Methicillin-resistant Staphylococcus aureus-related glomerulonephritis in a child.
Pediatr Nephrol
; 27(11): 2149-2152, 2012 Nov.
Article
en En
| MEDLINE
| ID: mdl-22714673
ABSTRACT
BACKGROUND:
Methicillin-resistant Staphylococcus aureus-associated glomerulonephritis (MRSA-GN), a syndrome in which superantigens play an important role in the pathogenesis of the infection, has been well described in adult patients but not previously recognized in children. CASE DIAGNOSIS/TREATMENT We report the case of a 6-year-old girl with MRSA-GN. She presented multiple malformations, including tracheal stenosis necessitating tracheotomy. She was admitted to our hospital because of acute pneumonia caused by a MRSA infection and was found to have proteinuria and abnormal renal function. MRSA was detected in her sputum, and this MRSA isolate produced toxic shock syndrome toxin-1, which acts as a superantigen and stimulates Vß2(+) T cells. A blood test revealed that the number of circulating Vß2(+) T cells expressing CD45RO, a marker of activation, was increased along with a concomitant elevation in the levels of serum immunoglobulins. Both are hallmarks of MRSA-GN. The eradication of MRSA using appropriate antibiotics resulted in the disappearance of the proteinuria; in contrast, corticosteroid treatment failed. To the best of our knowledge, this is the youngest patient to be diagnosed with MRSA-GN.CONCLUSIONS:
In summary, there should be a high index of suspicion for MRSA-GN, even in the very young, in order to avoid the unnecessary use of immune suppressants in this context.
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Neumonía Estafilocócica
/
Staphylococcus aureus Resistente a Meticilina
/
Glomerulonefritis
Tipo de estudio:
Diagnostic_studies
Idioma:
En
Revista:
Pediatr Nephrol
Asunto de la revista:
NEFROLOGIA
/
PEDIATRIA
Año:
2012
Tipo del documento:
Article