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

Heart Lung. 2003 Mar-Apr;32(2):140-3. doi: 10.1067/mhl.2003.2.


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.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents
  • Antibodies, Antineutrophil Cytoplasmic / immunology*
  • Combined Modality Therapy
  • Drug Therapy, Combination / administration & dosage
  • Endocarditis, Subacute Bacterial / immunology*
  • Endocarditis, Subacute Bacterial / microbiology*
  • Endocarditis, Subacute Bacterial / therapy
  • Follow-Up Studies
  • Heart Valve Prosthesis
  • Humans
  • Male
  • Middle Aged
  • Risk Assessment
  • Severity of Illness Index
  • Streptococcal Infections / diagnosis*
  • Streptococcal Infections / therapy
  • Treatment Outcome
  • Viridans Streptococci / isolation & purification*


  • Anti-Bacterial Agents
  • Antibodies, Antineutrophil Cytoplasmic