Baty G, Lanotte P, Hocqueloux L, Prazuck T, Bret L, Romano M, Mereghetti L
Service de bactériologie-virologie, hôpital Bretonneau, CHRU de Tours, Tours, France.
Med Mal Infect. 2010 Jun;40(6):358-62. doi: 10.1016/j.medmal.2009.08.003. Epub 2009 Sep 30.
We report the case of a 55 year-old man presenting with a double aortic and mitral endocarditis for which resected valve culture was repeatedly negative. Specific PCR made on valves because of highly positive blood tests for Bartonella henselae remained negative. A molecular approach was made with 16S rDNA PCR, followed by sequencing. Bartonella quintana was identified as the etiology of endocarditis. B. quintana, "fastidious" bacteria, even if hard to identify in a laboratory, is often reported as a blood culture negative endocarditis (BCNE) agent. Molecular biology methods have strongly improved the diagnosis of BCNE. We propose a review of the literature focusing on the interest of broad-spectrum PCR on valve for the etiological diagnosis of BCNE.
我们报告了一例55岁男性患者,其患有双主动脉瓣和二尖瓣心内膜炎,切除瓣膜的培养结果多次为阴性。由于针对汉赛巴尔通体的血液检测呈强阳性,因此对瓣膜进行了特异性PCR检测,但结果仍为阴性。采用16S rDNA PCR进行分子学检测,随后进行测序。鉴定出五日热巴尔通体为心内膜炎的病因。五日热巴尔通体是一种“苛求性”细菌,即便在实验室中难以鉴定,但它常被报告为血培养阴性的心内膜炎(BCNE)病原体。分子生物学方法极大地提高了BCNE的诊断水平。我们建议对文献进行综述,重点关注瓣膜广谱PCR在BCNE病因诊断中的应用价值。