Fatal myocarditis-associated Bartonella quintana endocarditis: a case report.
BACKGROUND
Bartonella spp. infection is not rare and must be considered with great care in patients with suspected infective endocarditis, particularly if regular blood cultures remain sterile. Management of these infections requires knowledge of the identification and treatment of these bacteria.


METHODS
A 50-year-old Senegalese man was admitted to our Department of Cardiac Surgery with a culture-negative endocarditis. Despite valvular surgery and adequate antibiotic treatment, recurrence of the endocarditis was observed on the prosthetic mitral valve. Heart failure required circulatory support. Weaning off the circulatory support could not be attempted owing to the absence of heart recovery. Bacteriological diagnosis of Bartonella quintana endocarditis was performed by molecular methods retrospectively after the death of the patient.


CONCLUSIONS
This case report underlines the severity and difficulty of the diagnosis of Bartonella quintana endocarditis. The clinical picture suggested possible Bartonella quintana associated myocarditis, a feature that should be considered in new cases.
Montcriol
Ambroise
A
Benard
Fréderic
F
Fenollar
Florence
F
Ribeiri
Alberto
A
Bonnet
Marc
M
Collart
Fréderic
F
Guidon
Catherine
C