Infective endocarditis due to Bartonella bacilliformis associated with systemic vasculitis: a case report

Area of Science:

• Infectious Diseases
• Cardiology
• Rheumatology

Background:

• Infective endocarditis (IE) is a serious infection of the heart's inner lining.
• Bartonella bacilliformis is an emerging cause of IE, particularly in the Andean region.
• This case explores a rare presentation of IE and its subsequent complications.

Observation:

• A 64-year-old woman presented with prolonged fever, myalgias, and arthralgias.
• Physical examination revealed a tricuspid systolic murmur.
• Echocardiography demonstrated endocardial lesions in the right atrium.

Findings:

• Blood cultures identified Bartonella bacilliformis, confirming the diagnosis of IE by Duke's criteria.
• The patient subsequently developed clinical and laboratory findings consistent with antineutrophil cytoplasmic antibody-associated vasculitis.
• This suggests a potential link between Bartonella bacilliformis infection and systemic vasculitis.

Implications:

• This case expands the known spectrum of complications associated with Bartonella bacilliformis infection.
• It underscores the importance of considering Bartonella in the differential diagnosis of IE, especially in endemic areas.
• The association with vasculitis warrants further investigation into the immunopathogenesis of Bartonella-related diseases.