[Stroke as a manifestation of acute Bartonella henselae endocarditis].
BACKGROUND
Bartonella, a small gram-negative bacillus, causes a variety of diseases and presents with different clinical manifestations, one of which is infective endocarditis (IE). IE due to B. henselae is associated with a high risk of morbidity and mortality due to the destructive potential of the organism to the heart valves and due to the great risk of embolic complications.


METHODS
A 37-year-old male was admitted to our hospital due to sub-febrile fever and weakness. Investigation revealed he had IE caused by B. henselae. His mitral valve was severely damaged and he experienced a cerebrovascular event, caused by septic emboli. The severe damage to the mitral valve and the presence of septic emboli necessitated valvular replacement surgery. The case involved a therapeutic dilemma, due to the patient's neurological complications.


CONCLUSIONS
Since B. henselae is an important pathogen associated with culture-negative IE, there should be a high index of suspicion for the presence of this pathogen in cases presenting with signs of infection associated with embolic events. This condition requires a careful diagnostic and therapeutic approach.
Schneer
Sonia
S
Internal Medicine D, Rabin Medical Center, Hasharon Hospital, Petah Tikva, Israel.
Marcoviciu
Dana
D
Beilin
Viktoria
V
Goffman
Marina
M
Dicker
Dror
D
D000208:Acute Disease; D000328:Adult; D016917:Angiomatosis, Bacillary / Q000150:complications / Q000175:diagnosis*; D018416:Bartonella henselae / Q000302:isolation & purification; D004697:Endocarditis, Bacterial / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008297:Male; D020521:Stroke / Q000209:etiology*