title: Outcome and treatment of Bartonella endocarditis.
abstract: BACKGROUND
  Endocarditis caused by Bartonella species is a potentially lethal infection characterized by a subacute evolution and severe valvular lesions.
  
  
  OBJECTIVE
  To evaluate the outcome of patients with Bartonella endocarditis and to define the best antibiotic regimen using the following measures: recovery, relapse, or death.
  
  
  METHODS
  We performed a retrospective study on 101 patients who were diagnosed in our laboratory as having Bartonella endocarditis between January 1, 1995, and April 30, 2001. Bartonella infection was diagnosed using immunofluorescence with a 1:800 cutoff, polymerase chain reaction amplification of DNA, and/or culture findings of Bartonella species from whole blood, serum, and/or valvular biopsy specimens. A standardized questionnaire was completed by investigators for each patient.
  
  
  RESULTS
  Twelve of the 101 patients died and 2 relapsed. Patients receiving an aminoglycoside were more likely to fully recover (P =.02), and those treated with aminoglycosides for at least 14 days were more likely to survive than those with shorter therapy duration (P =.02).
  
  
  CONCLUSIONS
  Effective antibiotic therapy for Bartonella endocarditis should include an aminoglycoside prescribed for a minimum of 2 weeks.
authors.affiliation: Unité des Rickettsies, Faculté de Médecine, Université de la Méditerranée, 27 Boulevard Jean Moulin, 13385 Marseille CEDEX 05, France. didier.raoult@medecine.univ-mrs.fr
authors.forename: Didier
authors.initials: D
authors.lastname: Raoult
authors.forename: Pierre-Edouard
authors.initials: PE
authors.lastname: Fournier
authors.forename: François
authors.initials: F
authors.lastname: Vandenesch
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Mainardi
authors.forename: Susannah J
authors.initials: SJ
authors.lastname: Eykyn
authors.forename: James
authors.initials: J
authors.lastname: Nash
authors.forename: Edward
authors.initials: E
authors.lastname: James
authors.forename: Catherine
authors.initials: C
authors.lastname: Benoit-Lemercier
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Marrie
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000617:Aminoglycosides; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001474:Bartonella Infections / Q000188:drug therapy*; D004697:Endocarditis, Bacterial / Q000188:drug therapy*; D006349:Heart Valve Diseases / Q000382:microbiology; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents