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Bartonella quintana, an Unrecognized Cause of Infective Endocarditis in Children in Ethiopia

Diana Tasher, Alona Raucher-Sternfeld, Akiva Tamir

    Emerging Infectious Diseases
    |July 22, 2017
    PubMed

    Insights

    Bartonella quintana endocarditis is rarely seen in children but is a significant cause of culture-negative endocarditis in Ethiopian children with heart defects. Diagnosis requires specific testing for this bacterial infection.

    Area of Science:

    • Infectious Diseases
    • Pediatrics
    • Cardiology

    Background:

    • Bartonella quintana endocarditis is a known cause of culture-negative endocarditis in adults.
    • This infection is rarely reported in pediatric populations.
    • Ethiopia presents a unique demographic for studying endemic infectious diseases.

    Observation:

    • Five pediatric patients (7-16 years) from Ethiopia with congenital heart defects and endocarditis were studied.
    • Four cases were confirmed as Bartonella quintana infections; one involved an undetermined Bartonella species.
    • Patients were often afebrile and oligosymptomatic, despite some experiencing heart failure.

    Findings:

    • Diagnosis was confirmed via echocardiography, elevated Bartonella IgG titers, and Bartonella quintana DNA detection in vegetations.
    • Elevated erythrocyte sedimentation rate was noted, while C-reactive protein levels were normal or slightly elevated.
    • Embolic events occurred in two patients, highlighting the systemic potential of the infection.

    Implications:

    • Bartonella quintana may be an underrecognized cause of native valve endocarditis in Ethiopian children with heart defects.
    • Clinicians should consider Bartonella quintana in culture-negative endocarditis cases, especially in individuals from or with travel history to East Africa.
    • Increased awareness and diagnostic pursuit are crucial for timely management of pediatric Bartonella endocarditis in endemic regions.

    Keywords:
    Bartonella quintanaBartonella spp.East AfricaEthiopiaGermanyIsraelbacteriachildrenculture-negative endocarditisheart defectsheart failureinfective endocarditisliceparasitesvector-borne infections

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