Yeungnam Univ J Med.  2017 Jun;34(1):140-145. 10.12701/yujm.2017.34.1.140.

C-ANCA-positive glomerulonephritis associated with subacute infective endocarditis caused by Bartonella infection

Affiliations
  • 1Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Korea. kimhjyh@naver.com
  • 2Institute of Health Sciences, Gyeongsang National University, Jinju, Korea.

Abstract

Glomerulonephritis (GN) is sometimes associated with infective endocarditis (IE). Bartonella endocarditis is difficult to diagnose because it is rare and cannot be detected by blood culture. This is the first report of cytoplasmic anti-neutrophil cytoplasmic antibody-positive subacute endocarditis-associated GN caused by Bartonella infection in South Korea. A 67-year-old man was hospitalized due to azotemia. He complained of weight loss and anorexia for 6 months. A diagnosis of IE was made based upon echocardiographic detection of vegetations on the mitral and aortic valves and a Bartonella antibody titer of 1:2,048. Renal histology identified focal crescentic GN. Azotemia and proteinuria improved after doxycycline and rifampin treatment combining with steroid therapy.

Keyword

ANCA-associated glomerulonephritis; Bartonella; Infectious endocarditis

MeSH Terms

Aged
Anorexia
Aortic Valve
Azotemia
Bartonella Infections*
Bartonella*
Cytoplasm
Diagnosis
Doxycycline
Echocardiography
Endocarditis*
Glomerulonephritis*
Humans
Korea
Proteinuria
Rifampin
Weight Loss
Doxycycline
Rifampin
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