Systemic Haemophilus parainfluenzae Infection Manifesting With Endocarditis and Membranoproliferative Glomerulonephritis

Infective endocarditis (IE) is a potentially fatal disease that primarily caused by Staphylococci and Streptococci. The HACEK group of bacteria (Hemophilus species, Aggregatibacter Cardiobacterium hominis, Eikenella corrodens, Kingella kingae) account for only 1-3% reported IE cases. has long been known to cause glomerulonephritis. most common histologic patterns seen are crescentic diffuse proliferative Notably, membranoproliferative glomerulonephritis (MPGN) one the less with IE. We present rare case MPGN associated Haemophilus parainfluenzae endocarditis. A 56-year-old male no significant past medical history presented local hospital complaints fever, night sweats, dyspnea, diarrhea, dark urine about month. He was found have hemoglobin 4g/dL, requiring multiple transfusions. also had bilateral pleural effusions pulmonary edema. In following days, he worsening renal function transferred our further workup. Initial labs showed anemia, thrombocytopenia, leukocytosis. creatinine elevated at 5.28 mg/dL low estimated glomerular filtration rate (eGFR) 12 mL/min/1.73m2. Urinalysis proteinuria, hemoglobin, white blood cells (WBCs), red (RBCs). Blood cultures revealed H. parainfluenzae. Transesophageal echocardiogram (TEE) large vegetations perforation mitral valve leaflet. Serology complement levels. Renal biopsy displayed pattern on light microscopy. hepatitis panel negative, as autoimmune patient diagnosed His complex clinical course required replacement aortic repair. completed antibiotics, improvement in cardiac function.