Diffuse crescentic glomerulonephritis in bacterial endocarditis.
Renal involvement is common in patients with bacterial endocarditis. The most common bacteria are staphylococci and streptococci, and the commonest renal histopathological lesion is a diffuse proliferative and exudative type of glomerulonephritis. Very rarely, patients may present with an extensive glomerular epithelial crescent formation with a rapid deterioration in the renal function. This study reviews the published literature on diffuse crescentic glomerulonephritis in bacterial endocarditis and reports a 24-year-old male patient with endocarditis due to Capnocytophagia species, a gramnegative facultative anaerobic bacillus, which normally inhabits the oral cavity. Appropriate antibiotic therapy is essential to eradicate the infection. A brief course of corticosteroid therapy may be helpful in those with deteriorating renal function. Plasmapheresis may be useful in those with persistent hypocomplementemia, increased circulating immune complexes, and a progressive deterioration in the renal function. Removal of vegetation or valve replacement may be necessary. Prognosis is generally good.
Kannan
S
S
ICU, Children's Hospital of Michigan, Detroit, MI 48201, USA.
Mattoo
T K
TK
D000328:Adult; D004698:Endocarditis, Subacute Bacterial / Q000150:complications* / Q000382:microbiology; D005921:Glomerulonephritis / Q000209:etiology* / Q000382:microbiology / Q000473:pathology*; D016905:Gram-Negative Bacterial Infections / Q000473:pathology; D006801:Humans; D007677:Kidney Function Tests; D007678:Kidney Glomerulus / Q000473:pathology; D008297:Male; D008854:Microscopy, Electron