Journal Article

Use of Corticosteroids in Glomerulonephritis Related to Infective Endocarditis: Three Cases and Review

Vincent Le Moing, Flore Lacassin, Michel Delahousse, Xavier Duval, Pascale Longuet, Catherine Leport and Jean-Louis Vildé

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 28, issue 5, pages 1057-1061
Published in print May 1999 | ISSN: 1058-4838
Published online May 1999 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/514734
Use of Corticosteroids in Glomerulonephritis Related to Infective Endocarditis: Three Cases and Review

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We report the cases of three patients treated for infective endocarditis (IE) for whom corticosteroids were added to the antibiotic treatment. They all had clinical and biological evidence of immune-mediated glomerulonephritis. The microorganisms responsible for IE were Coxiella burnetii, Streptococcus bovis, and Cardiobacterium hominis. Median duration of IE before antimicrobial therapy was 7 months. In all patients, renal function deteriorated despite appropriate antimicrobial treatment for a mean duration of 16 days, but it improved after addition of corticosteroid therapy. All patients were cured of IE. A literature review revealed four additional cases of IE-related glomerulonephritis in which adjunctive immunosuppressive therapy was considered to be effective. Although corticosteroid therapy is generally not recommended for IE, it should be considered for patients whose renal dysfunction secondary to glomerulonephritis does not improve with appropriate antimicrobial treatment, especially if the duration of the illness is long.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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