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Nephrol Dial Transplant (2002) 17: 663-665
© 2002 European Renal Association-European Dialysis and Transplant Association

Case Report

Glomerulonephritis caused by Actinobacillus actinomycetemcomitans mimicking c-ANCA-positive vasculitis

Jean-François Viallard1,, Stéphane Bonnet1, Lionnel Couzi1, Colette Deminière2, Véronique Miossec3, Patrick Mercié1, Michel Aparicio4 and Jean-Luc Pellegrin1

1 Clinique de Médecine Interne et Maladies Infectieuses, Hôpital Haut-Lévêque, avenue de Magellan, F-33604 Pessac Cedex, 2 Laboratoire d'Anatomopathologie, 3 Laboratoire d'Immunologie and 4 Service de Néphrologie, Hôpital Pellegrin, place Amélie Rabat-Léon, F-33076 Bordeaux Cedex, France

Keywords: Actinobacillus actinomycetemcomitans; c-ANCA, endocarditis; glomerulonephritis



   Introduction
 
Actinobacillus actinomycetemcomitans (Aa) is a fastidious Gram-negative coccobacillus that belongs to the HACEK group [1]. It grows slowly and optimally at 37°C as small colonies on blood or chocolate agar, and blood cultures need to be incubated in CO2 and maintained for 2–3 weeks. These characteristics of Aa may retard the diagnosis. Aa is well known as the causative agent of localized juvenile periodontal disease, but the most common severe infections caused by Aa are endocarditis and soft-tissue abscesses [1]. Less common are Aa brain abscesses, pneumonia, osteomyelitis and urinary tract infections. We describe a patient who developed Aa septicaemia mimicking c-ANCA (cytoplasm-labelling anti-neutrophil cytoplasm antibodies)-positive small-vessel vasculitis with kidney and nerve damage.



   Case
 
A 66-year-old man was hospitalized for fever (40°C), anorexia and 12-kg weight loss over 3 months. His past medical history was remarkable only for bradycardia-paroxysmal atrial fibrillation syndrome requiring a pacemaker and cholecystectomy . . . [Full Text of this Article]



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B. HENDERSON, M. WILSON, L. SHARP, and J. M. WARD
Actinobacillus actinomycetemcomitans
J. Med. Microbiol., December 1, 2002; 51(12): 1013 - 1020.
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