Endocarditis caused by Rochalimaea quintana in a patient infected with human immunodeficiency virus

Abstract

Rochalimaea quintana and Rochalimaea henselae are closely related, fastidious, gram-negative rickettsiae. Thus far, the spectrum of human Rochalimaea sp. infections has not included endocarditis. We describe a 50-year-old human immunodeficiency virus-positive man who developed endocarditis caused by R. quintana. DNA relatedness studies, which compared our patient's blood culture isolate with known Rochalimaea species, identified the organism as R. quintana. Our report expands the spectrum of Rochalimaea sp. infections and identifies a new infectious cause of endocarditis.

Infective endocarditis not related to intravenous drug abuse in HIV-1-infected patients: report of eight cases and review of the literature

“…Fourteen cases of IE not related to IVDA in HIV-1-infected patients were found in the extensive literature review, using the criteria mentioned above [12][13][14][15][16][17][18][19][20][21][22][23][24]. In only four cases was it possible to find in the report all the parameters recorded in the present series.…”

Cat Scratch Disease: The Story Continues

“…B henselae, B quintana and, in one instance, B elizabethae have been isolated from the blood of patients with endocarditis who presented with symptoms including fever, weight loss and malaise (65)(66)(67)(68)(69)(70)(71). The majority had extensive disease involving the aortic valve that appeared to develop over a subacute clinical course (65)(66)(67)(68)(69)(70)(71). In apparent culture negative endocarditis, the use of the lysis-centrifugation culture method, and blind subculture to chocolate agar at days 7 to 14, should be considered to increase the yield of Bartonella species (68).…”

“…Staining blood culture bottle contents with acridine orange and cocultivation of blood samples with endothelial cells have also been used to isolate the organism (64,71). Additional diagnostic strategies include bartonella serology and analysis of valve tissue with culture, pathology and PCR where available (65)(66)(67)(68)(69)(70)(71). Antimicrobial therapy varied considerably among cases, and with most patients undergoing valvular surgery, no conclusive recommendations can be made.…”

Detection of Bartonella (Rochalimaea) quintana by routine acridine orange staining of broth blood cultures

“…from clinical specimens has become increasingly important. Bartonella quintana, long known as the agent of trench fever, a febrile syndrome rarely recognized in nonepidemic situations, recently has been reported as a likely cause of bacillary angiomatosis (6) and endocarditis (18). The newly described Bartonella elizabethae also has been isolated from a patient with endocarditis (2).…”

“…Bartonella spp. have been isolated from blood specimens by several different methods, including the Septi-Chek biphasic system (8), subculture of BACTEC 460 bottles (2,8), the BACTEC NR-660 infrared CO2 detection system (18), direct plating of whole blood onto agar (12,19), and the Isolator lysis-centrifugation system (6,8,17). The speed and frequency of isolation of Bartonella spp.…”