Oteo José Antonio, Castilla Alberto, Arosey Angel, Blanco José Ramón, Ibarra Valvanera, Morano Luis Enrique
Area de Enfermedades Infecciosas, Complejo Hospitalario San Millán-San Pedro de La Rioja, Hospital de La Rioja, Logroño, España.
Enferm Infecc Microbiol Clin. 2006 May;24(5):297-301. doi: 10.1157/13089663.
Infections by Bartonella spp. include a wide spectrum of emerging and re-emerging infectious diseases, such as culture-negative endocarditis.
Description of 3 cases of endocarditis due to Bartonella spp. and review of those previously reported in Spain.
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.
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.
巴尔通体属感染包括一系列新出现和再次出现的传染病，如血培养阴性的心内膜炎。
描述3例由巴尔通体属引起的心内膜炎病例，并回顾西班牙先前报道的病例。
包括这3例新的由巴尔通体属引起的心内膜炎病例，西班牙共报道了6例。患者的中位年龄为51.6岁，83.3%为男性。66.7%有接触猫的病史，50%为酗酒者。只有1例患者有既往瓣膜病。没有任何巴尔通体菌种典型的临床表现。主动脉瓣是最常受累的瓣膜。所有病例中，汉赛巴尔通体均为致病原。5例（83.3%）通过血清学诊断。所有患者预后良好，尽管其中4例（66.7%）需要进行瓣膜置换。
西班牙存在由巴尔通体属引起的心内膜炎，可能被低估。对于血培养阴性、有慢性酒精中毒史的患者、无家可归者以及有接触猫史或被跳蚤或虱子叮咬史的患者，以及心内膜炎且衣原体属血清学阳性的患者，我们应怀疑这种病原体。
