Bartonella endocarditis mimicking adult Still's disease.
We describe the case of a 39-year-old Caucasian woman who was admitted to the University Hospital of Antwerp with a clinical picture suggestive of adult Still's disease. Even though a transoesophageal echocardiography showed endocarditis of the aortic valve, blood cultures remained negative. Additional serological testing revealed a positive result for Bartonella henselae. Histology of the supraclavicular lymph node showed a reactive lymph node with a positive polymerase chain reaction (PCR) for Bartonella henselae. Prednisolone treatment was started in a dosage of 10 mg per day and rifampicin 600 mg/d in combination with doxycyclin 200 mg/d was given for 6 months. During therapy the patient gradually improved and signs of endocarditis disappeared on echocardiography.
De Clerck
K F
KF
Department of Immunology-Allergology-Rheumatology, University of Antwerp, Belgium.
Van Offel
J F
JF
Vlieghe
E
E
Van Marck
E
E
Stevens
W J
WJ
D000328:Adult; D001474:Bartonella Infections / Q000175:diagnosis / Q000382:microbiology*; D018416:Bartonella henselae / Q000235:genetics / Q000302:isolation & purification*; D001706:Biopsy; D004269:DNA, Bacterial / Q000032:analysis; D003937:Diagnosis, Differential; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000382:microbiology*; D005260:Female; D006801:Humans; D016133:Polymerase Chain Reaction; D016706:Still's Disease, Adult-Onset / Q000175:diagnosis*
D004269:DNA, Bacterial