# ANCA-Negative Pauci-Immune Glomerulonephritis Associated with Bartonella Endocarditis

## TL;DR

This paper describes a rare case of kidney inflammation linked to a hard-to-diagnose heart infection caused by Bartonella.

## Contribution

The novelty lies in reporting a case of ANCA-negative pauci-immune glomerulonephritis associated with Bartonella endocarditis.

## Key findings

- ANCA-negative pauci-immune glomerulonephritis can occur in Bartonella endocarditis.
- Kidney biopsy showed florid crescents in this case.
- Bartonella endocarditis can be challenging to diagnose due to culture-negative results.

## Abstract

Kidney complications can occur due to infective endocarditis, one of which is glomerulonephritis. Most often, an immune complex or complement-mediated glomerulonephritis is seen on kidney biopsy. In a minor subset of cases, pauci-immune glomerulonephritis may be present. Most often, such patients will demonstrate the presence of antineutrophil cytoplasmic antibodies (ANCA) on serologic testing. A growing number of cases of ANCA-associated glomerulonephritis due to Bartonella endocarditis have been reported. This type of endocarditis can present diagnostic difficulties given that these patients are often culture negative. Herein, we report a challenging case of ANCA-negative pauci-immune glomerulonephritis showing florid crescents on biopsy that was associated with Bartonella endocarditis.