Enterococcal endocarditis associated with crescentic glomerulonephritis |
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Authors: | Alper Kirkpantur Akif Altinbas Mustafa Arici Dilek Ertoy Baydar Bulent Altun Serap Arslan |
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Institution: | (1) Department of Internal Medicine, Nephrology Unit, Hacettepe University, School of Medicine, Eriskin Nefroloji Bolumu 06100, Sihhiye, Ankara, Turkey;(2) Department of Internal Medicine, Hacettepe University, School of Medicine, Ankara, Turkey;(3) Department of Pathology, Hacettepe University, School of Medicine, Ankara, Turkey;(4) Department of Internal Medicine, Gastroenterology Unit, Hacettepe University, School of Medicine, Ankara, Turkey |
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Abstract: | 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. |
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Keywords: | Enterococcus faecalis Infective endocarditis Crescentic glomerulonephritis Mortality |
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