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Enterococcal endocarditis associated with crescentic glomerulonephritis.
Alper Kirkpantur1, Akif Altinbas2, Mustafa Arici3
1Department of Internal Medicine, Nephrology Unit, Hacettepe University, School of Medicine, Eriskin Nefroloji Bolumu 06100, Sihhiye, Ankara, Turkey. alperk@hacettepe.edu.tr.
Clinical and Experimental Nephrology
|December 19, 2007
Summary
Necrotizing glomerulonephritis from Enterococcus faecalis endocarditis is rare but serious. This immune-complex disease can be fatal despite aggressive treatment for kidney failure.
Area of Science:
- Nephrology
- Infectious Diseases
- Cardiology
Background:
- Infective endocarditis (IE) rarely causes glomerulonephritis, typically with blood-culture-positive bacteria.
- Enterococcus faecalis endocarditis is an uncommon cause of secondary glomerulonephritis.
Observation:
- A patient presented with renal abnormalities due to necrotizing glomerulonephritis.
- Renal biopsy revealed immune complex-mediated necrotizing and crescentic glomerulonephritis.
- Mesangial and capillary deposition of immunoglobulin M, immunoglobulin G, and complement 3 were observed.
Findings:
- The patient had glomerulonephritis secondary to culture-positive Enterococcus faecalis endocarditis.
- Despite treatment with antibiotics (ampicillin, gentamicin) and immunosuppressants (steroids, cyclophosphamide), the patient died of renal failure.
- The condition is characterized by necrotizing and crescentic glomerular lesions.
Implications:
- Enterococcus faecalis endocarditis-associated glomerulonephritis is a severe, immune-complex-mediated renal disease.
- Aggressive antimicrobial and immunosuppressive therapy may not prevent fatal outcomes.
- Highlights the importance of considering IE in patients with unexplained glomerulonephritis.
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