Staphylococcus-Induced Glomerulonephritis Following Burn Injury: A Case Report.

Abstract

BACKGROUND Infection-related glomerulonephritis occurs when immune complexes formed in response to bacterial infection injure the glomerular basement membrane. Here, we describe a rare case of Staphylococcus-induced glomerulonephritis following burn injury. CASE REPORT A 65-year-old woman was admitted to the Emergency Department after sustaining multiple burns from boiling water. She had second-degree burns covering 19% of her total body surface area and received conservative treatment. On day 4, she developed a burn wound infection caused by methicillin-susceptible Staphylococcus aureus and Pseudomonas aeruginosa. Antibiotic therapy was initiated; however, she developed a sudden and rapid deterioration in kidney function on day 15. Sepsis-associated acute kidney injury was initially suspected, and the fluid infusion rate was increased accordingly. However, her kidney function deteriorated further, and she subsequently developed generalized edema. After considering the staphylococcal wound infection, marked hematuria and proteinuria, and hypocomplementemia, the diagnosis was revised to Staphylococcus-induced glomerulonephritis secondary to the burn wound infection. Fluid restriction and intermittent hemodialysis were initiated on day 19 of hospitalization. Her clinical condition improved approximately 1 month later, and a kidney biopsy result on day 74 was consistent with the recovery phase of infection-related glomerulonephritis. The patient was discharged 94 days after admission. CONCLUSIONS Acute kidney injury secondary to a burn wound infection should be distinguished from infection-related glomerulonephritis and sepsis-associated acute kidney injury. Source control and fluid restriction are recommended when infection-related glomerulonephritis is suspected in older patients with staphylococcal wound infections, marked proteinuria or hematuria, and hypocomplementemia.