Tuesday, February 1, 2011

CLINICAL CASE 32, ANSWERS AND SUMMARY

Which infectious agent is the most common cause of Post infectious Glomerulonephritis in the elderly?


Streptococus 48%
Staphlylococcus 30%
E Coli 11%
Pseudomonas 1%
Candida 2%
Viral Cause 4%

Hmm. Most of you got this answer wrong. The correct answer is Staph.
Post infections GN ( PIGN) is usually a childhood illness following a Streptococcus infection.  In the Elderly, the disease is not as well defined. The question above is asking about the most common organism in the elderly leading to PIGN.  The correct answer is Staph. There is a large series of patients close to 110 cases of >65 years of age and biopsy showing PIGN.  Mostly males more than females and diabetes or malignancy on the background in 60%of the patients.  The most common infection was Staphylococcus 46% and followed by Streptococcus at 16% and then gram negative organisms.  Low c3 was present in 70% of patients and most common site of infection was skin and then lung and then UTI.  Prognosis is poorer compared to childhood PIGN and only 25% had full renal recovery. Check out the full reference below.



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