The possible occurrence of staphylococcal postinfectious glomerulonephritis in a renal allograft

Abstract

A 38-year-old male with a 5-year history of dialysis-dependent renal failure secondary to membranoproliferative glomerulonephritis, type I, received a cadaveric renal allograft from a 51-year-old male dying from acute trauma. A pretransplant biopsy of the donor kidney revealed no glomerular disease. One month after transplantation, the patient was discharged with a stable creatinine of less than 2.0 mg/dl, but subsequently developed positive urine cultures for Staphylococcus aureus and Escherichia coli and eventually underwent transplant nephrectomy. Blood cultures were positive postoperatively for S. aureus, and examination of the transplant nephrectomy showed ultrastructural, histological, and immunofluorescent findings characteristic of postinfectious glomerulonephritis. While numerous types of glomerular disease have been reported in kidney transplants, this report represents the first case suggestive of bacterial postinfectious type glomerulonephritis we have seen occurring de novo in a renal allograft.