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[Bartonella quintana endocarditis. Aortic localization and mitral valve abscess]
P Jourdain1, H Blanchard, L Cabanes
1Service de cardiologie, Hôpital Cochin, Paris.
Archives Des Maladies Du Coeur Et Des Vaisseaux
|December 2, 1998
Summary
Bartonella Quintana endocarditis is an increasing, underdiagnosed infection, often affecting the aortic valve in socially deprived individuals. Diagnosis requires specialized methods like serology and PCR due to negative blood cultures.
Area of Science:
- Infectious Diseases
- Cardiology
- Microbiology
Background:
- Bartonella Quintana is a rare but increasingly recognized cause of endocarditis.
- Transmission occurs via body lice, often affecting socially deprived populations.
- Aortic valve involvement is most common, with potential for mitral annulus abscess.
Purpose of the Study:
- To highlight the diagnostic challenges and suggest methods for identifying Bartonella Quintana endocarditis.
- To discuss the controversial treatment and follow-up strategies for this infection.
Main Methods:
- Suspect Bartonella endocarditis in patients with negative blood cultures and specific clinical context.
- Utilize Bartonellosis serology, Gimenez stain on effusions, and PCR for diagnosis.
- Send operative specimens to specialized labs for bacterial culture.
Main Results:
- Bartonella Quintana endocarditis is often missed due to diagnostic difficulties.
- Specialized serological and molecular techniques are crucial for accurate diagnosis.
- Mitral annulus abscess can be a complication, as seen in this case.
Conclusions:
- Early suspicion and specialized diagnostic methods are vital for Bartonella Quintana endocarditis.
- Treatment remains controversial, with recommended regimens including antibiotics and close follow-up.
- Monthly serological monitoring is advised to detect relapses.