"Abacterial " and bacterial pyelonephritis. Immunofluorescent localization of bacterial antigen.

Abstract Immunofluorescent detection of bacterial antigen in bacterial and "abacterial" pyelonephritis was evaluated with the use of antiserum against an antigen shared by most strains of enterobacteriaceae. Bacterial antigen could not be detected in renal specimens from 20 subjects without renal disease or in eight of nine specimens from patients with various forms of chronic renal disease other than pyelonephritis. Bacterial antigen was found in all six kidneys from patients with pyelonephritis caused by bacteria containing this common antigen. Bacteria and amorphous bacterial antigen were observed in the interstitial tissue, renal tubules, tubular epithelium, macrophages and blood-vessel walls in specimens from the latter patients. Bacterial antigen was also detected in renal specimens from six of the seven patients with "abacterial" pyelonephritis, suggesting that remote asymptomatic renal infection had initiated their renal disease.