Enfermedades infecciosas y microbiologia clinica · 2006
[Endocarditis due to Bartonella spp. Three new clinical cases and Spanish literature review].
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Oteo José Antonio, Castilla Alberto, Arosey Angel, Blanco José Ramón, Ibarra Valvanera, Morano Luis Enrique
Аннотация
INTRODUCTION: Infections by Bartonella spp. include a wide spectrum of emerging and re-emerging infectious diseases, such as culture-negative endocarditis.
METHODS: Description of 3 cases of endocarditis due to Bartonella spp. and review of those previously reported in Spain.
RESULTS: Including these 3 new cases of endocarditis due to Bartonella spp., a total of 6 cases have been reported in Spain. The median age of the patients was 51.6 years and 83.3% were men. There was history of contact with cats in 66.7%, and 50% were alcoholic. Only one patient had prior valvular disease. There were no clinical manifestations typical to any of the Bartonella species. The aortic valve was the one most commonly affected. In all cases, B. henselae was the agent implicated. The diagnosis was made by serology in 5 cases (83.3%). The outcome was favorable in all patients, although 4 of them (66.7%) required valve replacement.
CONCLUSION: Endocarditis due to Bartonella spp. is present in Spain and is likely to be underestimated. We should suspect this pathogen in patients with negative blood cultures and a history of chronic alcoholism, homeless patients, and those who have had contact with cats or who have been bitten by fleas or lice, as well as patients with endocarditis and positive serology against Chlamydia spp.
METHODS: Description of 3 cases of endocarditis due to Bartonella spp. and review of those previously reported in Spain.
RESULTS: Including these 3 new cases of endocarditis due to Bartonella spp., a total of 6 cases have been reported in Spain. The median age of the patients was 51.6 years and 83.3% were men. There was history of contact with cats in 66.7%, and 50% were alcoholic. Only one patient had prior valvular disease. There were no clinical manifestations typical to any of the Bartonella species. The aortic valve was the one most commonly affected. In all cases, B. henselae was the agent implicated. The diagnosis was made by serology in 5 cases (83.3%). The outcome was favorable in all patients, although 4 of them (66.7%) required valve replacement.
CONCLUSION: Endocarditis due to Bartonella spp. is present in Spain and is likely to be underestimated. We should suspect this pathogen in patients with negative blood cultures and a history of chronic alcoholism, homeless patients, and those who have had contact with cats or who have been bitten by fleas or lice, as well as patients with endocarditis and positive serology against Chlamydia spp.
Предметные рубрики MeSH
Actinobacillus InfectionsAdultAgedAggregatibacter actinomycetemcomitansAlcoholismAnimalsAnti-Bacterial AgentsAntibodies, BacterialAortic ValveBartonella InfectionsBartonella henselaeBloodCardiomyopathy, HypertrophicCat-Scratch DiseaseCatsCeftriaxoneChlamydiaCiprofloxacinCombined Modality TherapyDisease SusceptibilityDoxycyclineEndocarditis, BacterialEndocarditis, Subacute BacterialFalse Negative ReactionsFemaleGentamicinsHeart Valve Prosthesis ImplantationHumansMaleMiddle AgedSpainVancomycin