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Culture-negative endocarditis caused by Bartonella henselae
E Baorto1, R M Payne, L N Slater
1Edward Mallinckrodt Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
The Journal of Pediatrics
|June 17, 1998
Summary
Bartonella henselae can cause culture-negative infective endocarditis in children, even when blood cultures are sterile. Diagnosis requires advanced testing on affected valves.
Area of Science:
- Pediatric Infectious Diseases
- Cardiovascular Pathology
- Microbiology
Background:
- Infective endocarditis (IE) is a serious infection of the heart's inner lining.
- Aortic valve involvement is a common manifestation of IE in children.
- Sterile blood cultures can complicate the diagnosis of IE.
Observation:
- A 4-year-old girl presented with clinical signs of aortic valve infective endocarditis.
- Initial blood cultures were negative, posing a diagnostic challenge.
- The patient underwent surgical resection of the affected aortic valve.
Findings:
- Serologic studies confirmed Bartonella henselae infection.
- Immunohistochemistry and PCR analysis of the resected valve identified Bartonella henselae.
- This established the diagnosis of Bartonella henselae endocarditis.
Implications:
- Bartonella henselae should be considered in pediatric cases of culture-negative endocarditis.
- Advanced diagnostic techniques are crucial for identifying atypical pathogens in IE.
- Awareness of Bartonella henselae as a cause of endocarditis is vital for clinicians.