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BMJ Case Reports 2015; doi:10.1136/bcr-2014-208513
  • CASE REPORT

IgA-dominant postinfectious glomerulonephritis induced by methicillin-sensitive Staphylococcus aureus

  1. José Delgado Alves1,3
  1. 1Department of Medicine 4, Fernando Fonseca Hospital, Amadora, Portugal
  2. 2Department of Nephrology, Fernando Fonseca Hospital, Amadora, Portugal
  3. 3CEDOC – Center for Chronic Diseases of NOVA Medical School, Lisbon, Portugal
  1. Correspondence to José Delgado Alves, jose.alves{at}fcm.unl.pt
  • Accepted 26 April 2015
  • Published 14 May 2015

Summary

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.

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