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Endocarditis Caused by Bartonella quintana: A Case Report
Madalena Santos1, Rita Figueiredo1, Pedro Vasconcelos2
1Internal Medicine, Centro Hospitalar Universitário Lisboa Norte, Hospital de Santa Maria, Lisbon, PRT.
Cureus
|February 28, 2025
Summary
A rare case of Bartonella quintana infective endocarditis (IE) involved three heart valves and presented as a stroke. Early diagnosis and treatment are crucial for this aggressive infection.
Area of Science:
- Infectious Diseases
- Cardiology
- Microbiology
Background:
- Infective endocarditis (IE) is a serious heart infection.
- Bartonella species, particularly Bartonella quintana, are increasingly recognized causes of IE, especially culture-negative cases.
- Managing Bartonella-induced IE requires understanding its unique pathophysiology and tailored treatments.
Observation:
- A unique case of Bartonella quintana IE affecting the mitral, tricuspid, and aortic valves simultaneously.
- The patient's initial presentation was a massive ischemic stroke, an atypical IE symptom.
- Systemic embolization, including splenic septic emboli, was also observed.
Findings:
- Multisite valvular vegetations indicate an aggressive Bartonella quintana infection.
- Embolic stroke can be the primary clinical manifestation of IE.
- Bartonella species should be suspected in culture-negative endocarditis with embolic events.
Implications:
- Highlights the importance of considering IE in embolic stroke patients, even without typical symptoms.
- Emphasizes the need for high suspicion of Bartonella in culture-negative endocarditis with multisite valve involvement.
- Underscores that prompt diagnosis and targeted therapy are vital for improving outcomes in complex IE cases.
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