Endocarditis-associated IgA vasculitis: Two subtle presentations of endocarditis caused by Candida parapsilosis and Cardiobacterium hominis

Wang, Jake X.; Perkins, Sara; Totonchy, Mariam B.; Stamey, Christopher; Levy, Lauren; Imaeda, Suguru; Cowper, Shawn E.; Little, Alicia J.

doi:10.1016/j.jdcr.2020.01.009

Cited by 6 publications

(5 citation statements)

References 8 publications

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“…Hypocomplementemia was found in 56% of patients and antineutrophilic cytoplasmic antibody (ANCA) in 28% of patients 5. In a report by Wang et al , IgA vasculitis was seen in a patient with a bioprosthetic pulmonary valve and subacute C. hominis endocarditis 6 . C. hominis is a pleomorphic, facultatively anaerobic, gram negative bacilli 7.…”

Section: Discussionmentioning

confidence: 99%

Polymicrobial native valve endocarditis due toBacillus cereusandCardiobacterium hominis

et al. 2021

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We present a case of polymicrobial subacute bacterial endocarditis and bacteremia with Bacillus cereus and Cardiobacterium hominis in a 72-year-old man with pre-existing mitral valve disease and prior mitral valve repair who presented with renal failure and glomerulonephritis. Bacillus is often a contaminant in blood cultures but has been rarely implicated in patients with invasive infections such as endocarditis. Intravenous drug use, prosthetic heart valves, valvular heart disease and venous catheters are the most frequently described risk factors for Bacillus bacteremia and endocarditis in the medical literature. Management is challenging as Bacillus is resistant to penicillin and cephalosporin antibiotics due to production of beta-lactamase. Polymicrobial endocarditis is uncommon and when it occurs typically involves Staphylococcal species. To our knowledge, this is the first reported case of polymicrobial endocarditis in which both Bacillus and a HACEK organism are implicated.

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Section: Discussionmentioning

confidence: 99%

Polymicrobial native valve endocarditis due toBacillus cereusandCardiobacterium hominis

et al. 2021

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“…Although mucosal infection is the major cause of IgA vasculitis, several cases of IgA vasculitis with infective endocarditis have been reported. More than half of the patients reported as IgA-vasculitis-related infective endocarditis had risk factors for infective endocarditis such as intravenous drug use, history of infective endocarditis, congenital heart disease and hepatitis C infection [ 10 , 17 – 20 ]. Hemodialysis is also a risk factor for infective endocarditis because of recurrent venipuncture.…”

Section: Discussion and Limitationsmentioning

confidence: 99%

A case of vasculitis triggered by infective endocarditis in a patient undergoing maintenance hemodialysis: a case report

Park¹,

Lee

Jeong

2022

BMC Nephrol

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Background Immunoglobulin A vasculitis (IgA vasculitis) is one of the most common forms of vasculitis in children. It rarely occurs in adults. It is a systemic vasculitis with IgA deposition and is characterized by the classical tetrad of purpura, arthritis/arthralgia, gastrointestinal and renal involvement. Certain types of infections, and pharmacological agents have been reported to be associated with IgA vasculitis. Here, we describe a case of IgA vasculitis triggered by infective endocarditis in a patient undergoing maintenance hemodialysis. Case presentation A 70-year-old man undergoing hemodialysis was admitted because of skin purpura, abdominal pain, diarrhea, and lower back pain. We suspected him as IgA vasculitis based on the clinical features and skin biopsy findings. Transesophageal echocardiography revealed infective endocarditis, which predisposed him to IgA vasculitis. He was treated with antibiotics and low-dose corticosteroids, which led to resolution of vasculitis. Conclusions This is the first case of IgA vasculitis triggered by infective endocarditis in a patient undergoing hemodialysis. Patients undergoing hemodialysis are at a high risk of infection because of immune dysfunction and frequent venipuncture. The incidence of infective endocarditis associated with IgA vasculitis is very low, but it has been repeatedly reported. Therefore, it is necessary to consider infective endocarditis in patients with clinical features that indicate IgA vasculitis.

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“…These complexes activate the complement pathway, which further leads to neutrophilic activation resulting in vasculitis [ 3 ]. The most common triggers include mucosal infections; however, IE as a trigger for IgA vasculitis is very rare, with less than 10 cases reported in the literature [ 4 ]. In our patient, the vasculitis resolved after the treatment of endocarditis, which further supports the association.…”

Section: Discussionmentioning

confidence: 99%

Infective Endocarditis: A Rare Trigger of Immunoglobulin A Vasculitis in an Adult

Gadela

Drekolias

Rizkallah

et al. 2020

Cureus

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Immunoglobulin A vasculitis (IgA vasculitis) is a small-vessel vasculitis usually triggered by bacterial or viral infections, antibiotics, and vaccinations. Although it is a disease of the pediatric population, it can occur in adults as well. We present a case of IgA vasculitis that was triggered by underlying infective endocarditis (IE). IE is a rare and fatal cause of the vasculitis that requires timely diagnosis and management to prevent catastrophic outcomes. Our patient was treated with antibiotics for IE, which led to the resolution of vasculitis.

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Endocarditis-associated IgA vasculitis: Two subtle presentations of endocarditis caused by Candida parapsilosis and Cardiobacterium hominis

Cited by 6 publications

References 8 publications

Polymicrobial native valve endocarditis due toBacillus cereusandCardiobacterium hominis

Polymicrobial native valve endocarditis due toBacillus cereusandCardiobacterium hominis

A case of vasculitis triggered by infective endocarditis in a patient undergoing maintenance hemodialysis: a case report

Infective Endocarditis: A Rare Trigger of Immunoglobulin A Vasculitis in an Adult

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