Lactobacillus Endocarditis With Mixed Glomerulonephritis: A Case Report

We present a case of Lactobacillus prosthetic valve endocarditis with associated antineutrophil cytoplasmic antibody glomerulonephritis. A 41-year-old man presented with recurrent dark brown urine, lower-extremity rash, and acute kidney injury. Kidney biopsy confirmed the diagnosis of glomerulonephritis, with pathologic findings concerning for an infectious cause. Blood cultures returned positive for Lactobacillus species, and transesophageal echocardiogram findings were positive for prosthetic valve vegetation. Antimicrobial and low-dose steroid therapy were initiated to treat the endocarditis with confidence that resolution of his glomerulonephritis also would occur.