Outcome and Treatment of Bartonella Endocarditis

Hôpital Européen Georges-Pompidou (Hôpitaux Universitaires Paris-Ouest), Lutetia Parisorum, Île-de-France, France
Archives of Internal Medicine (Impact Factor: 17.33). 02/2003; 163(2):226-30. DOI: 10.1001/archinte.163.2.226
Source: PubMed


Endocarditis caused by Bartonella species is a potentially lethal infection characterized by a subacute evolution and severe valvular lesions.
To evaluate the outcome of patients with Bartonella endocarditis and to define the best antibiotic regimen using the following measures: recovery, relapse, or death.
We performed a retrospective study on 101 patients who were diagnosed in our laboratory as having Bartonella endocarditis between January 1, 1995, and April 30, 2001. Bartonella infection was diagnosed using immunofluorescence with a 1:800 cutoff, polymerase chain reaction amplification of DNA, and/or culture findings of Bartonella species from whole blood, serum, and/or valvular biopsy specimens. A standardized questionnaire was completed by investigators for each patient.
Twelve of the 101 patients died and 2 relapsed. Patients receiving an aminoglycoside were more likely to fully recover (P =.02), and those treated with aminoglycosides for at least 14 days were more likely to survive than those with shorter therapy duration (P =.02).
Effective antibiotic therapy for Bartonella endocarditis should include an aminoglycoside prescribed for a minimum of 2 weeks.

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    • "Significant predisposing factors were homelessness and chronic alcoholism, less commonly immunocompromising comorbidities. The infection predominantly affected native valves of the left heart (Raoult et al. 2003). The incidence of B. quintana infections in the territory of former Czechoslovakia is unknown. "
    Folia Microbiologica 03/2013; 58(6). DOI:10.1007/s12223-013-0235-9 · 1.00 Impact Factor
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    • "Bartonella spp. are susceptible to most antimicrobial agents, including penicillins, cephalosporins, aminoglycosides, tetracyclines, macrolides, rifampicin, fluoroquinolones, and cotrimoxazole (17). However, only aminoglycosides have a bactericidal effect and it has been recommended to use aminoglycosides for minimum 2 weeks in combination with other class of antibiotics (12, 17, 18). "
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    ABSTRACT: Since microbial gene sequencing was utilized for etiologic diagnosis of culture-negative endocarditis, cases of Bartonella endocarditis have been reported in various countries. Herein we report the first case of Bartonella quintana endocarditis, which was confirmed for the first time in Korea by 16S rRNA gene sequencing from the excised valve. A 75-yr-old woman was hospitalized due to dyspnea. Echocardiography demonstrated large oscillating vegetation at the aortic valve. Blood culture was negative. She underwent valve replacement and sequencing of the 16S rRNA gene from excised valve identified Bartonella quintana. She was successfully treated with combined use of ceftriaxone and gentamicin.
    Journal of Korean medical science 11/2012; 27(11):1433-5. DOI:10.3346/jkms.2012.27.11.1433 · 1.27 Impact Factor
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    • "This patient died of cardiac failure. Despite adequate antibiotic treatment and valvular surgery, the mortality rate of B. quintana endocarditis remains about 12% [12]. "
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    ABSTRACT: 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. 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. 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.
    Journal of Medical Case Reports 07/2009; 3(1):7325. DOI:10.4076/1752-1947-3-7325
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