Blood Culture-Negative Endocarditis Caused by Bartonella
Open Forum Infectious Diseases (Ordaya E., et al.) 5.29.23 published “‘Let the Cat Out of the Heart’: Clinical Characteristics of Patients Presenting With Blood Culture-Negative Endocarditis Due to Bartonella Species.” The study was performed in an effort to define the clinical features of patients with Blood Culture-Negative Endocarditis (BCNE) due to Bartonella spp at Mayo Clinic in Rochester, Minnesota.
This retrospective study included adult patients with the diagnosis of “possible” or “definitive” Bartonella endocarditis, based on the modified Duke criteria, from November 1, 2005, to June 30, 2021. Sixteen patients were diagnosed with Bartonella endocarditis during the study time frame. Most had prior prosthetic cardiac valves and exposure to cats with other risk factors. Nine patients presented with novel or worsening renal failure and three were misdiagnosed with renal vasculitis. Their renal function showed improvement with antimicrobial therapy.
The findings suggest that a Bartonella infection should be suspected as a potential etiology of BCNE, in patients with a prosthetic cardiac valve, relevant epidemiological exposures, and/or renal failure with positive PR3-ANCA.
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