Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918

This article has now been updated. Please use the final version.

Clinical Implications of Steroid Therapy for Crescentic Glomerulonephritis and Gemella morbillorum-associated Infective Endocarditis
Shiori KobayashiKota KakeshitaTeruhiko ImamuraHayato FujiokaHidenori YamazakiTsutomu KoikeKoichiro Kinugawa
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JOURNAL OPEN ACCESS Advance online publication

Article ID: 5319-20

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Abstract

A 54-year-old man was admitted to our institute with a diagnosis of infectious endocarditis 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 infectious endocarditis remains controversial, it might be indicated if comorbid glomerulonephritis is critical.

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© 2021 by The Japanese Society of Internal Medicine
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