Occult odontogenic infection as a possible trigger of post-streptococcal glomerulonephritis: a case report and...

Chronic odontogenic infections may represent overlooked infectious foci in patients with infection-related glomerulonephritis when conventional sources, such as skin or upper respiratory tract infections, are not identified. This manuscript first reports the case of a 36-year-old man who presented with nephritic syndrome and acute kidney injury requiring dialysis. Renal biopsy demonstrated infection-related glomerulonephritis with features compatible with post-streptococcal glomerulonephritis, although antistreptococcal serology was not available. Extensive medical investigation did not identify a conventional infectious source. A subsequent dental evaluation revealed an untreated chronic endodontic infection associated with pulpal necrosis, which was considered a plausible odontogenic infectious focus rather than a definitively proven causal source. After endodontic treatment, together with supportive medical care, the patient experienced progressive recovery of renal function and dialysis was discontinued. To contextualize this clinical observation, a scoping review was then conducted according to the Joanna Briggs Institute methodology and reported in accordance with PRISMA-ScR guidelines, aiming to map previously published cases in which oral or odontogenic infections were described as possible infectious foci associated with post-streptococcal or infection-related glomerulonephritis. Searches were performed in MEDLINE/PubMed, LILACS, SciELO, Web of Science, Scopus, Embase, Open Access Theses and Dissertations, and DANS Easy. Eligible reports were charted descriptively, focusing on patient characteristics, oral infectious source, renal diagnosis, treatment, and clinical outcome. The available evidence remains limited and predominantly descriptive, supporting hypothesis generation rather than causal inference. Nevertheless, both the present case and the mapped literature reinforce the importance of considering occult oral infectious foci in selected cases of infection-related glomerulonephritis of unclear origin. Interdisciplinary collaboration between nephrology and dentistry may contribute to more comprehensive diagnostic workup and management in these complex presentations.