title: High prevalence of Bartonella quintana endocarditis in Sfax, Tunisia.
abstract: Bartonella quintana is a fastidious microorganism associated with blood culture negative endocarditis. In this study, 40 sera with cross-reactivity between Chlamydia species from patients from Sfax, Tunisia, were serologically tested for Bartonella. Thirteen sera were positive for Bartonella with IgG titers >/=1:800. Western blot and cross-absorption confirmed the diagnosis of Bartonella quintana endocarditis in 12 cases and Bartonella henselae endocarditis in 1 case. These sera were also positive by LightCycler nested PCR amplification for the rnpb (7 of 13) and fur (11 of 13) genes. Eleven patients had a definite diagnosis of endocarditis, which represents 9.8% of all endocarditis. Because Bartonella endocarditis seems to be very common in Tunisia, we suggest that its serology be performed systematically whenever endocarditis is suspected.
authors.affiliation: Unité des Rickettsies, CNRS UMR 6020, Université de la Méditerranée, Faculté de Médecine, Marseille, France.
authors.forename: Abir
authors.initials: A
authors.lastname: Znazen
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Rolain
authors.forename: Nader
authors.initials: N
authors.lastname: Hammami
authors.forename: Samir
authors.initials: S
authors.lastname: Kammoun
authors.forename: Adnane
authors.initials: A
authors.lastname: Hammami
authors.forename: Didier
authors.initials: D
authors.lastname: Raoult
mesh_terms: D000328:Adult; D004697:Endocarditis, Bacterial / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D014205:Trench Fever / Q000175:diagnosis* / Q000453:epidemiology; D014416:Tunisia / Q000453:epidemiology