Bartonella henselea Prosthetic Valve Endocarditis Mimicking Vasculitis: A Case Report With Literature Review
Troy J. Fishman, Efrain Irizarry, Ayesha Kaleem, Robert J. Yancey, Uma Iyer
Abstract
We present one of the first reported cases of Bartonella henselae prosthetic valve endocarditis, which mimicked p-antineutrophil cytoplasmic autoantibody (p-ANCA), an anti-proteinase 3 positive necrotizing glomerulonephritis caused by a cat scratch resulting in temporary dialysis. Documentation of such infections is necessary as zoonotic infections are becoming more prevalent with early identification essential for proper treatment. Although pauci-immune patterns are not a unique finding in bacterial endocarditis associated with glomerulonephritis, they are an atypical finding in Bartonella henselae endocarditis. Furthermore, p-ANCA-associated vasculitis can also be responsible for renal and cardiac disease. Because of the similar disease presentation of different etiologies (autoimmune and infectious), it can make the diagnosis much more challenging. Our patient’s presentation is unique as there are no documented cases in the medical literature of Bartonella henselae resulting in temporary hemodialysis from previously healthy kidneys with recovery. Our case documents the success of early identification and appropriate treatment.