# Drowning in Fluid: Post-infectious Glomerulonephritis Presenting as Acute Heart Failure

## TL;DR

A case of post-infectious glomerulonephritis mistaken for heart failure highlights the need for careful diagnosis in older adults.

## Contribution

This case emphasizes the importance of distinguishing glomerulonephritis from cardiorenal syndrome in patients with heart failure.

## Key findings

- IRGN can mimic cardiorenal syndrome type 1 in patients with preexisting heart failure.
- Delayed diagnosis of IRGN may occur due to its similarity to other conditions.
- A high index of suspicion is needed to diagnose IRGN in older adults.

## Abstract

Staphylococcal infection is as common as streptococcal infection as a cause of infection-related glomerulonephritis (IRGN). It is seen more frequently in the pediatric population and is relatively rare in adults. Glomerular disease manifests as either nephritic or nephrotic syndrome. A high index of suspicion is necessary for diagnosing this condition as it can be mistaken for other common conditions in the elderly. IRGN may present as volume overload and may masquerade as cardiorenal syndrome type 1 in patients with preexisting heart failure, emphasizing the importance of distinguishing between the two because the treatment and prognosis may be different. We present an older adult male who was evaluated for suspected acute decompensation of heart failure in the setting of recent left knee septic arthritis and was found to have IRGN. This diagnosis may be delayed or missed due to it mimicking similar conditions and it requires a high index of suspicion.