Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0014118 (endocarditis)
 15,629 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The nephropathy associated with methicillin sodium therapy is considered to be rare, but its prevalence is unknown. We reviewed the antibiotic therapy of 81 cases of Staphylococcus aureus bacteremia to establish the frequency and determinants of methicillin nephropathy in that disease. Fifty-two patients received methicillin; nine (17%) experienced the characteristic clinical signs previously associated with drug-induced acute interstitial nephritis. This nephropathy uniformly subsided after methicillin was withdrawn, and did not always include deterioration of renal function. Factors that correlated with methicillin nephropathy were endocarditis and prolonged treatment, but not intravenous drug abuse. There was only one adverse reaction among 29 patients treated with a cephalosporin. It was similar to the nephropathic reactions to methicillin. Thus, reversible renal abnormalities are prevalent during methicillin therapy, particularly among patients with staphylococcal infections such as endocarditis. When prolonged therapy with methicillin is required, the urinary sediment and renal excretory function should be monitored.
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PMID:Nephropathy associated with methicillin therapy. Prevalence and determinants in patients with staphylococcal bacteremia. 87 56

The authors report a case of anuria which lasted 3 months in a patient with sub-acute streptoccocal endocarditis. The investigations led to the discovery, at the level of the kidneys, of arterial aneurysms, renal infarction and diffuse endo-capillary proliferative glomerulonephritis, with deposits of complement and immunoglobulin and finally, interstitial nephritis, perhaps of metastatic origin, which was probably the lesion responsible for the renal failure. Renal function progressively improved and hemodialysis was stopped at the 6th month after correction of the mitral and aortic valve disease.
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PMID:[Prolonged anuria during bacterial endocarditis]. 122 52

The kidney diseases in patients with bacterial endocarditis and intravenous drug addicts (IVDA) tend to be of glomerular origin. Interstitial nephritis has been related to drug toxicity and only occasionally has it been described in other associations. We describe a 27-year-old patient IVDA with tricuspid endocarditis caused by S. Aureus whose first manifestations was acute renal failure. The renal biopsy showed an interstitial nephritis. It was treated with antibiotic and hemodialysis, obtaining the cure and normal levels of plasmatic creatinine.
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PMID:[Acute interstitial secondary to tricuspid endocarditis caused by Staphylococcus aureus]. 256 4

We report the results of a survey within the United Kingdom of the importance of persistent systemic infection in patients with unexplained renal disease who undergo renal biopsy. Twenty-two units participated. Overall 1.7 per cent of patients undergoing biopsy had an infection but there was large variation between units. Interstitial nephritis and amyloid deposits were more common in patients with infection, and minimal change nephropathy was less common than in patients undergoing biopsy but without infection. The respiratory tract was the most common site of infection but was rarely associated with glomerulonephritis of which the most common cause was infective endocarditis. Drug treatment may have caused the renal lesion in 16 per cent of patients. Amyloid deposits, present in 13.6 per cent of patients, was the most common cause of progressive renal failure. Most other patients had some improvement in renal function once the putative cause, whether infection or antibiotic, was removed.
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PMID:Persistent infection as a cause of renal disease in patients submitted to renal biopsy: a report from the Glomerulonephritis Registry of the United Kingdom MRC. 371 66

Systemic pathological alterations were studied in thirty-seven autopsied patients with Kawasaki disease. Systemic vasculitis was the most characteristic pathological finding and was present in all the patients. In addition to the vasculitis, there was a high incidence of inflammatory lesions in various organs and tissues: in the heart, endocarditis, myocarditis, and pericarditis; in the digestive system, stomatitis, sialoduct-adenitis, catarrhal enteritis, hepatitis, cholangitis, pancreatitis, and pancreas ductitis; in the respiratory system, bronchitis and segmental interstitial pneumonia; in the urinary system, focal interstitial nephritis, cystitis, and prostatitis; in the nervous system, aseptic leptomeningitis, choriomeningitis, gangliontis, and neuritis; in the hematopoietic system, lymphadenitis, splenitis, and thymitis. Dermatitis, panniculitis or myositis were also observed in some patients. Therefore, Kawasaki disease is a systemic inflammatory disease which mainly affects the cardiovascular system. These systemic inflammatory lesions are considered to correspond to the variegated clinical manifestaitions. The relationship between Kawasaki disease and infantile polyarteritis nodosa (IPN) were discussed, based on the clinicopathological characteristics.
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PMID:General pathology of Kawasaki disease. On the morphological alterations corresponding to the clinical manifestations. 744 9

The authors report a case of tubulo-interstitial nephritis with acute renal failure due to vancomycin used to treat a patient with enterococcus endocarditis. Rechallenge with vancomycin several days after stopping the drug resulted in the appearance of a maculopapular rash and rapid onset of acute oligo-anuric renal failure. Renal biopsy revealed acute interstitial nephritis. This feature is suggestive of cellular mediated hypersensitivity.
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PMID:[Acute interstitial nephropathy induced by vancomycin]. 897 51

To illustrate diagnostic approaches, potential pathogenetic differences, epidemiological implications and therapeutic dilemmas posed by glomerulonephritis (GN) with acute renal failure (ARF) complicating bacterial infections, we analyzed the course of four male patients, aged 53-71 years, who developed GN and ARF following bacterial infections. The first two patients developed GN with immunoglobulin A (IgA) deposits after infections with hospital-acquired methicillin resistant Staphylococcus aureus (MRSA). Clinical, serologic and histological features, classification of GN and treatment differed between the two patients. In the first patient, serological features (transient hypocomplementemia, normal serum protein electrophoresis) and histological findings were consistent with typical post-infectious GN. Treatment with antibiotics alone resulted in normalization of the renal function despite the severity of ARF, which required temporary hemodialysis. In the second patient, serological features (normal serum complement, polyclonal elevation of gamma globulins) and histological picture of the kidneys were characteristic of IgA nephropathy with fibrocellular crescents, and skin histology was consistent with vasculitis. Cyclophosphamide and corticosteroids were added to the antibiotics, with partial improvement of the renal failure. The third patient developed simultaneous acute rheumatic fever and post-streptococcal GN causing severe ARF requiring hemodialysis. Complete recovery of ARF and migratory polyarthritis followed initiation of corticosteroids. The fourth patient developed ARF and cerebral vasculitis following a prolonged course of Streptococcus mutans endocarditis with delayed diagnosis. He also developed multiple serological abnormalities including elevated titers of antineutrophil cytoplasmic antibodies (ANCA), antinuclear antibodies (ANA), anti-phospholipid antibodies, rheumatoid factor, and modest hypocomplementemia. Kidney biopsy revealed ANCA-mediated focal GN with 10% crescents and acute interstitial nephritis. Treatment with cyclophosphamide plus corticosteroids, but not with antibiotics alone, resulted in resolution of both the ARF and the features of cerebral vasculitis. GN following bacterial infections may have various pathogenetic mechanisms, presents complex diagnostic challenges, may be preventable in the case of hospital-acquired MRSA, and, in addition to antibiotics, may require immunosuppressive therapy in carefully selected and monitored cases.
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PMID:Glomerulonephritis causing acute renal failure during the course of bacterial infections. Histological varieties, potential pathogenetic pathways and treatment. 1824 52

Of the two postmortem examinations on rat-bite fever previously reported, the patient of Miura and Toriyama, a woman, aged 32 years, died on the 70th day after the onset of the disease. Anatomically there were no marked changes. Histological examinations were not made. Macroscopically, the following findings are reported: increase of cerebrospinal fluid, hyperemia of the meninges, inflammatory edema of the lungs, cloudy swelling of the liver, etc. The other, Blake's case, was a woman of 67, who died 1 month after the bite of a rat. The anatomical findings were acute ulcerative endocarditis, subacute myocarditis, interstitial hepatitis, glomerular and interstitial nephritis. The suprarenals contained a large amount of perivascular fluid. There were infarcts in the spleen and kidney. In general, the organs were hyperemic; the lung showed hemorrhages and edema, Histologically, Blake found marked degeneration, necrosis, and infiltration in the cardiac muscles, infiltration of polynuclear cells, and increase in the interstices of the liver, also marked polynuclear infiltration of the shrunken kidney.
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PMID:A CONTRIBUTION TO THE ETIOLOGY AND PATHOLOGY OF RAT-BITE FEVER. 1986 55

A 54-year-old man was diagnosed with Streptococcus mutans endocarditis of the mitral valve. Serological tests disclosed the presence of multiple autoantibodies including c-ANCA, anti-PR3 and anti-MPO. While the fever subsided with antibiotics, mental status and renal function deteriorated rapidly. Kidney biopsy revealed pauci-immune glomerulonephritis and acute eosinophilic interstitial nephritis. The abnormal clinical features improved rapidly after addition of corticosteroids and cyclophosphamide to the antibiotics. Immunosuppressive agents may be required in a fraction of the patients with infective endocarditis who develop ANCA and ANCA-mediated renal disease. Histological identification of the type of renal disease is imperative for the choice of the treatment.
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PMID:Symptomatic anti-neutrophil cytoplasmic antibody-positive disease complicating subacute bacterial endocarditis: to treat or not to treat? 2319 52

Mycobacterium chimaera is a rare infection associated with cardiopulmonary bypass. We describe a case of granulomatous interstitial nephritis caused by M. chimaera in a patient with prosthetic aortic valve endocarditis. A 63-year-old female with a mechanical aortic valve replacement developed fatigue, 20 lbs. weight loss, anemia, and an elevated creatinine. Fat pad aspirate at an outside hospital was suspicious for amyloidosis which prompted hematology referral at our institution. Bone marrow biopsy revealed a single granuloma, negative for amyloid or acid fast bacillus (AFB). She was admitted to our hospital for worsening kidney function refractory to intravenous fluid challenge. Transesophageal echocardiogram showed aortic root abscess and valve vegetation with negative blood cultures at seven days. Renal biopsy showed granulomatous interstitial nephritis and negative AFB stain. Prednisone 40 mg was started and renal function partially improved. Blood cultures obtained before biopsy subsequently grew M. chimaera. Three-drug antimicrobial therapy was initiated and prednisone discontinued. One month later, creatinine improved and follow up echocardiogram showed no lesion. Our case highlights this rare infection inducing granulomatous interstitial nephritis despite lack of positive AFB or gram stains on renal biopsy.
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PMID:Prosthetic valve endocarditis from Mycobacterium chimaera infection causing granulomatous interstitial nephritis. 3215 5


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