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

Area of Science:

• Nephrology
• Infectious Diseases
• Neurology

Background:

• Spinal epidural abscesses are serious infections requiring prompt diagnosis and treatment.
• Comorbidities such as cirrhosis, hypertension, and diabetes can complicate patient management and outcomes.
• Staphylococcus aureus is a common pathogen in spinal epidural abscesses.

Observation:

• A 56-year-old male with alcohol-associated cirrhosis, hypertension, and diabetes presented with fever, back pain, and lower limb weakness.
• MRI revealed a large spinal epidural abscess from cervical to dorsolumbar regions.
• The patient developed anasarca, renal failure, and nephrotic-range proteinuria during treatment.

Findings:

• Blood cultures identified methicillin-sensitive Staphylococcus aureus.
• Initial meropenem treatment was ineffective; vancomycin was initiated.
• Renal biopsy confirmed membranoproliferative glomerulonephritis with IgA deposition.
• Complete abscess resolution and neurological recovery occurred after 2 months of antibiotics.

Implications:

• This case highlights the potential for severe systemic complications, including glomerulonephritis, secondary to spinal epidural abscesses.
• Effective antibiotic therapy is crucial for both infection control and preventing long-term sequelae.
• Management requires a multidisciplinary approach to address infectious, neurological, and renal aspects.