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Necrotizing Crescentic Glomerulonephritis Complicating Bivalvular Bacterial Endocarditis

Arsalan Talib Hashmi1, Muhammad Khalid2, Husnain Waseem3

  • 1Internal Medicine, Maimonides Medical Center, Brooklyn, USA.

Cureus
|June 27, 2018
PubMed

Insights

Necrotizing crescentic glomerulonephritis (GN) can occur with Streptococcus parasanguinis endocarditis. Despite antibiotics and immunosuppression, this patient required hemodialysis, highlighting treatment challenges for this rare condition.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Cardiology

Background:

  • Bacterial endocarditis incidence is rising in the United States.
  • Native valve endocarditis requires prompt diagnosis and treatment.
  • Streptococcus parasanguinis is a known cause of infective endocarditis.

Observation:

  • A patient presented with necrotizing crescentic glomerulonephritis (GN).
  • The GN was associated with native valve bacterial endocarditis caused by Streptococcus parasanguinis.
  • The patient's kidney function continued to decline despite initial antibiotic therapy.

Findings:

  • Immunosuppressive therapy was initiated due to worsening kidney function.
  • Despite antibiotics and immunosuppression, renal function did not improve.
  • The patient ultimately required chronic hemodialysis.

Implications:

  • This case highlights the rare association between Streptococcus parasanguinis endocarditis and severe GN.
  • There are no established treatment guidelines for this rare condition.
  • Further research is needed for early diagnosis and improved treatment strategies, potentially involving antibiotics, steroids, and immunosuppressive agents.

Keywords:
crescentic glomerulonephritisend stage renal diseaseinfective endocarditis

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