Bartonella Endocarditis Mimicking Crescentic Glomerulonephritis with PR3-ANCA Positivity

Case Reports in Nephrology
Joseph VercellonePaul S Kellerman

Abstract

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.

References

Sep 30, 1983·Science·D J WearF M King
Oct 19, 2007·Journal of Clinical Microbiology·Holenarasipur R VikramFranklin R Cockerill
Jan 1, 2010·BMJ Case Reports·Laurence S G TeohDominic S Rai-Chaudhuri
Feb 4, 2014·The Journal of Rheumatology·Elisabeth AslangulJean-Luc Mainardi
Feb 6, 2014·Arthritis & Rheumatology·Alfred MahrUNKNOWN IMAGE Study Group
Jan 29, 2016·Case Reports in Nephrology·Sophie Van Haare HeijmeijerLaura Labriola
Nov 26, 2016·Infectious Diseases in Clinical Practice : IDCP·Jillian E RaybouldPrincy N Kumar

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Methods Mentioned

BETA
ESR
enzyme-linked immunosorbent assay
biopsy
light-microscopy

Related Concepts

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Cat-scratch disease

Cat-scratch disease, a relatively common infectious disease, is caused by Bartonella henselae and characterized by a fever and regional lymphadenitis. Here is the latest research.

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Bartonellosis is an infection caused by bacteria in the genus Bartonella and can present as a variety of diseases depending on the organism involved. While asymptomatic infection has been reported, immunocompromised individuals are more susceptible to severe infection. Find the latest research on bartonellosis here.

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