[A surgical case of infective endocarditis accompanied with immune complex glomerulonephritis]

Infective endocarditis (IE) is often accompanied with renal disease. Recently it is thought that immune complex is formed by infecting agent of IE deposit to glomerulus and this contributes to glomerulonephritis. The case was 59-year-old man. He admitted with symptoms of proteinuria, hematuria and fever and diagnosed aortic regurgitation with vegetative change of aortic valve with echocardiogram. After admission he had stroke. Renal function was poor and circulating immune complex (CIC) value was high. Str. viridans was defined by blood culture examination. Aortic valve replacement was done because of no normalization of infective response and of renal function. Bacteria was not detected from the vegetation of valve but detected in the vegetation of transitional zone to mitral valve. Postoperative course was uneventful and renal function became normal with normalization of infective response. Anti C3d antibody value became normal and he discharged 50th postoperative day. In case of ineffective medical treatment the early removal of infected valve will make a successful result.