Poststreptococcal acute glomerulonephritis with 22F pneumococcal bacteremia.

Area of Science:

• Pediatrics
• Infectious Diseases
• Nephrology

Background:

• Pneumococcal vaccines (PCV13) are widely used, reducing reports of pneumococcal infections and related complications like poststreptococcal acute glomerulonephritis (PSAGN).
• PSAGN is typically associated with Streptococcus pyogenes, but pneumococcal infections can also trigger this condition.

Purpose of the Study:

• To report a case of PSAGN and concurrent pneumococcal bacteremia caused by a serotype not included in the PCV13 vaccine.
• To emphasize the importance of considering non-vaccine pneumococcal serotypes in the etiology of PSAGN.

Main Methods:

• A 5-year-old boy, vaccinated with PCV13, presented with fever and hematuria.
• Diagnostic workup included throat swab for streptococcal antigen, serum creatinine, anti-streptolysin O, C3 levels, and blood culture.
• Treatment involved intravenous ceftriaxone for 10 days.

Main Results:

• The patient was diagnosed with PSAGN and pneumonia, with blood cultures identifying Streptococcus pneumoniae serotype 22F, which is not covered by PCV13.
• Following treatment, the patient showed improvement in kidney function, pneumonia, and bacteremia.

Conclusions:

• Children diagnosed with PSAGN should be evaluated for underlying pneumococcal bacteremia.
• This evaluation should include testing for pneumococcal serotypes not covered by current vaccines, such as PCV13.