Pulmonary-Renal Syndrome in a Patient with Bacterial Endocarditis

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-yekr-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 survive and remained on regular hemodialysis. We conclude that bactrial endocarditis should be included in the differential diagnosis of pu1onary-renal syndrome.

並列關鍵字

Bacterial endocarditis ； Case reports ； Glomerulonephritis ； Goodpasture Syndrome ； Hemorrhage ； Lung diseases

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