Aortic valve endocarditis caused by Bartonella henselae: a rare surgical entity

We report a case of aortic valve endocarditis caused by Bartonella henselae. The patient initially presented to a regional hospital with generalized symptoms including lethargy, malaise and decreased appetite. Transthoracic echocardiogram revealed a large vegetation on the aortic valve and he was treated empirically with broad spectrum intravenous antibiotics. Several blood cultures were obtained which all returned negative results and the white blood cell count was normal. He was transferred to our hospital, with persistence of his initial symptoms and additional low-grade fevers. In light of his negative culture results, serological testing for Bartonella and Chlamydia was performed, which gave a positive result for Bartonella henselae. In view of this result and following development of severe aortic valve insufficiency, he underwent an aortic valve replacement and made a good recovery.