Infections associated with Mixed cryoglobulinemia
After HCV, human immunodeficiency virus is the most common.
Other infectious agents are less frequently seen and the association is not as clearly established. In many of these cases, the underlying infection is associated with the transient appearance of type III cryoglobulins, but without associated disease.
Examples include hepatitis B, Epstein–Barr virus, cytomegalovirus, hepatitis A, Coxiella burnetii (Q fever), parvovirus B19, poststreptococcal nephritis, subacute bacterial endocarditis, tuberculosis, leprosy, brucellosis, coccidioidomycosis, parasitic infections, and others.
Pearl: a patient with fever, valvular heart disease, and negative cultures in the setting of MC must be evaluated for Q fever.