Culture-negative infectious endocarditis caused by Bartonella spp.: 2 case reports and a review of the literature.
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.
Dreier
Jens
J
Institut für Laboratoriums und Transfusionsmedizin, Herz und Diabeteszentrum Nordrhein-Westfalen, 32545 Bad Oeynhausen, Germany. jdreier@hdz-nrw.de
Vollmer
Tanja
T
Freytag
Claudia Christine
CC
Bäumer
Dietrich
D
Körfer
Reiner
R
Kleesiek
Knut
K
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
D001426:Bacterial Proteins; D004269:DNA, Bacterial; D004275:DNA, Ribosomal; D021903:DNA, Ribosomal Spacer