Successful treatment of post-MRSA infection glomerulonephritis with steroid therapy

Clin Nephrol. 2008 Oct;70(4):344-7. doi: 10.5414/cnp70344.

Abstract

A 48-year-old man without underlying disease developed mediastinitis and was treated by mediastinal drainage. Methicillin-resistant Staphylococcus aureus (MRSA) was detected in a culture of the abscess material. He was treated with anti-MRSA antibiotics and the MRSA infection improved. Four weeks after the onset of MRSA infection, he developed rapidly progressive glomerulonephritis (RPGN) with nephrotic syndrome (NS). A renal biopsy showed endocapillary proliferative glomerulonephritis with IgA-predominant glomerular deposition. These clinicopathological findings were consistent with those in glomerulonephritis following MRSA infection (post-MRSA infection glomerulonephritis). The level of serum creatinine increased to 6.3 mg/dl, 7 weeks after the onset of RPGN. At that time, the eradication of MRSA infection was considered. He was given middle-dose steroid therapy. Thereafter, his RPGN with NS improved. MRSA infection did not recur. If the disease activity of post-MRSA infection glomerulonephritis persists after the disappearance of MRSA infection, the application of immunosuppressive therapy with steroids may be useful.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Angiotensin II Type 1 Receptor Blockers / therapeutic use*
  • Anti-Bacterial Agents / therapeutic use*
  • Biopsy
  • Drug Therapy, Combination
  • Glomerulonephritis / drug therapy*
  • Glomerulonephritis / microbiology
  • Humans
  • Imidazoles / therapeutic use*
  • Male
  • Methicillin Resistance*
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification*
  • Prednisolone / therapeutic use*
  • Staphylococcal Infections / drug therapy*
  • Staphylococcal Infections / microbiology
  • Tetrazoles / therapeutic use*

Substances

  • Angiotensin II Type 1 Receptor Blockers
  • Anti-Bacterial Agents
  • Imidazoles
  • Tetrazoles
  • olmesartan
  • Prednisolone