Enterococcal endocarditis associated with crescentic glomerulonephritis

Springer Science and Business Media LLC - Tập 11 - Trang 321-325 - 2007
Alper Kirkpantur1, Akif Altinbas2, Mustafa Arici1, Dilek Ertoy Baydar3, Bulent Altun1, Serap Arslan4
1Department of Internal Medicine, Nephrology Unit, hacettepe University School of Medicine, Ankara, Turkey
2Department of Internal Medicine, Hacettepe University, School of Medicine, Ankara, Turkey
3Department of Pathology, Hacettepe University School of Medicine, Ankara, Turkey
4Department of Internal Medicine, Gastroenterology Unit, Hacettepe University, School of Medicine, Ankara, Turkey

Tóm tắt

Glomerulonephritis secondary to infective endocarditis (IE) is an uncommon diagnosis and is usually associated with cardiac valvular infection by blood-culture-positive bacteria. We report a case of necrotizing glomerulonephritis associated with culture-positive endocarditis caused by Enterococcus faecalis. The patient presented with renal abnormalities and was further investigated by renal biopsy. He had immune complex-mediated necrotizing and crescentic glomerulonephritis with mesengial and capillary deposition of immunoglobulin M (Ig M), Ig G, and complement 3 (C3). He was treated with antibiotics, including ampicillin and gentamicin. In addition, steroid and cyclophosphamide were administered. The patient died of renal failure 48 days after hospital admission. In conclusion, glomerulonephritis caused by Enterococcus faecalis endocarditis is an immune-complex-mediated disease characterized by necrotizing and crescentic glomerular lesions that can be fatal despite aggressive antimicrobial and immunosuppressive therapy.

Tài liệu tham khảo

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