title: Expanding spectrum of illness due to community-associated methicillin-resistant Staphylococcus aureus: a case report.
abstract: BACKGROUND
  Xanthogranulomatous pyelonephritis is a rarely identified form of chronic pyelonephritis usually caused by gram-negative organisms. Herein, we report the first case caused by infection due to community-associated methicillin-resistant Staphylococcus aureus strain.
  
  
  METHODS
  An HIV-infected female with a history of intravenous drug use presented with a three month history of abdominal pain, distension, and fever. Computerized tomography of the abdomen revealed a large multicystic right kidney mass. During surgical exploration an intrarenal abscess was identified. Cultures revealed the presence of community-associated methicillin-resistant Staphylococcus aureus. Histopathological examination demonstrated xanthogranulomatous disease. The patient was successfully treated with nephrectomy and a prolonged antibiotic combination regimen with vancomycin and linezolid.
  
  
  CONCLUSIONS
  Our case illustrates the escalating spectrum of illness caused by infection due to community-associated methicillin-resistant Staphylococcus aureus.
authors.affiliation: Department of Infectious Diseases, Emory University School of Medicine, 550 Peachtree Street, MOT 7th Floor Atlanta, GA 30308, USA. rkempke@emory.edu
authors.forename: Russell
authors.initials: R
authors.lastname: Kempker
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Difrancesco
authors.forename: Alejandro
authors.initials: A
authors.lastname: Martin-Gorgojo
authors.forename: Carlos
authors.initials: C
authors.lastname: Franco-Paredes