Staphylococcus-associated acute glomerulonephritis in a patient with dermatomyositis

Staphylococcus-associated glomerulonephritis (SAGN) occurs as a complication of staphylococcal infection elsewhere in the body. Dermatomyositis (DM) can be associated with glomerulonephritis due to the disease per se. We report a case of a 40-year-old male patient with DM who presented with acute kidney injury, and was initially pulsed with methylprednisolone for 3 days, followed by dexamethasone equivalent to 1 mg/kg/day prednisolone. He was subsequently found to have SAGN on kidney biopsy along with staphylococcus bacteraemia and left knee septic arthritis. With proof of definitive infection, intravenous immunoglobulin 2 g/kg over 2 days was given and steroids were reduced. He was treated with intravenous vancomycin. With treatment, the general condition of the patient improved. On day 38, he developed infective endocarditis and died of congestive heart failure subsequently. Undiagnosed staphylococcal sepsis complicating a rheumatological disease course can lead to complications like SAGN, infective endocarditis and contribute to increased morbidity and mortality, as is exemplified by our case.

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Linezolid Induced Skin Reactions in a Multi Drug Resistant Infective Endocarditis Patient: A Rare Case

Current Drug Safety ◽

10.2174/1574886315666200516175053 ◽

2020 ◽

Vol 15 (3) ◽

pp. 222-226 ◽

Cited By ~ 1

Author(s):

Asha K. Rajan ◽

Ananth Kashyap ◽

Manik Chhabra ◽

Muhammed Rashid

Keyword(s):

Case Report ◽

Infective Endocarditis ◽

Rare Case ◽

Case Reports ◽

Multidrug Resistant ◽

The Body ◽

Prior History ◽

Skin Reactions ◽

Rare Case Report ◽

Multiple Drugs

Rationale: Linezolid (LNZ) induced Cutaneous Adverse Drug Reactions (CADRs) have rare atypical presentation. Till date, there are very few published case reports on LNZ induced CADRs among the multidrug-resistant patients suffering from Infective Endocarditis (MDR IE). Here, we present a rare case report of LNZ induced CARs in a MDR IE patient. Case report: A 24-year-old female patient was admitted to the hospital with chief complaints of fever (101°C) associated with rigors, chills, and shortness of breath (grade IV) for the past 4 days. She was diagnosed with MDR IE, having a prior history of rheumatic heart disease. She was prescribed LNZ 600mg IV BD for MDR IE, against Staphylococcus coagulase-negative. The patient experienced flares of cutaneous reactions with multiple hyper-pigmented maculopapular lesions all over the body after one week of LNZ therapy. Upon causality assessment, she was found to be suffering from LNZ induced CADRs. LNZ dose was tapered gradually and discontinued. The patient was prescribed corticosteroids along with other supportive care. Her reactions completely subsided and infection got controlled following 1 month of therapy. Conclusion: Healthcare professionals should be vigilant for rare CADRs, while monitoring the patients on LNZ therapy especially in MDR patients as they are exposed to multiple drugs. Moreover, strengthened spontaneous reporting is required for better quantification.

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Acute interstitial nephritis and drug-induced systemic lupus erythematosus due to chlorthalidone and amiodarone: A case report

SAGE Open Medical Case Reports ◽

10.1177/2050313x20910029 ◽

2020 ◽

Vol 8 ◽

pp. 2050313X2091002 ◽

Cited By ~ 1

Author(s):

Umut Selamet ◽

Ramy M Hanna ◽

Anthony Sisk ◽

Lama Abdelnour ◽

Lena Ghobry ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Interstitial Nephritis ◽

Lupus Erythematosus ◽

Kidney Biopsy ◽

Kidney Injury ◽

Acute Interstitial Nephritis ◽

Systemic Lupus ◽

Drug Induced ◽

Systemic Manifestations

Drug-induced lupus erythematosus has features distinct from primary systemic lupus erythematosus. It can occur with a wide variety of agents that result in the generation of anti-histone or other types of antibodies. Systemic manifestations of drug-induced systemic lupus erythematosus may include renal dysfunction due to circulating immune complexes or due to other immune reactions to the culprit medication(s). Acute interstitial nephritis occurs due to DNA–drug or protein–drug complexes that trigger an allergic immune response. We report a patient who developed acute kidney injury, rash, and drug-induced systemic lupus diagnosed by serologies after starting chlorthalidone and amiodarone. A renal biopsy showed acute interstitial nephritis and not lupus-induced glomerulonephritis. It is important to note that systemic lupus erythematosus and acute interstitial nephritis can occur together, and this report highlights the role of the kidney biopsy in ascertaining the pathological diagnosis and outlining therapy in drug-induced lupus erythematosus.

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Granulomatous interstitial nephritis in a patient with SARS-CoV-2 infection

BMC Nephrology ◽

10.1186/s12882-020-02213-w ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Katarzyna Szajek ◽

Marie-Elisabeth Kajdi ◽

Valerie A. Luyckx ◽

Thomas Hans Fehr ◽

Ariana Gaspert ◽

...

Keyword(s):

Acute Kidney Injury ◽

Interstitial Nephritis ◽

Kidney Biopsy ◽

Kidney Diseases ◽

Case Reports ◽

Kidney Injury ◽

Maculopapular Rash ◽

Tubular Injury ◽

Granulomatous Interstitial Nephritis ◽

First Case

Abstract Background Acute kidney injury (AKI) associated with severe coronavirus disease 19 (COVID-19) is common and is a significant predictor of morbidity and mortality, especially when dialysis is required. Case reports and autopsy series have revealed that most patients with COVID-19 – associated acute kidney injury have evidence of acute tubular injury and necrosis - not unexpected in critically ill patients. Others have been found to have collapsing glomerulopathy, thrombotic microangiopathy and diverse underlying kidney diseases. A primary kidney pathology related to COVID-19 has not yet emerged. Thus far direct infection of the kidney, or its impact on clinical disease remains controversial. The management of AKI is currently supportive. Case Presentation The patient presented here was positive for SARS-CoV-2, had severe acute respiratory distress syndrome and multi-organ failure. Within days of admission to the intensive care unit he developed oliguric acute kidney failure requiring dialysis. Acute kidney injury developed in the setting of hemodynamic instability, sepsis and a maculopapular rash. Over the ensuing days the patient also developed transfusion-requiring severe hemolysis which was Coombs negative. Schistocytes were present on the peripheral smear. Given the broad differential diagnoses for acute kidney injury, a kidney biopsy was performed and revealed granulomatous tubulo-interstitial nephritis with some acute tubular injury. Based on the biopsy findings, a decision was taken to adjust medications and initiate corticosteroids for presumed medication-induced interstitial nephritis, hemolysis and maculo-papular rash. The kidney function and hemolysis improved over the subsequent days and the patient was discharged to a rehabilitation facility, no-longer required dialysis. Conclusions Acute kidney injury in patients with severe COVID-19 may have multiple causes. We present the first case of granulomatous interstitial nephritis in a patient with COVID-19. Drug-reactions may be more frequent than currently recognized in COVID-19 and are potentially reversible. The kidney biopsy findings in this case led to a change in therapy, which was associated with subsequent patient improvement. Kidney biopsy may therefore have significant value in pulling together a clinical diagnosis, and may impact outcome if a treatable cause is identified.

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Immunotherapy‐related acute kidney injury: Kidney biopsy or not?

Nephrology ◽

10.1111/nep.13687 ◽

2020 ◽

Vol 26 (1) ◽

pp. 89-90 ◽

Cited By ~ 1

Author(s):

Sophie Chatterton ◽

Sarah Williams ◽

Kazi Nahar ◽

Alexander M. Menzies ◽

Muh G. Wong

Keyword(s):

Acute Kidney Injury ◽

Kidney Biopsy ◽

Kidney Injury

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Staphylococcal infection and pathomurfological characteristic of the pituitary-adrenal-thyroid system

NATURE AND SCIENCE ◽

10.36719/2707-1146/04/69-73 ◽

2020 ◽

Vol 03 (04) ◽

pp. 69-73

Author(s):

Samira Mammadhasan Yagubova ◽

◽

Elchin Chingiz Akbarov ◽

Tarana Nadir Mirzayeva ◽

◽

...

Keyword(s):

Structural Changes ◽

Adrenal Glands ◽

Early Stage ◽

Morphological Changes ◽

Endocrine System ◽

Staphylococcal Infection ◽

The Body ◽

Glandular Cells ◽

Exogenous Factors ◽

Specific Symptoms

During the staphylococcal infection, changes in the interaction of glandular cells, dystrophic and disorganizing pathologies in tissues, especially acute structural and hemodynamic changes in the stroma of the glands in the pituitary-adrenal-thyroid system, develop from the first day of the experiment. At the end of the experiment, on the background of a decrease in exudative processes, fibroplastic reactions are significantly activated, resulting in signs of incomplete regeneration – mainly sclerotic processes and cystic-atrophic changes in the parenchyma. Structural changes in tissues in the early stages of staphylococcal infection and the dynamics of development are characterized by specific symptoms in each of the glands. Since the pituitary gland is exposed to endogenous and exogenous factors earlier and more often than the adrenal glands, and the adrenal glands are earlier than the thyroid gland, dystrophic and destructive changes in the pituitary and adrenal glands are more pronounced at the early stage of the experiment. These morphological changes can change the hormonal status of the body and lead to dysfunction of the endocrine system as a whole – a decrease in the functional activity of the glands to some extent, and even inhibition of adenohypophyseal cells. Key words: staphylococcal infection, peritonitis, pituitary, adrenal and thyroid glands

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Cervical Adenitis

Pediatrics in Review ◽

10.1542/pir.7.1.13 ◽

1985 ◽

Vol 7 (1) ◽

pp. 13-24

Author(s):

Andrew M. Margileth

Keyword(s):

Cervical Lymphadenopathy ◽

Staphylococcal Infection ◽

The Body ◽

Cervical Lymphadenitis ◽

Neck Node ◽

Cervical Lymph Nodes ◽

Cervical Adenitis ◽

Viral Illness ◽

Infection And Inflammation ◽

Reactive Hyperplasia

Children with acutely tender and inflamed cervical lymph nodes are observed commonly by family physicians and pediatricians. Cervical lymphadenitis is usually associated with a systemic viral illness and subsides within a few days to 2 weeks. Bacterial adenitis, seen less often, is usually due to (β-hemolytic streptococcal or to staphylococcal infection. However, when a neck node remains enlarged following a systemic illness or when a nontender regional cervical node (adenopathy) persists longer than 2 or 3 weeks with or without associated illness, the physician and parents become worried. Concern is enhanced if the nodes increase in size or number. Infection and inflammation are the most common causes for persistent chronic (3 or more weeks' duration) lymphadenopathy in children. Whereas neoplasm is rare (1.4%) in the child or adolescent less than 17 years of age with a superficial lump on any part of the body, maligancy (Hodgkin disease, lymphoma, neuroblastoma) was found in 31 (13%) of 239 enlarged cervical nodes in similar-aged children at the same institution. Congenital and acquired cysts, pilomatrixomas, and benign neoplasms (lipoma, neurofibroma, lymphangioma) account for the majority of noninflammatory lesions in the neck in children and adolescents. However, most cervical lymphadenopathy in children is due to adenitis or reactive hyperplasia in response to an infection.

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MO302ACUTE POST-INFECTIOUS GLOMERULONEPHRITIS IN ADULTS: A TUNISIAN SINGLE CENTER EXPERIENCE

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab104.0060 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Imen El Meknassi ◽

Mrabet Sanda ◽

Guedri Yosra ◽

Zellema Dorsaf ◽

Azzabi Awatef ◽

...

Keyword(s):

Acute Kidney Injury ◽

Kidney Injury ◽

Acute Glomerulonephritis ◽

Industrialized Countries ◽

Single Center Experience ◽

Nephritic Syndrome ◽

Stage Renal Disease ◽

End Stage ◽

Post Infectious

Abstract Background and Aims Acute post-infectious glomerulonephritis (APIGN) is a reactive immunological disease. Its prevalence in industrialized countries is declining contrasting with developed ones. It is uncommon in adults but the prognosis may be reserved. The aim of our study was to evaluate the epidemiological, clinical and histological features of APIGN as well as its prognosis. Method A retrospective and descriptive study was conducted in our department. Were included all cases of histologically proven APIGN between December 2006 and December 2017. Results We had collected 38 cases. The mean age was 37.7 ± 17.8 years. The sex ratio was 1.92. Twelve (31.6%) patients were diabetic and four of them had already a chronic kidney disease (CKD). APIGN was preceded by an infection in 27 cases with an average interval of 10 ± 5 days. The most common site of infection was the respiratory tract (15 cases). At presentation, 27 patients had nephritic syndrome and 13 had nephrotic-range proteinuria. Hematuria was observed in 97.4%, peripheral edema in 84.2% and hypertension in 73.7% of cases. Most patients (78.9%) had acute kidney injury and 10 (26.3%) patients required dialysis. Renal biopsy had shown benign acute glomerulonephritis in 31 cases and malignant form in 7 cases. An underlying nephropathy was found in 12 cases with mostly a diabetic nephropathy. Corticosteroids were used in 3 cases of benign APIGN and 5 cases of malignant form. During the follow-up, CKD was noted in 14(36.8%) patients including 7(18.4%) patients who progressed to end-stage renal disease. Poor prognostic factors were diabetes, the presence of an underlying nephropathy in the biopsy, acute kidney injury and the need for dialysis. Conclusion The APIGN is uncommon in adults, yet its prognosis may be reserved with progression to CKD.

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Concentration and Visualization Techniques in Buddhist Meditation

The Oxford Handbook of Meditation ◽

10.1093/oxfordhb/9780198808640.013.19 ◽

2021 ◽

Author(s):

Nobuyoshi Yamabe

Keyword(s):

Fifth Century ◽

The Body ◽

Early Form ◽

Significant Development ◽

Buddhist Meditation ◽

Esoteric Buddhism ◽

Reflective Thought ◽

Visual Approach ◽

Per Se ◽

Visualization Techniques

This chapter outlines the early form and development of Buddhist meditation. First, it discusses the “application of mindfulness,” especially “mindfulness of the body,” which can be largely classified into two types of practice. One is “mindfulness per se,” without reflective thought, and the other is a more reflective or visual approach. “Mindfulness per se” (in particular, mindful breathing) was transmitted to East Asia and remains the cardinal method there. The chapter discusses close ties between traditional mindfulness and Japanese Sōtō practice. It then moves on to describe meditation on the decomposition of a corpse, which is a representative form of the more reflective and visual type of practice, involving the observation of a dead body in its stages of decomposition. This is found in early scriptures. Later texts came to teach a more elaborate method of “grasping the images” of a corpse. A notable development in visualization is that the images seen by the practitioner came to include ones that were more enigmatic. The discussion finally turns to another significant development in Buddhist meditation, one which involves Buddha visualization. Its undeveloped form is found in early Mahayana sutras, but a fully developed version employing statues as aides for visualization is found in later meditation texts from the fifth century onward. This type of visualization was inherited by Esoteric Buddhism and is still practiced today.

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Organization of Therapeutic Nutrition in a Complex of Therapeutic Measures for Acute Glomerulonephritis

Spravočnik vrača obŝej praktiki (Journal of Family Medicine) ◽

10.33920/med-10-2010-02 ◽

2020 ◽

pp. 14-20

Author(s):

Elena Vitalievna Perminova

Keyword(s):

Salt Content ◽

The Body ◽

Acute Glomerulonephritis ◽

Dietary Recommendations ◽

Excretory Function ◽

Special Diet ◽

Organization Of Care ◽

Negative Effect ◽

Therapeutic Measures ◽

High Incidence Rate

Organization of care for patients with glomerulonephritis is a rather urgent problem today, due to the high incidence rate and the tendency to progression of renal dysfunction. When discussing treatment issues, it is necessary to pay attention to the fulfillment of three basic requirements for patients, which include normalization of the life regime (in particular, the exclusion of night work, avoiding stressful situations and heavy physical activity when having high blood pressure), the implementation of certain dietary recommendations and prolonged drug treatment [3]. Diseases of the kidneys as the main organ, the affection of which leads to a deterioration of excretory function, require a special diet with a restriction of a number of products. Against the background of glomerulonephritis disruption of the process of glomerular filtration, which in some cases leads to the development of renal failure, it is necessary to reduce the intake of food substances that can have a negative effect on the body — alcohol, smoked meats, spicy, salty foods, preserves, sausages, foods with high protein and salt content. Moreover, one should also take control of the amount of fluid consumed and ensure compliance with the frequency and regularity of food intake.

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