Bartonella infection: A significant cause of native valve endocarditis necessitating surgical management

Aortic Valve Endocarditis with Bartonella Quintana—a Rare Entity

“…Furthermore, Bartonella species are susceptible to a wide range of antibiotics in vitro [1,2]. Due to the significant valvular tissue destruction and secondary hemodynamic compromise, a surgical valve replacement is necessary in > 80% of all patients and recommended early [2,8]. Although there is no clear recommendation for the duration of the antibiotic therapy, it should be continued > 14 days, since Bartonella infections have a tendency to persist or recur [3].…”

Bartonella quintana Endocarditis of the Tricuspid and Mitral Valves

“…The presence of recurrent pulmonary events over a long period of time, renal failure andas in our casethe presence of multiple comorbidities, all of which are established risk factors and/or indicators, should lead to a suspicion of tricuspid valve endocarditis. [5][6][7][8] To the best of our knowledge, no case of a primarily rightsided Bartonella quintana endocarditis that spread to the mitral valve and potentially culminated in spondylodiscitis in a non-IVDA has been reported in the English-speaking literature.…”

“…Because negative cultures delay diagnosis and treatment and consequently clinical outcome, general serological screening of all culture-negative endocarditis should be complemented with PCR on biopsy material. 7,8 A poor clinical response to antibiotic therapy leading to extensive destruction of the heart valves and other comorbidities, might have been avoided if adequate diagnostics with the timely detection of the Bartonella antibody titer using specific serology had been applied earlier. Since Bartonella infections tend to persist for extended periods and/or to recur, doxycyclin plus gentamicin should be administered for at least 14 days followed by several weeks of doxycyclin monotherapy under regular monitoring of the patient's clinical response.…”

“…Due to the immense valvular tissue destruction that subsequently negatively impacts on hemodynamics, patients should be evaluated for early valve replacement surgery, as this improves general survival. 7,8 The early postoperative period is also critical. Especially in immunocompromised individuals, manifesting symptoms of endocarditis (or recurrent endocarditis) may be nonspecific, making underdiagnosis likely.…”

Culture-negative Bartonella endocarditis in a patient with renal failure: the value of molecular methods in diagnosis

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Today, the Bartonella genus is generally considered to consist of 16 species, which are emerging or re-emerging pathogens. 19 This genus is a member of the α 2 Proteobacteria 20 and is phylogenetically closely related to Brucella spp., Agrobacterium spp., Sinorrhizobium spp., Rhizobium spp.…”