The diagnosis is Staphylococcus infection–associated glomerulonephritis (SAGN), as indicated by methicillin-sensitive Staphylococcus aureus (MSSA) in blood and synovial fluid, acute kidney injury (AKI) with macroscopic hematuria, nephrotic proteinuria, C3 staining, glomerular hypercellularity in renal pathology, and exclusion of other possible etiologic causes of AKI via screening tests. No single clinical or pathological feature is pathognomonic for SAGN. Clinical features, biopsy findings, culture results, and urinalysis findings should be taken into consideration at the time of diagnosis.
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SAGN treatment is based on eliminating the underlying infection and controlling the symptoms secondary to acute nephritis. The patient’s antibiotic treatment was completed in 6 weeks; during which time, we provided supportive treatment for AKI. Renal replacement therapy was not required. Renal function tests tended to improve from the 4th week of treatment, but macroscopic hematuria continued until the 6th week. After the 6th week, the patient’s acute kidney damage completely resolved. One month after discharge, he had normal renal function tests and normal blood pressure, no proteinuria, and microscopic hematuria (Figs. 1 and 2).
