Persistent Left Superior Vena Cava in the Setting of Granulicatella adiacens Bactermia and Crescentic...

Area of Science:

• Cardiology
• Nephrology
• Infectious Diseases

Background:

• Persistent left superior vena cava (PLSVC) is a rare congenital vascular anomaly.
• PLSVC can lead to coronary artery dilatation, predisposing to bacterial growth.
• Infection-associated glomerulonephritis is a potential complication of bacteremia.

Purpose of the Study:

• To report a unique case of bacteremia and subsequent renal failure in a patient with PLSVC.
• To highlight the diagnostic challenges and management strategies for this rare clinical presentation.
• To emphasize the role of multimodal imaging in identifying vascular anomalies.

Main Methods:

• Case report detailing clinical presentation, diagnostic workup, and treatment.
• Multimodal imaging techniques including echocardiography and CT venography were utilized.
• Microbiological analysis identified Granulicatella adiacens as the causative agent.
• Renal biopsy confirmed IgA-dominant infection-associated glomerulonephritis.

Main Results:

• The patient presented with high-grade bacteremia and developed acute renal failure.
• Granulicatella adiacens bacteremia was identified as the etiology.
• IgA-dominant infection-associated glomerulonephritis was diagnosed.
• PLSVC was confirmed as the underlying vascular anomaly.

Conclusions:

• PLSVC can be an underlying factor in severe infections and renal complications.
• Early and accurate diagnosis of PLSVC using multimodal imaging is crucial.
• Management requires addressing both the bacteremia and the associated glomerulonephritis.
• This case underscores the importance of considering rare etiologies in complex clinical scenarios.