Diffuse crescentic glomerulonephritis in bacterial endocarditis

Abstract

Renal involvement is common in patients with bacterial endocarditis. The most common bacteria are staphylococci and streptococci, and the commonest renal histopathological lesion is a diffuse proliferative and exudative type of glomerulonephritis. Very rarely, patients may present with an extensive glomerular epithelial crescent formation with a rapid deterioration in the renal function. This study reviews the published literature on diffuse crescentic glomerulonephritis in bacterial endocarditis and reports a 24-year-old male patient with endocarditis due to Capnocytophagia species, a gramnegative facultative anaerobic bacillus, which normally inhabits the oral cavity. Appropriate antibiotic therapy is essential to eradicate the infection. A brief course of corticosteroid therapy may be helpful in those with deteriorating renal function. Plasmapheresis may be useful in those with persistent hypocomplementemia, increased circulating immune complexes, and a progressive deterioration in the renal function. Removal of vegetation or valve replacement may be necessary. Prognosis is generally good.