title: Devastating renal outcome caused by skin infection with methicillin-resistant Staphylococcus aureus: A case report.
abstract: Methicillin-resistant Staphylococcus aureus (MRSA) is an emerging pathogen that infects the skin and soft tissue. However, there are few reports of renal complications from MRSA involving immunoglobulin (Ig)A-dominated rapidly progressive glomerulonephritis (GN). Favorable renal outcomes from IgA GN are achieved by administering timely therapy. In the present study, we describe the case of a healthy young woman suffering from a cutaneous MRSA infection that initially presented with gross hematuria. Six months after eradicating the infection, severe impairment of renal function was noted because of intractable nausea and vomiting. Renal pathology revealed advanced IgA nephropathy with fibrocellular crescent formation. An aggressive treatment plan using immunosuppressants was not adopted because of her irreversible renal pathology, and she was therefore administered maintenance hemodialysis.This instructive case stresses the importance of being aware of the signs of IgA nephropathy post-MRSA infection, such as cutaneous lesions that are mostly painless and accompanied by hematuria and mild proteinuria. If the kidney cannot be salvaged, it will undergo irreversible damage with devastating consequences.
authors.affiliation: aDivision of Nephrology, Department of Medicine, Ten-Chen General Hospital, Yang-Mei bDivision of Nephrology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital cUltrastructural and Molecular Pathology, Department of Pathology, Veterans General Hospital, Taipei, Taiwan.
authors.forename: Jun-Hua
authors.initials: JH
authors.lastname: Liang
authors.forename: Yu-Wei
authors.initials: YW
authors.lastname: Fang
authors.forename: An-Hung
authors.initials: AH
authors.lastname: Yang
authors.forename: Ming Hsien
authors.initials: MH
authors.lastname: Tsai
mesh_terms: D005260:Female; D005922:Glomerulonephritis, IGA / Q000382:microbiology*; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus; D012720:Severity of Illness Index; D013207:Staphylococcal Skin Infections; D055815:Young Adult