Advertisement
Heart, Lung and Circulation

Clinical and Echocardiographic Characteristics of Bartonella Infective Endocarditis: An 8-Year Single-Centre Experience in the United States

Published:August 27, 2021DOI:https://doi.org/10.1016/j.hlc.2021.07.021

      Background

      Infective endocarditis due to Bartonella species is rare. The clinical and echocardiographic characteristics are not well defined. We aimed to investigate the clinical and echocardiographic findings of Bartonella endocarditis in the contemporary era.

      Methods

      The infective endocarditis (IE) registry and echocardiographic database at our institution were retrospectively analysed to evaluate the clinical and echocardiographic features of Bartonella endocarditis.

      Results

      Between January 2008 and December 2015, there were 11 patients with Bartonella IE (0.84% among a total of 1,308 cases of definite IE): median age 54 (30–69) years, all male, 9 Caucasian, 10 had a history of cat exposure, 10 had a pre-existing valvulopathy including 6 patients with a prosthetic valve with prosthesis age range between 3 to 5 years and 1 patient with implantable cardioverter defibrillator (ICD). Bartonella henselae was responsible for all the cases. Echocardiographic evidence of IE was found in 6 of 11 patients on transthoracic echocardiography (TTE), and 6 of 8 on transoesophageal echocardiography (TEE). Bartonella IE was associated with significant valvular destruction and dysfunction on echocardiography. Nine (9) patients were managed surgically with excellent outcomes, including two patients who failed initial medical therapy. Two (2) patients who were managed medically had progression of valvular dysfunction. At a median follow-up of 6 months, there were no deaths attributable to IE or other cardiovascular causes.

      Conclusion

      In a contemporary single-centre cohort in the United States, Bartonella IE remains rare, but should be considered when pathogen could not be identified in patients with suspected IE, especially those with prosthetic valves or bicuspid aortic valve (BAV). The vast majority of patients with Bartonella IE were managed surgically with excellent outcomes.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Heart, Lung and Circulation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Houpikian P.
        • Raoult D.
        Blood culture-negative endocarditis in a reference center: etiologic diagnosis of 348 cases.
        Med Baltim. 2005; 84: 162-173
        • Edouard S.
        • Nabet C.
        • Lepidi H.
        • Fournier P.E.
        • Raoult D.
        Bartonella, a common cause of endocarditis: a report on 106 cases and review.
        J Clin Microbiol. 2015; 53: 824-829
        • Maurin M.
        • Raoult D.
        Bartonella infections: diagnostic and management issues.
        Curr Opin Infect Dis. 1998; 11: 189-193
        • La Scola B.
        • Raoult D.
        Culture of Bartonella quintana and Bartonella henselae from human samples: a 5-year experience (1993 to 1998).
        J Clin Microbiol. 1999; 37: 1899-1905
        • Fournier P.E.
        • Lelievre H.
        • Eykyn S.J.
        • Mainardi J.L.
        • Marrie T.J.
        • Bruneel F.
        • et al.
        Epidemiologic and clinical characteristics of Bartonella quintana and Bartonella henselae endocarditis: a study of 48 patients.
        Med Baltim. 2001; 80: 245-251
        • Fournier P.E.
        • Mainardi J.L.
        • Raoult D.
        Value of microimmunofluorescence for diagnosis and follow-up of Bartonella endocarditis.
        Clin Diagn Lab Immunol. 2002; 9: 795-801
        • Raoult D.
        • Fournier P.E.
        • Vandenesch F.
        • Mainardi J.L.
        • Eykyn S.J.
        • Nash J.
        • et al.
        Outcome and treatment of Bartonella endocarditis.
        Arch Intern Med. 2003; 163: 226-230
        • Spach D.H.
        • Callis K.P.
        • Paauw D.S.
        • Houze Y.B.
        • Schoenknecht F.D.
        • Welch D.F.
        • et al.
        Endocarditis caused by Rochalimaea quintana in a patient infected with human immunodeficiency virus.
        J Clin Microbiol. 1993; 31: 692-694
        • Spach D.H.
        • Kanter A.S.
        • Dougherty M.J.
        • Larson A.M.
        • Coyle M.B.
        • Brenner D.J.
        • et al.
        Bartonella (Rochalimaea) quintana bacteremia in inner-city patients with chronic alcoholism.
        N Engl J Med. 1995; 332: 424-428
        • Ghidey F.Y.
        • Igbinosa O.
        • Mills K.
        • Lai L.
        • Woods C.
        • Ruiz M.E.
        • et al.
        Case series of Bartonella quintana blood culture-negative endocarditis in Washington, DC.
        JMM Case Rep. 2016; 3: e005049
        • Raybould J.E.
        • Raybould A.L.
        • Morales M.K.
        • Zaheer M.
        • Lipkowitz M.S.
        • Timpone J.G.
        • et al.
        Bartonella endocarditis and pauci-immune glomerulonephritis: a case report and review of the literature.
        Infect Clin Pr Balt Md. 2016; 24: 254-260
        • Vercellone J.
        • Cohen L.
        • Mansuri S.
        • Zhang P.L.
        • Kellerman P.S.
        Bartonella endocarditis mimicking crescentic glomerulonephritis with PR3-ANCA positivity.
        Case Rep Nephrol. 2018; 2018 (9607582)
        • Shrestha N.K.
        • Ledtke C.S.
        • Wang H.
        • Fraser T.G.
        • Rehm S.J.
        • Hussain S.T.
        • et al.
        Heart valve culture and sequencing to identify the infective endocarditis pathogen in surgically treated patients.
        Ann Thorac Surg. 2015; 99: 33-37
        • Shrestha N.K.
        • Shah S.Y.
        • Hussain S.T.
        • Pettersson G.B.
        • Griffin B.P.
        • Nowacki A.S.
        • et al.
        Association of surgically treatment with survival in patients with prosthetic valve endocarditis.
        Ann Thorac Surg. 2020; 109: 1834-1843
        • Raoult D.
        • Fournier P.E.
        • Drancourt M.
        • Marrie T.J.
        • Etienne J.
        • Cosserat J.
        • et al.
        Diagnosis of 22 new cases of Bartonella endocarditis.
        Ann Intern Med. 1996; 125: 646-652
        • Nakasu A.
        • Ishimine T.
        • Yasumoto H.
        • Tengan T.
        • Mototake H.
        Infective endocarditis associated with Bartonella henselae: a case series.
        IDCases. 2018; 12: 127-129
        • Chomel B.B.
        • Kasten R.W.
        • Williams C.
        • Wey A.C.
        • Henn J.B.
        • Maggi R.
        • et al.
        Bartonella endocarditis: a pathology shared by animal reservoir and patients.
        Ann N Acad Sci. 2009; 1166: 120-126
        • Pachirat O.
        • Prathanee S.
        • Watt G.
        Echocardiographic features in Bartonella endocarditis: a case series.
        Cardiol Res. 2018; 9: 116-119
        • La Scola B.
        • Raoult D.
        Serological cross-reactions between Bartonella quintana, Bartonella henselae, and Coxiella burnetii.
        J Clin Microbiol. 1996; 34: 2270-2274