Streptococcal viridans subacute bacterial endocarditis associated with antineutrophil cytoplasmic autoantibodies (ANCA)

de Corla-Souza, André; Cunha, Burke A.

doi:10.1067/mhl.2003.2

« PreviousHeart & Lung: The Journal of Acute and Critical Care
Volume 32, Issue 2 , Pages 140-143, March 2003

Streptococcal viridans subacute bacterial endocarditis associated with antineutrophil cytoplasmic autoantibodies (ANCA)☆☆☆

Mineola and Stony Brook, New York

From the Infectious Disease Division and Department of Medicine, Winthrop-University Hospital, Mineola, New York; and State University of New York School of Medicine, Stony Brook, New York

Abstract

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. (Heart Lung® 2003;32:140-3.)