Staphyloccal Infection Associated Glomerulonephritis Mimicking Henoch-Schönlein Purpura
Anjali A Satoskar, Rosemary Shim, Sergey Brodsky, Gyongyi Nadasdy, Lee Hebert, Tibor Nadasdy. Ohio State University Medical Center, Columbus, OH
Background: A patient with IgA dominant immune complex glomerulonephritis (GN) who presented with joint pain, petechial and bullous skin rash, and renal failure was treated with steroids and became septic. This prompted us to review our kidney biopsy material for Staphylococcus infection associated GN cases presenting clinically like HSP. Petechial rash has been described in patients with Stahylococcal infection related GN, but in the absence of known history of infection, this can be a diagnostic pitfall.
Design: We found 33 kidney biopsies from patients with culture proven Staphylococcus infection associated GN in our biopsy archives from 2005 to 2010. Seven of these had petechial skin rash.
|Patient||Diabetes||Infection||Organism||Blood culture||Creatinine at biopsy||Creatinine at follow up||C3 ; C4|
|1||present||leg ulcers, osteomyelitis||MRSA||Negative||9.7||dialysis||69 ; 30|
|2||present||leg ulcers||MRSA||Negative||4.5||dialysis||not known|
|3||absent||groin abscess||MSSA||Negative||4.6||dialysis||11 ; normal|
|4||absent||endocarditis||MRSA||Positive||2||2||104 ; 18|
|5||absent||skin wounds; motor vehicle accident||MRSA||Negative||1.9||dialysis||163 ; 25|
|6||absent||osteomyelitis||MSSA||Negative||2.8||1.3 improved||144 ; 24|
|7||absent||Abdominal wall abscess||MRSE||Positive||2.3||dialysis||169 ; 43|