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Bartonella endocarditis in complex congenital heart disease
Risa M Hoffman1, Jamil AboulHosn, John S Child
1Division of Infectious Diseases, Department of Internal Medicine, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA. rhoffman@mednet.ucla.edu
Congenital Heart Disease
|April 2, 2008
Summary
Bartonella henselae can cause culture-negative endocarditis, especially in patients with complex congenital heart disease and prosthetic valves. Early diagnosis using antibody and PCR testing is crucial for successful treatment.
Area of Science:
- Infectious Diseases
- Cardiology
- Hematology
Background:
- Bartonella species are a significant cause of culture-negative endocarditis.
- Risk factors include alcoholism, homelessness, cat exposure, and pre-existing valvular disease.
Observation:
- A 36-year-old woman with complex congenital heart disease presented with hemolytic anemia, vasculitis, and fevers.
- Echocardiography showed vegetations on native and prosthetic valves.
Findings:
- Bartonella henselae endocarditis was diagnosed via serum antibody and PCR testing.
- Successful treatment involved surgery and prolonged antibiotics (ceftriaxone, gentamicin, doxycycline).
Implications:
- Prosthetic valves and complex congenital heart disease are identified as risk factors.
- A high index of suspicion and prompt diagnostic testing (antibody, PCR) can improve outcomes for Bartonella endocarditis.
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