Duke criteria-negative endocarditis caused by Bartonella quintana.
Bartonella spp. were recently recognized as causative agents of culture-negative endocarditis. Molecular techniques, such as broad-range PCR, are now available to detect fastidious or slow-growing microorganisms, or those which cannot be cultured. Such microorganisms may be responsible for culture-negative endocarditis. Alcoholism and homelessness are known risk factors for Bartonella quintana endocarditis, even in patients without previous valvular disease. We report a case of B. quintana endocarditis diagnosed by PCR amplification on the excised heart valve, in a young non-alcoholic and immunocompetent patient with few clinical signs of infection who did not fulfill the Duke criteria.
Simon-Vermont
I
I
Department of Internal Medicine, University Hospitals Basel, Switzerland.
Altwegg
M
M
Zimmerli
W
W
Flückiger
U
U
D000328:Adult; D001021:Aortic Valve; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D018413:Bartonella quintana / Q000302:isolation & purification*; D004452:Echocardiography; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006801:Humans; D016133:Polymerase Chain Reaction; D013902:Radiography, Thoracic; D016896:Treatment Outcome; D014205:Trench Fever / Q000175:diagnosis