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From trench fever to endocarditis
1Aintree Cardiac Centre, University Hospital Aintree, Liverpool, UK. Paul1Mann@aol.com
Postgraduate Medical Journal
|December 5, 2003
Abstract:
The case of a 44 year old woman with infective endocarditis due to Bartonella quintana, an organism long recognised to cause a condition known as trench fever, is reported. This case illustrates the lengthy differential diagnosis of "culture negative" endocarditis. In addition the presence of serological cross reactivity of Bartonella spp and Chlamydia spp demonstrates the potential for misdiagnosis in these circumstances.
Insights
A Bartonella quintana infection caused infective endocarditis in a woman, highlighting challenges in diagnosing culture-negative cases. Serological cross-reactivity with Chlamydia spp. can lead to misdiagnosis.
Area of Science:
- Infectious Diseases
- Cardiology
- Microbiology
Background:
- Infective endocarditis is a serious infection of the heart lining or valves.
- Culture-negative endocarditis presents diagnostic challenges, requiring consideration of atypical pathogens.
- Bartonella quintana is known to cause trench fever, historically associated with WWI soldiers.
Observation:
- A case report details a 44-year-old woman diagnosed with infective endocarditis.
- The causative agent identified was Bartonella quintana.
- The patient's presentation was characterized as culture-negative endocarditis.
Findings:
- Bartonella quintana, the cause of trench fever, was identified as the pathogen in infective endocarditis.
- This case underscores the complexity of diagnosing culture-negative endocarditis.
- Serological cross-reactivity between Bartonella species and Chlamydia species was observed.
Implications:
- The findings highlight the importance of considering Bartonella species in the differential diagnosis of culture-negative endocarditis.
- Awareness of serological cross-reactivity is crucial to prevent misdiagnosis, particularly differentiating between Bartonella and Chlamydia infections.
- This case contributes to understanding the clinical spectrum of Bartonella quintana infections.
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