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Bartonella quintana as a cause for prosthetic valve endocarditis and post-sternotomy mediastinitis

Nienke L Plantinga1, Roemer J Vos2, Lyuba Georgieva3

  • 1Department of Medical Microbiology, University Medical Centre Utrecht, Utrecht, The Netherlands.

Access Microbiology
|June 21, 2021
PubMed

Insights

Bartonella quintana caused severe prosthetic valve endocarditis and mediastinitis in a healthy patient. This pathogen may be overlooked in routine diagnostics, even in individuals not typically at risk for severe infections.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Microbiology

Background:

  • Prosthetic valve endocarditis (PVE) is a serious complication requiring prompt diagnosis and treatment.
  • Bartonella species are increasingly recognized as causes of human infections, including endocarditis.
  • Standard diagnostic work-ups for endocarditis may not always include specific testing for Bartonella.

Observation:

  • A previously healthy patient presented with minimal signs of infection.
  • Diagnosis of Bartonella quintana prosthetic valve endocarditis was confirmed using 16S PCR.
  • The patient later developed post-sternotomy mediastinitis, with Bartonella quintana identified as the sole pathogen.

Findings:

  • Bartonella quintana can lead to severe PVE and mediastinitis.
  • Infection occurred in an individual without typical risk factors.
  • The pathogen was detected via 16S PCR, highlighting its utility.

Implications:

  • Bartonella quintana should be considered in the differential diagnosis of endocarditis, even in seemingly low-risk patients.
  • Current diagnostic protocols may need to be expanded to include Bartonella screening.
  • Early detection and targeted therapy are crucial for managing Bartonella infections to prevent severe complications.
Keywords:
16S PCR sequencingBartonella quintanaBlood culture negative endocarditismediastinitis

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