Bartonella Endocarditis in Spain: Case Reports of 21 Cases

Blood culture negative endocarditis (BCNE) is frequent in infective endocarditis (IE). One of the causes of BCNE is fastidious microorganisms, such as Bartonella spp. The aim of this study was to describe the epidemiologic, clinical characteristics, management and outcomes of patients with Bartonell...

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Detalles Bibliográficos
Autores: García Álvarez, Lara, García García, María Concepción, Muñoz García, Patricia Carmen, Fariñas Álvarez, María del Carmen, Cuadra, Manuel Gutiérrez, Fernández Hidalgo, Nuria, García Vázquez, Elisa, Moral Escudero, Encarnación, Alonso Socas, María del Mar, García Rosado, Dácil, Hidalgo Tenorio, Carmen, Domínguez, Fernando, Goikoetxea Agirre, Josune, Gainzarain, Juan Carlos, Rodríguez Esteban, María Ángeles, Bosch Guerra, Xerach, Oteo, José A.
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universidad Complutense de Madrid (UCM)
Repositorio:Docta Complutense
Idioma:inglés
OAI Identifier:oai:docta.ucm.es:20.500.14352/72525
Acceso en línea:https://hdl.handle.net/20.500.14352/72525
Access Level:acceso abierto
Palabra clave:Infective endocarditis
Blood culture negative endocarditis
Bartonella endocarditis
Bartonella spp.
Cardiología
Enfermedades infecciosas
Inmunología
3205.01 Cardiología
3205.05 Enfermedades Infecciosas
2412 Inmunología
Descripción
Sumario:Blood culture negative endocarditis (BCNE) is frequent in infective endocarditis (IE). One of the causes of BCNE is fastidious microorganisms, such as Bartonella spp. The aim of this study was to describe the epidemiologic, clinical characteristics, management and outcomes of patients with Bartonella IE from the “Spanish Collaboration on Endocarditis-Grupo de Apoyo al Manejo de la Endocarditis infecciosa en España (GAMES)”cohort. Here we presented 21 cases of Bartonella IE. This represents 0.3% of a total of 5590 cases and 2% of the BCNE from the GAMES cohort. 62% were due to Bartonella henselae and 38% to Bartonella quintana. Cardiac failure was the main presenting form (61.5% in B. hensalae, 87.5% in B. quintana IE) and the aortic valve was affected in 85% of the cases (76% in B. henselae, 100% in B. quintana IE). Typical signs such as fever were recorded in less than 40% of patients. Echocardiography showed vegetations in 92% and 100% of the patients with B. henselae and B. quintana, respectively. Culture was positive only in one patient and the remaining were diagnosed by serology and PCR. PCR was the most useful tool allowing for diagnosis in 16 patients (100% of the studied valves). Serology, at titers recommended by guidelines, only coincided with PCR in 52.4%. Antimicrobial therapy, in different combinations, was used in all cases. Surgery was performed in 76% of the patients. No in-hospital mortality was observed. One-year mortality was 9.4%. This article remarks the importance for investigating the presence of Bartonella infection as causative agent in all BCNE since the diagnosis needs specific microbiological tools and patients could benefit of a specific treatment.

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