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Necrotizing glomerulonephritis caused by Bartonella henselae endocarditis.
Ian Bookman1, James W Scholey, Sarbjit V Jassal
1Department of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Summary
Bartonella henselae endocarditis can cause immune complex-mediated glomerulonephritis, a kidney disease. Prompt antibiotic and surgical treatment may improve renal function in affected patients.
Area of Science:
- Nephrology
- Infectious Diseases
- Cardiology
Background:
- Glomerulonephritis is rarely caused by endocarditis, typically involving bacteria detected in blood cultures.
- Culture-negative endocarditis presents diagnostic challenges, particularly when associated with renal manifestations.
Observation:
- This study details three cases of necrotizing glomerulonephritis linked to culture-negative endocarditis caused by Bartonella henselae.
- Renal biopsy results prompted endocarditis investigation in two patients presenting with kidney abnormalities.
- All patients exhibited immune complex-mediated necrotizing and crescentic glomerulonephritis with characteristic immunoglobulin and complement deposition.
Findings:
- Histopathology revealed immune-type electron-dense deposits in the glomeruli.
- Treatment involved antibiotics (azithromycin/doxycycline, ceftriaxone/tobramycin), steroids, and valve replacement surgery in two cases.
- Two patients who received surgical intervention showed stable renal function post-discharge.
Implications:
- Bartonella henselae endocarditis is an identifiable cause of immune complex-mediated glomerulonephritis.
- Aggressive medical and surgical management can lead to favorable renal outcomes.
- Early diagnosis and treatment are crucial for patients with suspected Bartonella henselae-associated glomerulonephritis.