Glomerulonephritis with acute renal failure related to osteomyelitis.

We report a case of acute renal failure in which renal biopsy showed immune complex-mediated proliferative glomerulonephritis. The patient had been afflicted with progressive lower back pain for 2 months. No fever was noted. Magnetic resonance imaging of the lumbar spine demonstrated characteristic findings of vertebral osteomyelitis and bilateral psoas abscesses. Culture of the computed tomography-guided needle aspirated specimens grew Staphylococcus aureus. The patient was treated with prolonged antibiotic therapy. The lower back pain improved gradually. Furthermore, significant improvement in renal function occurred approximately 2 weeks after the beginning of antibiotic treatment. The pathologic findings and clinical causal relationship between the bacterial osteomyelitis and the glomerulonephritis suggests a close association of the 2 conditions. Although glomerulonephritis is well documented to be related to a variety of infectious diseases, its association with osteomyelitis has rarely been reported. We review the clinicopathologic characteristics of another 3 cases previously reported in the literature.