Bartonella quintana pulmonary native valve endocarditis.

Autor: Aranda-Domene R; Cardiovascular Surgery Department, Hospital Clínic Barcelona, University of Barcelona, Barcelona, Spain., Sandoval E; Cardiovascular Surgery Department, Hospital Clínic Barcelona, University of Barcelona, Barcelona, Spain., Cuervo G; Department of Infectious Diseases, Hospital Clínic Barcelona, University of Barcelona, Barcelona, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain., Fernández-Pittol M; Department of Microbiology, Hospital Clínic Barcelona, University of Barcelona, Barcelona, Spain., de la María CG; Infectious Diseases Department, Hospital Clínic-FCRB-IDIBAPS, University of Barcelona, Barcelona, Spain., Quintana E; Cardiovascular Surgery Department, Hospital Clínic Barcelona, University of Barcelona, Barcelona, Spain.
Jazyk: angličtina
Zdroj: Indian journal of thoracic and cardiovascular surgery [Indian J Thorac Cardiovasc Surg] 2024 May; Vol. 40 (Suppl 1), pp. 150-154. Date of Electronic Publication: 2024 Apr 10.
DOI: 10.1007/s12055-024-01727-4
Abstrakt: Bartonella quintana is a well-known cause of blood culture-negative endocarditis; however, pulmonary valve involvement is rare. The case of a 40-year-old African male who presented to the Emergency Department with chest pain, cardiac failure, and a 2-week history of fever is presented. Transoesophageal echocardiography confirmed an atrial septal defect, severe pulmonary insufficiency with large vegetations, severe mitral regurgitation due to anterior leaflet prolapse, and right ventricular dysfunction. Empirical antibiotic therapy was started, and urgent surgical intervention was decided. There were vegetations on the three pulmonary valve leaflets and the mitral valve. Closure of the atrial septal defect, mitral and tricuspid valve repair, pulmonary valve replacement with a biological prosthesis, and infundibuloplasty of the right ventricle were performed. The postoperative course was uneventful. Preoperative blood cultures were negative, and B. quintana was detected through 16S rRNA gene amplification and sequencing in mitral and pulmonary implants. Serology showed positive titers of 1/1260 for both B. quintana and B. henselae . Ceftriaxone and gentamicin were administered for 10 days, followed by oral doxycycline for 12 weeks. A one-year echocardiogram showed normal functioning of the pulmonary prosthesis and the mitral and tricuspid repair. Infection caused by B. quintana is a rare cause of endocarditis with negative blood cultures, and multivalvular and pulmonary valve involvement is exceptional.
Supplementary Information: The online version contains supplementary material available at 10.1007/s12055-024-01727-4.
Competing Interests: Conflict of interestThe authors declare that they have no conflict of interest in this study.
(© Indian Association of Cardiovascular-Thoracic Surgeons 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)
Databáze: MEDLINE
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