A Case of Glomerulonephritis Associated with Staphylococcal Retroperitoneal Abscess

Byun, Joo Won; Lee, Hyoung Joon; Choi, Yeun Jong; Kim, Jin Soo; Kim, Hyo Youl; Han, Byoung Geun; Lee, Eun Young; Choi, Seung Ok

Abstract

The development of renal glomerular lesions secondary to severe visceral infection (pulmonary, pleural, retroperitoneal or hepatic abscess) is not generally appreciated. Such patients resemble those with infective endocarditis. The suggested pathogenetic mechanisms by which infection can cause glomerular damage are immunologic interaction, direct toxicity of a bacterial products, and some other triggering factors; However, direct correlation between the infectious and immunologic events has not been demonstrated. The histopathologic findings of infectious glomerulonephritis are variable, and these findings, as well as the clinical abnormalities, may resolve with effective antimicrobial therapy or abscess drainage. We experienced a case of glomerulonephritis and acute renal failure due to staphylococcal retroperitoneal abscess. The patient was a 58-year-old man who presented with abdominal and back pain. We performed an abdominal CT scan which showed a retroperitoneal abscess which was proven to be a staphylococcal infection upon percutaneous abscess drainage. Furthermore, we performed a renal biopsy in order to investigate hematuria, RBC casts, and proteinuria. Pathologic findings revealed postinfectious glomerulonephritis. Abscess drainage and sensitive antibiotics were administered, after which his symptoms and urinary abnormalities disappeared, and the retroperitoneal abscess subsided. Here, we report a case of a staphylococcal retroperitoneal abscess which led to postinfectious glomerulonephritis and acute renal failure along with a brief review of the literatures.