Document Detail


Diagnosis of 22 new cases of Bartonella endocarditis.
MedLine Citation:
PMID:  8849149     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Bartonella species are emerging pathogens that are seldom reported as a cause of blood culture-negative endocarditis. OBJECTIVE: To report the occurrence of, risk factors for, and clinical features of Bartonella endocarditis and to evaluate the diagnostic tools available for this condition. DESIGN: Case series and comparison with past series. SETTING: Multicenter international study in Halifax, Nova Scotia, Canada; Lyon, France; and Marseille, France. PATIENTS: 22 patients from France, England, Canada, and South Africa were investigated for blood culture-negative endocarditis. MEASUREMENTS: Titer of antibodies to Bartonella species by microimmunofluorescence assay, blood or vegetation culture, and amplification of Bartonella DNA from valvular tissue by polymerase chain reaction. Cross-adsorption was done for patients with antibodies to Chlamydia species. RESULTS: 22 patients had definite endocarditis. Five were infected with B. quintana, 4 with B. henselae, and 13 with an undetermined Bartonella species. These cases were compared with the 11 previously reported cases. Of the patients with the newly reported cases, 19 had valvular surgery and 6 died. Nine were homeless, 11 were alcoholic, 4 owned cats, and 13 had preexisting valvular heart disease. Bartonella species caused 3% of the cases of endocarditis seen in the three study centers. The patients with these cases could have previously received a diagnosis of chlamydial endocarditis because of apparently high levels of cross-reacting antibodies to Chlamydia species. CONCLUSIONS: Bartonella species are an important cause of blood culture-negative endocarditis and can be identified by culture, serologic studies, or molecular biology techniques. Alcoholism and homelessness without previous valvular heart disease are risk factors for B. quintana infection but not for infection with other Bartonella species.
Authors:
D Raoult; P E Fournier; M Drancourt; T J Marrie; J Etienne; J Cosserat; P Cacoub; Y Poinsignon; P Leclercq; A M Sefton
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of internal medicine     Volume:  125     ISSN:  0003-4819     ISO Abbreviation:  Ann. Intern. Med.     Publication Date:  1996 Oct 
Date Detail:
Created Date:  1996-10-24     Completed Date:  1996-10-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372351     Medline TA:  Ann Intern Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  646-52     Citation Subset:  AIM; IM    
Affiliation:
Unité des Rickettsies, CNRS EPJ0054, Faculté de Médecine, Marseille, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Alcoholism / complications
Animals
Animals, Domestic
Antibodies, Bacterial / analysis,  immunology
Bartonella / immunology,  isolation & purification
Bartonella Infections / complications,  diagnosis*
Base Sequence
Cats
Chlamydia / immunology
Cross Reactions
DNA Primers
DNA, Bacterial / analysis
Endocarditis, Bacterial / complications,  diagnosis*,  microbiology
Female
Homeless Persons
Humans
Male
Middle Aged
Molecular Sequence Data
Prospective Studies
Retrospective Studies
Risk Factors
Chemical
Reg. No./Substance:
0/Antibodies, Bacterial; 0/DNA Primers; 0/DNA, Bacterial
Comments/Corrections
Erratum In:
Ann Intern Med 1997 Aug 1;127(3):249

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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