title: [Endocarditis due to Bartonella spp. Three new clinical cases and Spanish literature review].
abstract: BACKGROUND
  Infections by Bartonella spp. include a wide spectrum of emerging and re-emerging infectious diseases, such as culture-negative endocarditis.
  
  
  METHODS
  Description of 3 cases of endocarditis due to Bartonella spp. and review of those previously reported in Spain.
  
  
  RESULTS
  Including these 3 new cases of endocarditis due to Bartonella spp., a total of 6 cases have been reported in Spain. The median age of the patients was 51.6 years and 83.3% were men. There was history of contact with cats in 66.7%, and 50% were alcoholic. Only one patient had prior valvular disease. There were no clinical manifestations typical to any of the Bartonella species. The aortic valve was the one most commonly affected. In all cases, B. henselae was the agent implicated. The diagnosis was made by serology in 5 cases (83.3%). The outcome was favorable in all patients, although 4 of them (66.7%) required valve replacement.
  
  
  CONCLUSIONS
  Endocarditis due to Bartonella spp. is present in Spain and is likely to be underestimated. We should suspect this pathogen in patients with negative blood cultures and a history of chronic alcoholism, homeless patients, and those who have had contact with cats or who have been bitten by fleas or lice, as well as patients with endocarditis and positive serology against Chlamydia spp.
authors.affiliation: Area de Enfermedades Infecciosas, Complejo Hospitalario San Millán-San Pedro de La Rioja, Hospital de La Rioja, Logroño, España. jaoteo@riojasalud.es
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Oteo
authors.forename: Alberto
authors.initials: A
authors.lastname: Castilla
authors.forename: Angel
authors.initials: A
authors.lastname: Arosey
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Blanco
authors.forename: Valvanera
authors.initials: V
authors.lastname: Ibarra
authors.forename: Luis Enrique
authors.initials: LE
authors.lastname: Morano
mesh_terms: D000189:Actinobacillus Infections / Q000150:complications; D000328:Adult; D000368:Aged; D016976:Aggregatibacter actinomycetemcomitans / Q000302:isolation & purification; D000437:Alcoholism / Q000150:complications; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood; D001021:Aortic Valve / Q000382:microbiology; D001474:Bartonella Infections / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000601:surgery; D018416:Bartonella henselae / Q000276:immunology / Q000302:isolation & purification*; D001769:Blood / Q000382:microbiology; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications; D002372:Cat-Scratch Disease / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D002415:Cats; D002443:Ceftriaxone / Q000627:therapeutic use; D002689:Chlamydia / Q000276:immunology; D002939:Ciprofloxacin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004198:Disease Susceptibility; D004318:Doxycycline / Q000627:therapeutic use; D004697:Endocarditis, Bacterial / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology* / Q000601:surgery; D004698:Endocarditis, Subacute Bacterial / Q000209:etiology / Q000382:microbiology; D005188:False Negative Reactions; D005260:Female; D005839:Gentamicins / Q000627:therapeutic use; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D013030:Spain / Q000453:epidemiology; D014640:Vancomycin / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D005839:Gentamicins; D002939:Ciprofloxacin; D014640:Vancomycin; D002443:Ceftriaxone; D004318:Doxycycline