Bartonella Endocarditis Mimicking Crescentic Glomerulonephritis with PR3-ANCA Positivity

Bartonella henselae is a fastidious organism that causes cat scratch disease, commonly associated with fever and lymphadenopathy but, in rare instances, also results in culture-negative infectious endocarditis. We describe a patient who presented with flank pain, splenic infarct, and acute kidney in...

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Bibliographic Details
Published in:Case reports in nephrology 2018, Vol.2018 (2018), p.1-4
Main Authors: Zhang, Ping L., Mansuri, Saima, Cohen, Lisa, Vercellone, Joseph, Kellerman, Paul S.
Format: Article
Language:English
Subjects:
Abdomen
Antibiotics
Arthritis
Cardiology
Case Report
Case reports
Endocarditis
Immunoglobulins
Inflammatory bowel disease
Microscopy
Pain
Rheumatology
Ultrasonic imaging
Urinalysis
Urine
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Summary:Bartonella henselae is a fastidious organism that causes cat scratch disease, commonly associated with fever and lymphadenopathy but, in rare instances, also results in culture-negative infectious endocarditis. We describe a patient who presented with flank pain, splenic infarct, and acute kidney injury with an active urinary sediment, initially suspicious for vasculitis, which was subsequently diagnosed as B. henselae endocarditis. Bartonella endocarditis may present with a crescentic glomerulonephritis (GN) and elevated PR3-ANCA antibody titers, mimicking ANCA-associated GN, with 54 cases reported in the literature. Unique to our case in this series is a positive PR3-ANCA antibody despite a negative IIF-ANCA. Thus, the presentation of Bartonella can mimic ANCA-associated GN, and renal biopsy showing immune complex deposition is critical for diagnosis and appropriate treatment.
ISSN:2090-6641
2090-665X
DOI:10.1155/2018/9607582