Culture-negative infectious endocarditis caused by Bartonella spp.: 2 case reports and a review of the literature

Molecular methods for pathogen and microbial community detection and characterization: Current and potential application in diagnostic microbiology

“…Although heart valve culture remains part of the Duke classification scheme for the diagnosis of infectious endocarditis, its poor sensitivity (7.8-25.4%) and specificity (71.6-88.6%) has led several investigators to recommend that culture testing be replaced by broad-range PCR as a major diagnostic criterion because of its much higher sensitivity (range = 41.2-96%) and specificity (95-100%). Several studies have documented the reliability of broadrange PCR for the detection of bacteria in excised heart valves and this assay is being increasingly used in conjunction with blood cultures to determine the microbial aetiology in both blood culture-positive and -negative endocarditis cases Moore et al, 2001;Bosshard et al, 2003b;Lepidi et al, 2003Lepidi et al, , 2004Breitkopf et al, 2005;Greub et al, 2005;Houpikian and Raoult, 2005;Raoult et al, 2005;Rice and Madico, 2005;Rovery et al, 2005;Marin et al, 2007;Dreier et al, 2008;Munoz et al, 2008;Voldstedlund et al, 2008;Tang, 2009;Fournier et al, 2010;Caram et al, 2008). Broad-range 16S rDNA gene PCR on heart valve tissue allows diagnosis of unusual causative agents of culture-negative endocarditis including Cardiobacterium hominis (Mueller et al, 1999), Bartonella quintana (Houpikian and Raoult, 2005;Dreier et al, 2008), Tropheryma whipplei ( Interpretation of all broad-range PCR results should be correlated with the clinical picture due to the potential for DNA contamination from other sources.…”

First Case ofBartonella quintanaEndocarditis in Korea

“…have also been reported from other countries. An overview of published detailed cases of Bartonella endocarditis in Europe from 2000 to 2007 was presented, and the cases were reported from France, UK, Germany, Spain and the Netherlands (6). In addition, there have been reports of Bartonella endocarditis from Asian countries including India, Thailand and Japan as well as Australia (7).…”

“…Among various Bartonella species, B. quintana and B. henselae are the predominant human pathogens causing infective endocarditis (6, 12). Patients with B. henselae endocarditis frequently have a previous valvulopathy, and disease is associated with cat bites or scratches and cat flea exposure (13).…”

“…identification. Previous study on a review of published cases of Bartonella endocarditis in Europe reported that pathogen identification was carried out by molecular methods and/or serologic testing in 16 out of 18 cases (6). In only two cases, Bartonella pathogens could be identified by culture methods.…”

Editorial: Bartonella species: Important cause of culture-negative endocarditis

“…Bartonella species, small Gram-negative rods, have emerged as an important cause of blood culture-negative endocarditis (BCNIE) mainly by the progress in serological and molecular techniques for the diagnosis of infection [1][2][3][4][5][6]. Since the initial reports of Bartonella endocarditis in 1993 [7][8][9], seven types of Bartonella species (spp.)…”