
- Published: October 24, 2019
- By: Michael Kuperman, MD
- Tags: ANCA, Crescents, Endocarditis, Glomerulonephritis, Infection
The patient is a 45-year-old IV drug user who presents with fevers, chills, hematuria, and fatigue. On laboratory testing, he was found to have a creatinine of 4.8. Complement levels are depressed and blood cultures are positive. A transesophageal echocardiogram confirmed the presence of endocarditis. A kidney biopsy was obtained due to hematuria. Image 1 and Image 3 shows circumferential cellular crescents with fibrinoid necrosis (many intracapillary neutrophils are seen in image 3). Figure 2 shows severe interstitial fibrosis. Images 4 and 5 show immunofluorescence staining with IgM and C3, respectively. This is a case of endocarditis-associated glomerulonephritis with diffuse...