Streptococcal viridans subacute bacterial endocarditis associated with antineutrophil cytoplasmic autoantibodies (ANCA).
We report an illustrative case of a 60-year-old man with Streptococcus viridans subacute bacterial endocarditis (SBE) and positive antineutrophil cytoplasmic autoantibodies (c-ANCA). C-ANCA positivity has been associated with a variety of rheumatic and infectious disease areas, but has been rarely associated with SBE. The patient had mitral valve prolapse with mitral regurgitation, and S viridans SBE developed after a dental procedure. Laboratory abnormalities included anemia, elevated erythrocyte sedimentation rate, positive rheumatoid factor, positive anticardiolipin antibody, positive lupus anticoagulant, and highly elevated c-ANCA level. We believe this is only the ninth reported case of S viridans SBE with a positive c-ANCA, and the third with mitral valve prolapse and vegetations.
Infectious Disease Division and Department of Medicine, Winthrop-University Hospital, Mineola, New York 11501, USA.
André
A
de Corla-Souza
Burke A
BA
Cunha
D000900:Anti-Bacterial Agents; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000276:immunology*; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination / Q000008:administration & dosage; D004698:Endocarditis, Subacute Bacterial / Q000276:immunology* / Q000382:microbiology* / Q000628:therapy; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012720:Severity of Illness Index; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000628:therapy; D016896:Treatment Outcome; D034363:Viridans Streptococci / Q000302:isolation & purification*
D000900:Anti-Bacterial Agents; D019268:Antibodies, Antineutrophil Cytoplasmic