title: Fatal myocarditis-associated Bartonella quintana endocarditis: a case report.
abstract: 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.
authors.forename: Ambroise
authors.initials: A
authors.lastname: Montcriol
authors.forename: Fréderic
authors.initials: F
authors.lastname: Benard
authors.forename: Florence
authors.initials: F
authors.lastname: Fenollar
authors.forename: Alberto
authors.initials: A
authors.lastname: Ribeiri
authors.forename: Marc
authors.initials: M
authors.lastname: Bonnet
authors.forename: Fréderic
authors.initials: F
authors.lastname: Collart
authors.forename: Catherine
authors.initials: C
authors.lastname: Guidon