title: Culture-negative endocarditis due to Houston Complex Bartonella henselae acquired in Noumea, New Caledonia.
abstract: A 44-year-old man with a bioprosthetic aortic valve suffered destructive endocarditis with severe embolic disease due to Bartonella henselae infection. Multilocus sequence typing was successfully performed with crude preparations of operative tissue as templates, and the infecting organism was determined to be typical of the Houston clonal group, although it was never cultured from blood or tissue. This is the first report of B. henselae infection in the South Pacific, and it reminds one that B. henselae is a cause of potentially lethal culture-negative endocarditis which may respond poorly to conventional empirical therapy. Nothing is known of the epidemiology of the infection in this region, but it is likely to be common and to contain representatives of both major clonal complexes. This study emphasizes the ease with which multilocus sequence typing can be used directly with tissue, which is important because of suggestions of strain-dependent clinical outcomes.
authors.affiliation: Westmead Private Hospital, Sydney, New South Wales, Australia.
authors.forename: Dani
authors.initials: D
authors.lastname: Rodrick
authors.forename: Belinda
authors.initials: B
authors.lastname: Dillon
authors.forename: Mark
authors.initials: M
authors.lastname: Dexter
authors.forename: Ian
authors.initials: I
authors.lastname: Nicholson
authors.forename: Sebastien
authors.initials: S
authors.lastname: Marcel
authors.forename: David
authors.initials: D
authors.lastname: Dickeson
authors.forename: Jon
authors.initials: J
authors.lastname: Iredell
mesh_terms: D016917:Angiomatosis, Bacillary / Q000382:microbiology; D001426:Bacterial Proteins / Q000235:genetics; D018416:Bartonella henselae / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D001769:Blood / Q000382:microbiology; D003470:Culture Media; D004275:DNA, Ribosomal / Q000032:analysis; D004697:Endocarditis, Bacterial / Q000175:diagnosis* / Q000382:microbiology*; D006801:Humans; D008297:Male; D009510:New Caledonia; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D017422:Sequence Analysis, DNA
chemical_list: D001426:Bacterial Proteins; D003470:Culture Media; D004275:DNA, Ribosomal; D012336:RNA, Ribosomal, 16S