title: Culture-negative infectious endocarditis caused by Bartonella spp.: 2 case reports and a review of the literature.
abstract: Bartonella spp. are rare pathogens in humans and were recently recognized as important causative agents of culture-negative endocarditis. Here, we describe the 1st 2 documented cases of culture-negative endocarditis due to Bartonella henselae and Bartonella quintana encountered in a single hospital in Germany. Infection of the heart valve tissue was detected by broad-range polymerase chain reaction (PCR) and further confirmed by serologic testing. In particular, acute B. henselae infection with an impressive bacterial colonization of the infected cardiac valve was illustrated by transmission electron microscopy. B. henselae was further characterized by PCR assays targeting genotype-specific regions. Disease progression was initially monitored over the entire infection episode through inflammatory markers. In addition, a short overview of published detailed cases of Bartonella endocarditis in Europe within the last 7 years is given.
authors.affiliation: Institut für Laboratoriums und Transfusionsmedizin, Herz und Diabeteszentrum Nordrhein-Westfalen, 32545 Bad Oeynhausen, Germany. jdreier@hdz-nrw.de
authors.forename: Jens
authors.initials: J
authors.lastname: Dreier
authors.forename: Tanja
authors.initials: T
authors.lastname: Vollmer
authors.forename: Claudia Christine
authors.initials: CC
authors.lastname: Freytag
authors.forename: Dietrich
authors.initials: D
authors.lastname: Bäumer
authors.forename: Reiner
authors.initials: R
authors.lastname: Körfer
authors.forename: Knut
authors.initials: K
authors.lastname: Kleesiek
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001426:Bacterial Proteins / Q000737:chemistry / Q000235:genetics; D001474:Bartonella Infections / Q000382:microbiology*; D018416:Bartonella henselae / Q000235:genetics / Q000302:isolation & purification*; D018413:Bartonella quintana / Q000235:genetics / Q000302:isolation & purification*; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D004275:DNA, Ribosomal / Q000737:chemistry / Q000235:genetics; D021903:DNA, Ribosomal Spacer / Q000737:chemistry / Q000235:genetics; D004696:Endocarditis / Q000382:microbiology*; D005858:Germany; D006351:Heart Valves / Q000382:microbiology / Q000473:pathology; D006801:Humans; D008297:Male; D046529:Microscopy, Electron, Transmission; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction; D017422:Sequence Analysis, DNA
chemical_list: D001426:Bacterial Proteins; D004269:DNA, Bacterial; D004275:DNA, Ribosomal; D021903:DNA, Ribosomal Spacer