Clinical Implications of Steroid Therapy for Crescentic Glomerulonephritis and Gemella morbillorum-associated Infective Endocarditis

A 54-year-old man was admitted to our institute with a diagnosis of infective endocarditis (IE) with vegetation on the mitral valve and severe regurgitation due to Gemella morbillorum infection together with renal dysfunction, which was eventually diagnosed as infection-related pauci-immune necrotiz...

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Published inInternal Medicine Vol. 60; no. 2; pp. 299 - 303
Main Authors Kobayashi, Shiori, Kakeshita, Kota, Imamura, Teruhiko, Fujioka, Hayato, Yamazaki, Hidenori, Koike, Tsutomu, Kinugawa, Koichiro
Format Journal Article
LanguageEnglish
Published Japan The Japanese Society of Internal Medicine 15.01.2021
Japan Science and Technology Agency
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Summary:A 54-year-old man was admitted to our institute with a diagnosis of infective endocarditis (IE) with vegetation on the mitral valve and severe regurgitation due to Gemella morbillorum infection together with renal dysfunction, which was eventually diagnosed as infection-related pauci-immune necrotizing crescentic glomerulonephritis. Given the refractoriness to antibiotics, the persistent activity of nephritis, and repeated cerebral hemorrhaging, we prioritized steroid therapy over early surgical mitral valve replacement. Following steroid therapy, the glomerulonephritis completely improved. Although the administration of steroid therapy in the active phase of IE remains controversial, it might be indicated if comorbid glomerulonephritis is critical.
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Correspondence to Dr. Teruhiko Imamura, teimamu@med.u-toyama.ac.jp
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.5319-20