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Bartonella Endocarditis in Spain: Case Reports of 21 Cases



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García Álvarez, Lara and García García, Concepción and Muñoz García, Patricia and Fariñas Álvarez, María del Carmen and Cuadra, Manuel Gutiérrez and Fernández Hidalgo, Nuria and García Vázquez, Elisa and Moral Escudero, Encarnación and Alonso Socas, María del Mar and García Rosado, Dácil and Hidalgo Tenorio, Carmen and Domínguez, Fernando and Goikoetxea Agirre, Josune and Gainzarain, Juan Carlos and Rodríguez Esteban, María Ángeles and Bosch Guerra, Xerach and Oteo, José A. (2022) Bartonella Endocarditis in Spain: Case Reports of 21 Cases. Pathogens, 11 (5). p. 561. ISSN 2076-0817

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Official URL: https://doi.org/10.3390/pathogens11050561


Blood culture negative endocarditis (BCNE) is frequent in infective endocarditis (IE). One of the causes of BCNE is fastidious microorganisms, such as Bartonella spp. The aim of this study was to describe the epidemiologic, clinical characteristics, management and outcomes of patients with Bartonella IE from the “Spanish Collaboration on Endocarditis-Grupo de Apoyo al Manejo de la Endocarditis infecciosa en España (GAMES)”cohort. Here we presented 21 cases of Bartonella IE. This represents 0.3% of a total of 5590 cases and 2% of the BCNE from the GAMES cohort. 62% were due to Bartonella henselae and 38% to Bartonella quintana. Cardiac failure was the main presenting form (61.5% in B. hensalae, 87.5% in B. quintana IE) and the aortic valve was affected in 85% of the cases (76% in B. henselae, 100% in B. quintana IE). Typical signs such as fever were recorded in less than 40% of patients. Echocardiography showed vegetations in 92% and 100% of the patients with B. henselae and B. quintana, respectively. Culture was positive only in one patient and the remaining were diagnosed by serology and PCR. PCR was the most useful tool allowing for diagnosis in 16 patients (100% of the studied valves). Serology, at titers recommended by guidelines, only coincided with PCR in 52.4%. Antimicrobial therapy, in different combinations, was used in all cases. Surgery was performed in 76% of the patients. No in-hospital mortality was observed. One-year mortality was 9.4%. This article remarks the importance for investigating the presence of Bartonella infection as causative agent in all BCNE since the diagnosis needs specific microbiological tools and patients could benefit of a specific treatment.

Item Type:Article
Uncontrolled Keywords:infective endocarditis; blood culture negative endocarditis; Bartonella endocarditis; Bartonella spp.
Subjects:Medical sciences > Medicine > Cardiology
Medical sciences > Medicine > Communicable diseases
Medical sciences > Medicine > Immunology
ID Code:75126
Deposited On:14 Oct 2022 11:57
Last Modified:17 Oct 2022 07:02

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