An unusual cause of acute renal failure in a kidney transplant recipient: salmonella enteritidis post-infectious glomerulonephritis.
BACKGROUND
Salmonella enteritidis-associated acute renal failure has often been described and is usually a result of dehydration or of rhabdomyolysis. A few cases of acute renal failure with glomerular syndrome, caused by S. enteritidis infection, have been reported in the literature, but none have been proven by histological findings.


METHODS
Herein, we report on a case of S. enteritidis-related glomerulonephritis that occurred in a 42-year-old male transplant recipient. He was admitted with fever, signs of urinary infection, diarrhea, and nephritic syndrome, i.e. edema, hypertension, increase in serum creatinine, microscopic hematuria, proteinuria. His urine culture tested positive for S. enteritidis.


RESULTS
Under light microscopy, the graft biopsy showed proliferative and exudative endocapillary glomerulonephritis. In addition, there was polymorphonuclear infiltration of the interstitium, and extra-capillary proliferation in one glomerulus. Immunofluorescence showed granular deposits of C3 in the mesangium. Electron microscopy showed electron-dense deposits typical of humps. He fully recovered on a double antibiotic therapy that included ofloxacin and amikacin.


CONCLUSIONS
Although acute renal failure related to non-typhoidal Salmonella infections are often related to dehydration or rhabdomyolysis, this case report shows that it might also be related to immune complex-mediated glomerulonephritis manifesting as nephritic syndrome.
Pillet
A
A
Department of Nephrology, Dialysis and Multiorgan Transplantation, CHU Rangueil, Toulouse, France.
Guitard
J
J
Mehrenberger
M
M
Kamar
N
N
Orfila
C
C
Ribes
D
D
Modesto
A
A
Rostaing
L
L
D058186:Acute Kidney Injury / Q000188:drug therapy / Q000382:microbiology*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005921:Glomerulonephritis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation; D008297:Male; D012480:Salmonella Infections / Q000188:drug therapy / Q000382:microbiology*; D012477:Salmonella enteritidis; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000382:microbiology
D000900:Anti-Bacterial Agents; D007166:Immunosuppressive Agents