title: [Aggregatibacter segnis endocarditis mimicking antineutrophil cytoplasmic antibody-associated vasculitis presenting with cerebral hemorrhage: a case report].
abstract: A 56-year-old man who underwent a tooth extraction in the previous year presented with weakness of the right upper extremity. Brain CT and MRI scans showed subcortical hemorrhage in the left frontal lobe. His body temperature was 37.5°C. Blood examination revealed anemia, elevated levels of C-reactive protein, and a positive result for PR3-ANCA. Aggregatibacter segnis was identified in the incubated blood cultures, and transesophageal echocardiograms showed infectious growth in the anterior mitral leaflet. He was diagnosed with infectious endocarditis. After treatment with ceftriaxione, the clinical symptoms were improved. We concluded that infectious endocarditis caused cerebral hemorrhage and that the positive result for PR3-ANCA was a false positive. Infectious endocarditis can mimic ANCA-associated vasculitis. When ANCA-associated vasculitis is suspected, infectious endocarditis must be ruled out.
authors.affiliation: Department of Neurology, Japanese Red Cross Nagoya Daiichi Hospital.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Hirunagi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kawanishi
authors.forename: Norimasa
authors.initials: N
authors.lastname: Mitsuma
authors.forename: Yoji
authors.initials: Y
authors.lastname: Goto
authors.forename: Kazuo
authors.initials: K
authors.lastname: Mano
mesh_terms: D064208:Aggregatibacter segnis / Q000302:isolation & purification; D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000175:diagnosis*; D002543:Cerebral Hemorrhage / Q000209:etiology; D003937:Diagnosis, Differential; D004697:Endocarditis, Bacterial / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016871:Pasteurellaceae Infections / Q000175:diagnosis*