Lactobacillus acidophilus Endocarditis Complicated by Pauci-Immune Necrotizing Glomerulonephritis
Abstract
<jats:p>Infective endocarditis (IE) is more common in patients with predisposing cardiac
lesions and has many potential complications, including stroke and arterial thromboembolisms.
Renal manifestations have an estimated prevalence of ∼20%. Rapidly progressive glomerulonephritis
(RPGN) is a nephrological emergency manifested by autoimmune-mediated progressive
loss of renal function over a relatively short period of time. Here, we report the
case of a 60-year-old Caucasian male, who presented with speech impairment and was
found to have multiple embolic strokes caused by aortic valve IE. His renal function
declined rapidly, and his urine sediment featured hematuria and proteinuria. ANCA
titer was negative by immunofluorescence (IF); however, the PR3 antibody was elevated.
The renal biopsy revealed pauci-immune focally necrotizing glomerulonephritis with
the presence of ∼25% cellular crescents. He was initially treated with plasmapheresis
and pulse dose steroids. Hemodialysis was initiated for uremic symptoms. After four
weeks of antibiotic therapy and with blood cultures remaining negative, he was treated
with rituximab. Two months after discharge, his renal function showed improvement,
and hemodialysis was discontinued. This case highlights several complications associated
with lactobacillus endocarditis including RPGN.</jats:p>
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https://hdl.handle.net/10161/22311Published Version (Please cite this version)
10.1155/2020/1607141Publication Info
Chukwurah, Vivian O; Takang, Comfort; Uche, Chinelo; Thomas, David B; El Masry, Waguih;
& Toka, Hakan R (2020). Lactobacillus acidophilus Endocarditis Complicated by Pauci-Immune Necrotizing Glomerulonephritis.
Case Reports in Medicine, 2020. pp. 1-4. 10.1155/2020/1607141. Retrieved from https://hdl.handle.net/10161/22311.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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David Thomas
Adjunct Professor in the Department of Pathology

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