Medline ® Abstracts for References 6,7
of 'Renal disease in the setting of infective endocarditis or an infected ventriculoatrial shunt'
Pulmonary-renal syndrome of bacterial endocarditis mimicking Goodpasture's syndrome.
Griffin KA, Schwartz MM, Korbet SM
Am J Kidney Dis. 1989 Oct;14(4):329-32.
Department of Internal Medicine and Pathology, Rush Medical College, Rush-Presbyterian-St Luke's Medical Center, Chicago, IL.
Pulmonary-renal syndrome in a patient with bacterial endocarditis.
Wu HC, Wen YK, Chen ML, Fan CS
J Formos Med Assoc. 2005;104(8):588.
Pulmonary-renal syndrome is defined as a combination of pulmonary hemorrhage and glomerulonephritis. We report an unusual case of bacterial endocarditis presenting with pulmonary hemorrhage and rapidly progressive glomerulonephritis as the initial manifestations of the disease. A 37-year-old man was admitted with fever, hemoptysis, and dyspnea. Admission examinations revealed severe renal failure requiring dialysis therapy. Chest radiograph showed extensive pulmonary reticulonodular infiltrates. Echocardiography revealed ventricular septal defect. Furthermore, blood cultures grew viridians group streptococci. The kidney and lung biopsies demonstrated diffuse cresentic glomerulonephritis and alveolar hemorrhage, respectively. Bacterial endocarditis was diagnosed according to the Duke criteria and the patient was treated with intravenous antibiotic therapy. The pulmonary infiltrates disappeared gradually. However, renal function did not improve, even after trial of a course of immunosuppressive therapy. The patient survived and remained on regular hemodialysis. We conclude that bacterial endocarditis should be included in the differential diagnosis of pulmonary-renal syndrome.
Division of Nephrology, Department of Internal Medicine, Changhua Christian Hospital, Taiwan.