Gemella infective endocarditis complicated by crescentic glomerulonephritis with PR3-ANCA positivity: a case report

Objective

We report a case of Gemella infective endocarditis (IE) complicated by crescentic glomerulonephritis (GN) with proteinase 3-antineutrophil cytoplasmic antibody (PR3-ANCA) positivity and re-evaluate the clinicopathological spectrum of Gemella-associated renal disease. Patient/Methods: A Japanese man in his 80s presented with low-grade fever and progressive renal dysfunction for several weeks. Blood cultures yielded Gemella species and echocardiography demonstrated valvular vegetation consistent with IE. Laboratory tests revealed elevated urinary abnormalities, elevated inflammatory markers, hypocomplementemia, and PR3-ANCA positivity. A renal biopsy was performed to assess rapidly progressive GN.