Expanding spectrum of illness due to community-associated methicillin-resistant Staphylococcus aureus: a case report

INTRODUCTION: Xanthogranulomatous pyelonephritis is a rarely identified form of chronic pyelonephritis usually caused by gram-negative organisms. Herein, we report the first case caused by infection due to community-associated methicillin-resistant Staphylococcus aureus strain. CASE PRESENTATION: An HIV-infected female with a history of intravenous drug use presented with a three month history of abdominal pain, distension, and fever. Computerized tomography of the abdomen revealed a large multicystic right kidney mass. During surgical exploration an intrarenal abscess was identified. Cultures revealed the presence of community-associated methicillin-resistant Staphylococcus aureus. Histopathological examination demonstrated xanthogranulomatous disease. The patient was successfully treated with nephrectomy and a prolonged antibiotic combination regimen with vancomycin and linezolid. CONCLUSION: Our case illustrates the escalating spectrum of illness caused by infection due to community-associated methicillin-resistant Staphylococcus aureus.