Montcriol Ambroise, Benard Fréderic, Fenollar Florence, Ribeiri Alberto, Bonnet Marc, Collart Fréderic, Guidon Catherine
J Med Case Rep. 2009 Jul 17;3:7325. doi: 10.4076/1752-1947-3-7325.
Bartonella spp. infection is not rare and must be considered with great care in patients with suspected infective endocarditis, particularly if regular blood cultures remain sterile. Management of these infections requires knowledge of the identification and treatment of these bacteria.
A 50-year-old Senegalese man was admitted to our Department of Cardiac Surgery with a culture-negative endocarditis. Despite valvular surgery and adequate antibiotic treatment, recurrence of the endocarditis was observed on the prosthetic mitral valve. Heart failure required circulatory support. Weaning off the circulatory support could not be attempted owing to the absence of heart recovery. Bacteriological diagnosis of Bartonella quintana endocarditis was performed by molecular methods retrospectively after the death of the patient.
This case report underlines the severity and difficulty of the diagnosis of Bartonella quintana endocarditis. The clinical picture suggested possible Bartonella quintana associated myocarditis, a feature that should be considered in new cases.
巴尔通体属感染并不罕见，对于疑似感染性心内膜炎的患者必须格外谨慎地考虑，尤其是在常规血培养仍无菌生长的情况下。这些感染的管理需要了解这些细菌的鉴定和治疗方法。
一名50岁的塞内加尔男子因培养阴性的心内膜炎入住我们的心脏外科。尽管进行了瓣膜手术并给予了充分的抗生素治疗，但人工二尖瓣仍出现心内膜炎复发。心力衰竭需要循环支持。由于心脏未恢复，无法尝试撤掉循环支持。患者死亡后，通过分子方法回顾性地做出了五日热巴尔通体心内膜炎的细菌学诊断。
本病例报告强调了五日热巴尔通体心内膜炎诊断的严重性和困难。临床表现提示可能存在五日热巴尔通体相关性心肌炎，这一特征在新病例中应予以考虑。
