A 60-year-old man with a history of mitral valve prolapse presents with fever and weight loss after a recent dental procedure. At one week in the hospital, he has acute left flank pain. A CT shows a wedge-shaped area of hypoperfusion in the left kidney. If a biopsy of this area were done, what would it show?
The man presumably has bacterial endocarditis (likely Strep viridans) that occurred when oral flora entered his bloodstream during a dental procedure and infected his abnormal heart valve. A complication of endocarditis is systemic septic emboli, often to the spleen or kidney. Tissue death due to hypoperfusion is called coagulative necrosis.