did not respond to the treatments. We then treated her with methylprednisolone pulse therapy followed by prednisolone. She responded well, and achieved complete remission. Conclusion As central venous catheter infection-related glomeruloNephritis has a similar etiology to Shunt Nephritis, removal of the catheter and administration of antibiotics is fundamental to the treatment. If a patient is resistant to such conventional therapy, additional steroid and/or immunosuppressive agent could be considered. Although the number of patients with classical Shunt Nephritis is decreasing since the ventricular-peritoneal Shunt has become became the major procedure for hydrocephalus, central venous catheter infection-related glomeruloNephritis may increase in the future due to a marked increase in the number of patients receiving long-term parenteral nutrition. Routine urinalysis should be considered in such patients for early detection of central venous catheter infection-related glomeruloNephritis.
F. D. Daschner - One of the best experts on this subject based on the ideXlab platform.
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Shunt Nephritis associated withPropionibacterium acnes
Infection, 1994Co-Authors: Ulrike Setz, U. Frank, K. Anding, F. D. Daschner, A. GarbeAbstract:Membranoproliferative glomeruloNephritis was observed in a 22-year-old male patient in whom a ventriculoatrial Shunt and a ventricular catheter were implanted after he was diagnosed in September 1989 with a cerebral cyst. Propionibacterium acnes infection of a central nervous system Shunt was diagnosed. The venticuloatrial Shunt was removed (the catheter had become embedded in tissue and was left in place) and the patient was treated with cefotaxime (3×2 g) for 14 days. Renal function improved, but recovery was not complete. Bei einem 22jährigen Patienten, der im September 1989 einen ventrikuloatrialen Shunt und einen Ventrikelkatheter zur Therapie einer zerebralen Zyste implantiert erhielt, wurde eine membranoproliferative Glomerulonephritits in Assoziation mit einer Shuntinfektion durch Propionibacterium acnes diagnostiziert. Obgleich Infektionen von zentralnervösen Shunts nichts Ungewöhnliches darstellen, ist die Entwicklung einer GlomeruloNephritis eine Seltenheit. Vermutlich ist die ShuntNephritis die Folge einer Immunkomplexantwort und der Ablagerung von Immunkomplexen in der Niere. Nach der nur unvollständigen Entfernung des Shunts aufgrund technischer Probleme und zusätzlicher Gabe von 3 × 2 g Cefotaxim für 14 Tage verbesserte sich die Nierenfunktion, jedoch trat keine komplette Remission ein.
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Shunt Nephritis associated with Propionibacterium acnes.
Infection, 1994Co-Authors: Setz U, U. Frank, Anding K, Garbe A, F. D. DaschnerAbstract:Membranoproliferative glomeruloNephritis was observed in a 22-year-old male patient in whom a ventriculoatrial Shunt and a ventricular catheter were implanted after he was diagnosed in September 1989 with a cerebral cyst.Propionibacterium acnes infection of a central nervous system Shunt was diagnosed. The venticuloatrial Shunt was removed (the catheter had become embedded in tissue and was left in place) and the patient was treated with cefotaxime (3×2 g) for 14 days. Renal function improved, but recovery was not complete.
Mari Okada - One of the best experts on this subject based on the ideXlab platform.
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Central venous catheter infection-related glomeruloNephritis under long-term parenteral nutrition: a report of two cases
BMC research notes, 2016Co-Authors: Mari Okada, Mai Sato, Masao Ogura, Koichi Kamei, Kentaro Matsuoka, Shuichi ItoAbstract:Advances in long-term parenteral nutrition via indwelling central venous catheter have improved the quality of life and mortality in patients with life-threatening gastrointestinal diseases complicated with severely impaired absorption. However, infection to central venous catheter is still a common and critical complication for such patients. We encountered two patients under long-term parenteral nutrition who developed glomeruloNephritis associated with central venous catheter infection. Persistent bacterial infection in indwelling medical devices placed in the blood-stream such as a ventricular-atrial Shunt is known to cause glomeruloNephritis, a condition termed Shunt Nephritis. We reported the clinical manifestations, treatment and their pathological findings in the two patients with glomeruloNephritis associated with central venous catheter infection. Both patients suffered from megacystis microcolon intestinal hypoperistalsis syndrome, a form of pseudo-Hirschsprung’s disease. They had been receiving home parenteral nutrition via central venous catheter because of severe malabsorption. They presented proteinuria, hematuria, hypocomplementemia and positive PR3-antineutrophilic cytoplasmic antibody accompanied by Staphylococcus epidermidis infection in the central venous catheter. Their renal biopsy revealed membranoproliferative glomeruloNephritis with positive C3 deposition. One of them recovered completely following the removal of catheter and administration of antibiotics, while another did not respond to the treatments. We then treated her with methylprednisolone pulse therapy followed by prednisolone. She responded well, and achieved complete remission. As central venous catheter infection-related glomeruloNephritis has a similar etiology to Shunt Nephritis, removal of the catheter and administration of antibiotics is fundamental to the treatment. If a patient is resistant to such conventional therapy, additional steroid and/or immunosuppressive agent could be considered. Although the number of patients with classical Shunt Nephritis is decreasing since the ventricular-peritoneal Shunt has become became the major procedure for hydrocephalus, central venous catheter infection-related glomeruloNephritis may increase in the future due to a marked increase in the number of patients receiving long-term parenteral nutrition. Routine urinalysis should be considered in such patients for early detection of central venous catheter infection-related glomeruloNephritis.
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Central venous catheter infection-related glomeruloNephritis under long-term parenteral nutrition: a report of two cases
BMC Research Notes, 2016Co-Authors: Mari Okada, Mai Sato, Masao Ogura, Koichi Kamei, Kentaro Matsuoka, Shuichi ItoAbstract:Background Advances in long-term parenteral nutrition via indwelling central venous catheter have improved the quality of life and mortality in patients with life-threatening gastrointestinal diseases complicated with severely impaired absorption. However, infection to central venous catheter is still a common and critical complication for such patients. We encountered two patients under long-term parenteral nutrition who developed glomeruloNephritis associated with central venous catheter infection. Persistent bacterial infection in indwelling medical devices placed in the blood-stream such as a ventricular-atrial Shunt is known to cause glomeruloNephritis, a condition termed Shunt Nephritis. We reported the clinical manifestations, treatment and their pathological findings in the two patients with glomeruloNephritis associated with central venous catheter infection. Case presentation Both patients suffered from megacystis microcolon intestinal hypoperistalsis syndrome, a form of pseudo-Hirschsprung’s disease. They had been receiving home parenteral nutrition via central venous catheter because of severe malabsorption. They presented proteinuria, hematuria, hypocomplementemia and positive PR3-antineutrophilic cytoplasmic antibody accompanied by Staphylococcus epidermidis infection in the central venous catheter. Their renal biopsy revealed membranoproliferative glomeruloNephritis with positive C3 deposition. One of them recovered completely following the removal of catheter and administration of antibiotics, while another did not respond to the treatments. We then treated her with methylprednisolone pulse therapy followed by prednisolone. She responded well, and achieved complete remission. Conclusion As central venous catheter infection-related glomeruloNephritis has a similar etiology to Shunt Nephritis, removal of the catheter and administration of antibiotics is fundamental to the treatment. If a patient is resistant to such conventional therapy, additional steroid and/or immunosuppressive agent could be considered. Although the number of patients with classical Shunt Nephritis is decreasing since the ventricular-peritoneal Shunt has become became the major procedure for hydrocephalus, central venous catheter infection-related glomeruloNephritis may increase in the future due to a marked increase in the number of patients receiving long-term parenteral nutrition. Routine urinalysis should be considered in such patients for early detection of central venous catheter infection-related glomeruloNephritis.
U. Frank - One of the best experts on this subject based on the ideXlab platform.
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Shunt Nephritis associated withPropionibacterium acnes
Infection, 1994Co-Authors: Ulrike Setz, U. Frank, K. Anding, F. D. Daschner, A. GarbeAbstract:Membranoproliferative glomeruloNephritis was observed in a 22-year-old male patient in whom a ventriculoatrial Shunt and a ventricular catheter were implanted after he was diagnosed in September 1989 with a cerebral cyst. Propionibacterium acnes infection of a central nervous system Shunt was diagnosed. The venticuloatrial Shunt was removed (the catheter had become embedded in tissue and was left in place) and the patient was treated with cefotaxime (3×2 g) for 14 days. Renal function improved, but recovery was not complete. Bei einem 22jährigen Patienten, der im September 1989 einen ventrikuloatrialen Shunt und einen Ventrikelkatheter zur Therapie einer zerebralen Zyste implantiert erhielt, wurde eine membranoproliferative Glomerulonephritits in Assoziation mit einer Shuntinfektion durch Propionibacterium acnes diagnostiziert. Obgleich Infektionen von zentralnervösen Shunts nichts Ungewöhnliches darstellen, ist die Entwicklung einer GlomeruloNephritis eine Seltenheit. Vermutlich ist die ShuntNephritis die Folge einer Immunkomplexantwort und der Ablagerung von Immunkomplexen in der Niere. Nach der nur unvollständigen Entfernung des Shunts aufgrund technischer Probleme und zusätzlicher Gabe von 3 × 2 g Cefotaxim für 14 Tage verbesserte sich die Nierenfunktion, jedoch trat keine komplette Remission ein.
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Shunt Nephritis associated with Propionibacterium acnes.
Infection, 1994Co-Authors: Setz U, U. Frank, Anding K, Garbe A, F. D. DaschnerAbstract:Membranoproliferative glomeruloNephritis was observed in a 22-year-old male patient in whom a ventriculoatrial Shunt and a ventricular catheter were implanted after he was diagnosed in September 1989 with a cerebral cyst.Propionibacterium acnes infection of a central nervous system Shunt was diagnosed. The venticuloatrial Shunt was removed (the catheter had become embedded in tissue and was left in place) and the patient was treated with cefotaxime (3×2 g) for 14 days. Renal function improved, but recovery was not complete.
Anjali A. Satoskar - One of the best experts on this subject based on the ideXlab platform.
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Epidemiology, pathogenesis, treatment and outcomes of infection-associated glomeruloNephritis
Nature Reviews Nephrology, 2020Co-Authors: Anjali A. Satoskar, Samir V. Parikh, Tibor NadasdyAbstract:For over a century, acute ‘post-streptococcal glomeruloNephritis’ (APSGN) was the prototypical form of bacterial infection-associated glomeruloNephritis, typically occurring after resolution of infection and a distinct infection-free latent period. Other less common forms of infection-associated glomerulonephritides resulted from persistent bacteraemia in association with subacute bacterial endocarditis and Shunt Nephritis. However, a major paradigm shift in the epidemiology and bacteriology of infection-associated glomerulonephritides has occurred over the past few decades. The incidence of APSGN has sharply declined in the Western world, whereas the number of Staphylococcus infection-associated glomeruloNephritis (SAGN) cases increased owing to a surge in drug-resistant Staphylococcus aureus infections, both in the hospital and community settings. These Staphylococcus infections range from superficial skin infections to deep-seated invasive infections such as endocarditis, which is on the rise among young adults owing to the ongoing intravenous drug use epidemic. SAGN is markedly different from APSGN in terms of its demographic profile, temporal association with active infection and disease outcomes. The diagnosis and management of SAGN is challenging because of the lack of unique histological features, the frequently occult nature of the underlying infection and the older age and co-morbidities in the affected patients. The emergence of multi-drug-resistant bacterial strains further complicates patient treatment. Staphylococcus infection-associated glomeruloNephritis (SAGN) and acute post-streptococcal glomeruloNephritis (APSGN) are the two main types of bacterial infection-associated glomeruloNephritis. In this Review, the authors discuss the epidemiology of these diseases, common histopathology findings and the complexities of clinical diagnosis, as well as patient management and renal outcomes. In the last century, acute post-streptococcal glomeruloNephritis (APSGN) was the prototypical infection-associated GN. Over the past few decades, the incidence of APSGN declined sharply in the Western world, whereas the number of Staphylococcus infection-associated glomeruloNephritis (SAGN) cases increased. The surge in staphylococcal infections, mainly methicillin-resistant Staphylococcus aureus (MRSA), is a probable contributing factor. APSGN still occurs with high frequency among highly populated and economically disadvantaged communities around the world, where group A β-haemolytic streptococcal infections are common. APSGN remains the most common cause of acute GN among children, whereas SAGN has very different demographic features and mainly affects the elderly population. SAGN is associated with ongoing infection when the patient presents with acute GN and antibiotic treatment is the mainstay of management; aggressive immunosuppressive treatment is clearly contraindicated and detrimental to the patient when the infection is still active. Infective endocarditis is one of the most frequent infections implicated in SAGN; epidemic intravenous drug use is a major contributing factor, as well as the increased use of cardiac devices in elderly patients.
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Epidemiology, pathogenesis, treatment and outcomes of infection-associated glomeruloNephritis.
Nature Reviews Nephrology, 2019Co-Authors: Anjali A. Satoskar, Samir Parikh, Tibor NadasdyAbstract:For over a century, acute ‘post-streptococcal glomeruloNephritis’ (APSGN) was the prototypical form of bacterial infection-associated glomeruloNephritis, typically occurring after resolution of infection and a distinct infection-free latent period. Other less common forms of infection-associated glomerulonephritides resulted from persistent bacteraemia in association with subacute bacterial endocarditis and Shunt Nephritis. However, a major paradigm shift in the epidemiology and bacteriology of infection-associated glomerulonephritides has occurred over the past few decades. The incidence of APSGN has sharply declined in the Western world, whereas the number of Staphylococcus infection-associated glomeruloNephritis (SAGN) cases increased owing to a surge in drug-resistant Staphylococcus aureus infections, both in the hospital and community settings. These Staphylococcus infections range from superficial skin infections to deep-seated invasive infections such as endocarditis, which is on the rise among young adults owing to the ongoing intravenous drug use epidemic. SAGN is markedly different from APSGN in terms of its demographic profile, temporal association with active infection and disease outcomes. The diagnosis and management of SAGN is challenging because of the lack of unique histological features, the frequently occult nature of the underlying infection and the older age and co-morbidities in the affected patients. The emergence of multi-drug-resistant bacterial strains further complicates patient treatment. Staphylococcus infection-associated glomeruloNephritis (SAGN) and acute post-streptococcal glomeruloNephritis (APSGN) are the two main types of bacterial infection-associated glomeruloNephritis. In this Review, the authors discuss the epidemiology of these diseases, common histopathology findings and the complexities of clinical diagnosis, as well as patient management and renal outcomes.
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Epidemiology, pathogenesis, treatment and outcomes of infection-associated glomeruloNephritis.
Nature reviews. Nephrology, 2019Co-Authors: Anjali A. Satoskar, Samir Parikh, Tibor NadasdyAbstract:For over a century, acute 'post-streptococcal glomeruloNephritis' (APSGN) was the prototypical form of bacterial infection-associated glomeruloNephritis, typically occurring after resolution of infection and a distinct infection-free latent period. Other less common forms of infection-associated glomerulonephritides resulted from persistent bacteraemia in association with subacute bacterial endocarditis and Shunt Nephritis. However, a major paradigm shift in the epidemiology and bacteriology of infection-associated glomerulonephritides has occurred over the past few decades. The incidence of APSGN has sharply declined in the Western world, whereas the number of Staphylococcus infection-associated glomeruloNephritis (SAGN) cases increased owing to a surge in drug-resistant Staphylococcus aureus infections, both in the hospital and community settings. These Staphylococcus infections range from superficial skin infections to deep-seated invasive infections such as endocarditis, which is on the rise among young adults owing to the ongoing intravenous drug use epidemic. SAGN is markedly different from APSGN in terms of its demographic profile, temporal association with active infection and disease outcomes. The diagnosis and management of SAGN is challenging because of the lack of unique histological features, the frequently occult nature of the underlying infection and the older age and co-morbidities in the affected patients. The emergence of multi-drug-resistant bacterial strains further complicates patient treatment.
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Infection Related GlomeruloNephritis Associated with Staphylococcus epidermidis in the Absence of Prosthetic Material.
Case reports in nephrology, 2014Co-Authors: Samer Mohandes, Anjali A. Satoskar, Eshetu Obole, Hari PolenakovikAbstract:We report a case of a 72-year-old diabetic male who developed infection-related glomeruloNephritis (IRGN) in the setting of severe Staphylococcus epidermidis infection. He required renal replacement therapy for 6 weeks, but had full recovery of his kidney function with aggressive treatment of the infection. While this pathogen has been previously implicated as the cause of Shunt Nephritis, it is exceptionally rare to be associated with IRGN in the absence of a Shunt or other prosthetic material.