title: IgA-dominant postinfectious glomerulonephritis induced by methicillin-sensitive Staphylococcus aureus.
abstract: A 56-year-old man with alcohol-associated cirrhosis, arterial hypertension and diabetes, presented with a 1-month history of fever, lumbar back pain and lower limb weakness. MRI revealed a spinal epidural abscess extending from the cervical to the dorsolumbar spine. A methicillin-sensitive Staphylococcus aureus strain was isolated on blood cultures. Meropenem was initially started with no response, and then changed to vancomycin. During treatment, the patient's condition progressed with anasarca and renal failure with nephrotic-range proteinuria. The renal biopsy showed a membranoproliferative glomerulonephritis with IgA deposition. After completing 2 months of antibiotic therapy the patient recovered from the neurological deficits, with a complete resolution of the abscess and partial recovery of renal function and proteinuria.
authors.affiliation: Department of Medicine 4, Fernando Fonseca Hospital, Amadora, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Caetano
authors.affiliation: Department of Nephrology, Fernando Fonseca Hospital, Amadora, Portugal.
authors.forename: Fernando
authors.initials: F
authors.lastname: Pereira
authors.affiliation: Department of Medicine 4, Fernando Fonseca Hospital, Amadora, Portugal.
authors.forename: Susana
authors.initials: S
authors.lastname: Oliveira
authors.affiliation: Department of Medicine 4, Fernando Fonseca Hospital, Amadora, Portugal CEDOC - Center for Chronic Diseases of NOVA Medical School, Lisbon, Portugal.
authors.forename: José
authors.initials: J
authors.lastname: Delgado Alves
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D003928:Diabetic Nephropathies / Q000150:complications / Q000473:pathology; D020802:Epidural Abscess / Q000150:complications; D005334:Fever / Q000209:etiology; D005921:Glomerulonephritis / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology* / Q000382:microbiology; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood*; D017116:Low Back Pain / Q000382:microbiology*; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008875:Middle Aged; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D016896:Treatment Outcome; D014640:Vancomycin / Q000008:administration & dosage
chemical_list: D000900:Anti-Bacterial Agents; D007070:Immunoglobulin A; D014640:Vancomycin