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Erschienen in: Pediatric Nephrology 10/2019

08.04.2019 | Clinical Quiz

Glomerulonephritis and nephrotic syndrome in a child with DiGeorge syndrome: Answers

verfasst von: Leo Arkush, Orli Megged, Itamar Nitzan, Nurit Yaakobi-Simhayoff, Sofia Feinstein, Shimrit Tzvi-Behr

Erschienen in: Pediatric Nephrology | Ausgabe 10/2019

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Excerpt

1.
The findings on eye examination are consistent with Roth spots. In view of her background of congenital cardiac disease with the presence of an indwelling cardiac conduit, the most likely diagnosis is bacterial infective endocarditis with secondary immunologic sequelae including glomerulonephritis.
 
2.
The next step in evaluation and management is taking repeated sets of blood cultures and commencing empirical antibiotic treatment. In our patient, three repeated sets of blood cultures were positive for Leptotrichia goodfellowii, a rare, slow-growing anaerobe. Antibiotic treatment was adapted as per sensitivities of the bacteria and she received a total of 6 weeks parenteral antibiotic therapy.
 
3.
The recommended management for her glomerulonephritis with nephrotic syndrome is treating the causative agent with antibiotics, supportive care, in particular controlling hypertension. In rare cases, immunosuppressive therapy has been used for the treatment of non-responding infective endocarditis-associated glomerulonephritis [1].
 
Literatur
1.
Zurück zum Zitat Le Moing V, Lacassin F, Delahousse M, Duval X, Longuet P, Leport C, Vildé JL (1999) Use of corticosteroids in glomerulonephritis related to infective endocarditis: three cases and review. Clin Infect Dis 28:1057–1061CrossRefPubMed Le Moing V, Lacassin F, Delahousse M, Duval X, Longuet P, Leport C, Vildé JL (1999) Use of corticosteroids in glomerulonephritis related to infective endocarditis: three cases and review. Clin Infect Dis 28:1057–1061CrossRefPubMed
2.
3.
Zurück zum Zitat Martin JM, Neches WH, Wald ER (1997) Infective endocarditis: 35 years of experience at a children’s hospital. Clin Infect Dis 24:669–675CrossRefPubMed Martin JM, Neches WH, Wald ER (1997) Infective endocarditis: 35 years of experience at a children’s hospital. Clin Infect Dis 24:669–675CrossRefPubMed
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Zurück zum Zitat Lewena S (2005) Infective endocarditis: experience of a paediatric emergency department. J Paediatr Child Health 41:269–272CrossRefPubMed Lewena S (2005) Infective endocarditis: experience of a paediatric emergency department. J Paediatr Child Health 41:269–272CrossRefPubMed
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Zurück zum Zitat Caram LB, Linefsky JP, Read KM, Murdoch DR, Lalani T, Woods CW, Reller LB, Kanj SS, Premru MM, Ryan S, Al-Hegelan M, Donnio PY, Orezzi C, Paiva MG, Tribouilloy C, Watkin R, Harris O, Eisen DP, Corey GR, Cabell CH, Petti CA, International Collaboration on Endocarditis Investigator Group (2008) Leptotrichia endocarditis: report of two cases from the International Collaboration on Endocarditis (ICE) database and review of previous cases. Eur J Clin Microbiol Infect Dis 27:139–143CrossRefPubMed Caram LB, Linefsky JP, Read KM, Murdoch DR, Lalani T, Woods CW, Reller LB, Kanj SS, Premru MM, Ryan S, Al-Hegelan M, Donnio PY, Orezzi C, Paiva MG, Tribouilloy C, Watkin R, Harris O, Eisen DP, Corey GR, Cabell CH, Petti CA, International Collaboration on Endocarditis Investigator Group (2008) Leptotrichia endocarditis: report of two cases from the International Collaboration on Endocarditis (ICE) database and review of previous cases. Eur J Clin Microbiol Infect Dis 27:139–143CrossRefPubMed
6.
Zurück zum Zitat Matias WR, Bourque DL, Niwano T, Onderdonk AB, Katz JT (2016) Subacute bacterial endocarditis with Leptotrichia goodfellowii in a patient with a valvular allograft: a case report and review of the literature. Case Rep Infect Dis 2016:3051212PubMedPubMedCentral Matias WR, Bourque DL, Niwano T, Onderdonk AB, Katz JT (2016) Subacute bacterial endocarditis with Leptotrichia goodfellowii in a patient with a valvular allograft: a case report and review of the literature. Case Rep Infect Dis 2016:3051212PubMedPubMedCentral
Metadaten
Titel
Glomerulonephritis and nephrotic syndrome in a child with DiGeorge syndrome: Answers
verfasst von
Leo Arkush
Orli Megged
Itamar Nitzan
Nurit Yaakobi-Simhayoff
Sofia Feinstein
Shimrit Tzvi-Behr
Publikationsdatum
08.04.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Pediatric Nephrology / Ausgabe 10/2019
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-019-04243-5

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