Glomerulonephritis and Endocarditis

• Glomerulonephritis may be present in patients with endocarditis. The etiology may be embolic or immune. The association with Streptococcus viridans during the pre antibiotic era has been superceded by a more frequent association with Staphylococcus aureus. Focal embolic glomerulonephritis is characterized by proliferation of endothelial and mesangial cells, by neutrophil infiltration, and by localized bleeding. Fibrinoid necrosis and crescent formation may develop. Staph aureus can also cause multiple renal microabscesses. Interstitial nephritis, acute and chronic proliferative glomerulonephritis have all been reported. Staphylococcus epidermidis endocarditis may be accompanied by membranoproliferative glomerulonephritis.

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