title: Necrotizing fasciitis during de novo minimal change nephrotic syndrome in a kidney transplant recipient.
abstract: Skin infections and particularly necrotizing fasciitis (NF) represent a rare but serious complication after transplantation. Optimal management depends on prompt diagnosis with identification of the causative organisms to allow appropriate antibiotic therapy in association with surgical debridement. We report a case of a methicillin-resistant Staphylococcus aureus (MRSA) NF as the single pathogen in a renal transplant recipient, during the course of a de novo minimal-change nephrotic syndrome, treated with high-dose steroids. Antibiotic therapy together with surgical debridement and discontinuation of immunosuppressive treatment led to a complete recovery, despite persistence of the nephrotic syndrome. The development of de novo minimal-change nephrotic syndrome after renal allograft transplantation should alert physicians to the possibility of MRSA NF during an increase in the immunosuppressive regimen.
authors.affiliation: Department of Nephrology, Hopital Henri Mondor, Creteil, France.
authors.forename: V
authors.initials: V
authors.lastname: Audard
authors.forename: A
authors.initials: A
authors.lastname: Pardon
authors.forename: O
authors.initials: O
authors.lastname: Claude
authors.forename: M
authors.initials: M
authors.lastname: Jablonski
authors.forename: P
authors.initials: P
authors.lastname: Remy
authors.forename: D
authors.initials: D
authors.lastname: Desvaux
authors.forename: L
authors.initials: L
authors.lastname: Lantieri
authors.forename: P
authors.initials: P
authors.lastname: Lang
authors.forename: P
authors.initials: P
authors.lastname: Grimbert
mesh_terms: D019115:Fasciitis, Necrotizing / Q000382:microbiology* / Q000473:pathology; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D007866:Leg / Q000473:pathology; D016106:Methicillin Resistance; D008875:Middle Aged; D009402:Nephrosis, Lipoid / Q000150:complications*; D013203:Staphylococcal Infections / Q000382:microbiology / Q000473:pathology; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*