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Intrarenal Injection of Escherichia coli in a Rat Model of Pyelonephritis
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Megalocytic interstitial nephritis following acute pyelonephritis with Escherichia coli bacteremia: a case report

Hee Jin Kwon1, Kwai Han Yoo1, In Young Kim1

  • 1Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.

Journal of Korean Medical Science
|January 2, 2015
PubMed

Insights

Megalocytic interstitial nephritis, a rare kidney disease, was treated with steroids in a 45-year-old woman. High-dose steroid therapy significantly improved her renal function after antibiotics failed.

Area of Science:

  • Nephrology
  • Pathology
  • Infectious Diseases

Background:

  • Megalocytic interstitial nephritis is a rare kidney disease.
  • It is characterized by chronic inflammation and often presents with acute kidney injury.
  • Escherichia coli bacteremia can complicate interstitial nephritis.

Observation:

  • A 45-year-old woman presented with oliguric AKI and acute pyelonephritis with Escherichia coli bacteremia.
  • Despite appropriate antibiotic therapy, her renal function did not recover, though bacteremia and bacteriuria resolved.
  • Kidney biopsy showed histiocyte infiltration without Michaelis-Gutmann bodies.

Findings:

  • The patient was diagnosed with megalocytic interstitial nephritis.
  • Treatment with high-dose steroids led to marked improvement in renal function.

Implications:

  • This case highlights the potential efficacy of high-dose steroid therapy in managing megalocytic interstitial nephritis presenting as AKI.
  • Early recognition and consideration of alternative treatments beyond antibiotics are crucial for patients with refractory kidney injury.
  • Further research into the pathogenesis and optimal management of this rare condition is warranted.
Keywords:
Acute Kidney InjuryInterstitial NephritisMegalocytic Interstitial Nephritis

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