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Navigating diagnostic challenges in Bartonella-induced infective endocarditis: a case report.
Meriem Ghozzia1,2, Fares Azaiez3,4, Marwa Trabelsi3,4
1Department of Cardiology, Mongi Slim University Hospital Center, La Marsa, Tunis, Tunisia. meriem.ghozzia@etudiant-fmt.utm.tn.
Journal of Medical Case Reports
|February 27, 2025
Summary
Diagnosing Bartonella henselae infective endocarditis requires high suspicion, especially in blood culture-negative cases. Early targeted therapy with rifampin and doxycycline improved patient outcomes.
Area of Science:
- Infectious Diseases
- Cardiology
- Hepatology
Background:
- Blood culture-negative infective endocarditis (BCNIE) poses diagnostic challenges due to atypical presentations.
- Bartonella henselae is a rare but significant pathogen in BCNIE, complicating diagnosis and treatment.
Purpose of the Study:
- To report a case of Bartonella henselae-induced infective endocarditis in a 65-year-old female.
- To highlight the diagnostic and therapeutic complexities associated with this rare condition.
Main Methods:
- Case report detailing a patient with BCNIE presenting with fever, weight loss, and hepatic involvement.
- Diagnosis was guided by serological tests for Bartonella henselae and confirmed by aortic valve cultures.
- Treatment involved empirical antibiotics, followed by targeted rifampin and doxycycline therapy.
Main Results:
- The patient initially responded to empirical antibiotics but relapsed.
- Serological testing confirmed Bartonella henselae infection, leading to targeted therapy and clinical improvement.
- Subsequent discovery of severe coronary disease required surgical intervention (aortic valve replacement and CABG).
Conclusions:
- Heightened clinical awareness and comprehensive diagnostic imaging are crucial for atypical infective endocarditis.
- Early suspicion and identification of Bartonella henselae are vital in BCNIE cases, especially with relevant exposure history.
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