What would be your approach to managing severe ANCA-associated vasculitis in a patient who is also septic from a bacterial infection?

It is prudent to evaluate if the ANCA-associated vasculitis is being triggered by the underlying bacterial infection. Certain clues on the kidney biopsy including diffuse exudative as well as diffuse crescentic [of same age] pattern of injury on light microscopy, intense C3 staining on immunofluorescence microscopy, and the presence of subepithelial humps noted on electron microscopy point more towards the underlying bacterial infection being the primary driver of the crescentic process. In such cases, treatment of the underlying bacterial infection, typically a deep-seated infection like endocarditis/osteomyelitis, should be pursued.

If however, there are more histologic features suggestive of a primary ANCA-mediated kidney disease process...