Myocardial depression and nephrotic syndrome in Streptococcus sanguis endocarditis

Nephrotic syndrome is a most unusual complication of infective endocarditis. We report a case of Streptococcus sanguis endocarditis of the tricuspid valve in a patient with a small congenital ventricular septal defect who developed this complication. Severe myocardial depression also occurred and the clinical behaviour and subsequent recovery of this closely paralleled that of the nephrotic syndrome. These unusual associations, their possible interactions and pathogeneses are discussed.