Staphylococcal empyema secondary to IgA nephropathy

Abstract

A 27-year-old male patient, applied to the emergency unit with complaints of high fever, nausea, vomiting, and hematuria. In his physical examination, fever was 38 °C with normal findings in all other systems. The laboratory values were as follows: urea 58 mg/dL, creatinine 2.4 mg/dL, white blood cell count 15.9K/μL (PNL: 79 %). In his urine analysis; +1 proteinuria and +3 hematuria were detected. Kidney biopsy was performed. Kidney biopsy interpreted in favor of IgA nephropathy. As the patient had tonic–clonic seizures, cranial CT examination was performed. In the cranial CT, there was a subdural effusion in the anterolateral area of the right cerebral hemisphere with the left shift in the midline secondary to the effusion. Empyema fluid, which was drained postoperatively, was cultured. In the direct examination of the empyema fluid, Gram positive cocci and abundant amount of PNLs were observed. There was no growth in the culture. Although the most commonly encountered agents for post-infectious glomerulonephritis are streptococcus infections, it has been reported that glomerulonephritis attacks may be rarely observed due to staphylococcus infections. Proliferative glomerulonephritis cases are rarely encountered conditions characterized by mesangial IgA accumulations secondary to staphylococcus infections.