Glomerulonephritis associated with endocarditis, deep-seated infections, and shunt nephritis

Endocarditis is a cause of glomerulonephritis. Healthcare interventions (prosthetic valves, indwelling catheters, pacemaker wires) and intravenous drug abuse are presently the most common causes of endocarditis and Staphylococcus aureus is frequently the infecting bacteria. Shunt nephritis is a form of glomerulonephritis associated with infection of ventriculoatrial shunts implanted to relieve hydrocephalus and, typically, are caused by prolonged infections of low-pathogenicity microorganisms. This complication led to the replacement of the technique by ventriculoperitoneal shunts. Deep-seated infections such as chronic abscesses and osteomyelitis can sometimes cause a similar syndrome. In all cases, treatment of the infection is the key strategy. The nature of the glomerulonephritis tends in subacute infection to be a lobular membranoproliferative glomerulonephritis type I pattern associated with low C3 levels. However, an acute post-infectious pattern may also be seen, and a third pattern is focal necrotizing and crescentic glomerulonephritis, which tends to be pauci-immune as seen in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis, but usually without positive fluorescence or solid phase assays for ANCA antigens.