심내막염에 동반한 반월상 사구체신염에서 항생제만으로 치료된 1예
Recovery from crescentic glomerulonephritis with bacterial endocarditis with antibiotics alone
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A 59-year-old woman presented to our hospital with fever, petechiae, pyuria, gross hematuria, and rapidly progressive glomerulonephritis (GN). She had a history of urinary tract infection. A renal biopsy specimen revealed crescentic GN and an echocardiogram showed a vegetation 3.15×1.73 cm in size on the mitral valve and severe mitral valve regurgitation. Blood cultures grew Enterococcus faecalis. Treatment with antibiotics alone resulted in clinical improvement of the renal function and resolution of the fever. Three months after hospitalization, the echocardiogram showed mild mitral valve regurgitation. This case suggests that crescentic glomerulonephritis associated with even a huge vegetation of infectious endocarditis can be treated with antibiotics alone and result in stable renal function.
Abstract
A 59-year-old woman presented to our hospital with fever, petechiae, pyuria, gross hematuria, and rapidly progressive glomerulonephritis (GN). She had a history of urinary tract infection. A renal biopsy specimen revealed crescentic GN and an echocardiogram showed a vegetation 3.15×1.73 cm in size on the mitral valve and severe mitral valve regurgitation. Blood cultures grew Enterococcus faecalis. Treatment with antibiotics alone resulted in clinical improvement of the renal function and resolution of the fever. Three months after hospitalization, the echocardiogram showed mild mitral valve regurgitation. This case suggests that crescentic glomerulonephritis associated with even a huge vegetation of infectious endocarditis can be treated with antibiotics alone and result in stable renal function.
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