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A cat's scratch or a wolf's bite?
Haim Shmuely1,2, Gil Chernin2,3, Michael Giladi4
1Department of Internal Medicine D, Kaplan Medical Centre, Rehovot, Israel.
Lupus
|September 9, 2020
Summary
Bartonella henselae endocarditis can mimic systemic vasculitis. A patient with prosthetic valve endocarditis and positive anti-dsDNA antibodies was misdiagnosed with systemic lupus erythematosus (SLE).
Area of Science:
- Infectious Diseases
- Cardiology
- Rheumatology
Background:
- Bartonella henselae endocarditis is a rare condition.
- It can mimic systemic vasculitis, particularly in patients with valvulopathy.
- Diagnosis can be challenging due to overlapping clinical features.
Observation:
- A case of Bartonella henselae endocarditis involving a prosthetic pulmonic valve is presented.
- The patient exhibited positive anti-dsDNA antibodies.
- Initial diagnosis was systemic lupus erythematosus (SLE) based on revised classification criteria.
Findings:
- Bartonella henselae infection can induce autoantibodies, including anti-dsDNA.
- This can lead to misdiagnosis of autoimmune diseases like SLE.
- Prosthetic valve endocarditis requires specific diagnostic considerations.
Implications:
- Clinicians should consider Bartonella henselae infection in patients with prosthetic valves and autoimmune markers.
- Accurate diagnosis is crucial to avoid inappropriate immunosuppressive therapy for SLE.
- This case highlights the importance of a broad differential diagnosis in infectious endocarditis.
