Varga Zoltan, Gowda Smitha Narayana, Stys Adam
Sanford Cardiovascular Institute, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota.
University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota.
S D Med. 2020 Feb;73(2):68-70.
Bartonella species was first reported as a cause of endocarditis in 1993, currently it is thought to account for 3-4 percent of all diagnosed cases. Initial symptoms of Bartonella endocarditis are non-specific like weight loss, fever and fatigue. There are very few reported cases of Bartonella endocarditis causing mycotic aneurysm. We present a case of a 60-year-old male who presented with subarachnoid hemorrhage secondary to mycotic aneurysm. Due to high suspicion of endocarditis leading to mycotic aneurysm he underwent transesophageal echocardiography which showed mitral valve vegetations. His blood cultures were negative, he was eventually diagnosed with Bartonella henselae by elevated IgG titers greater than 1:800. Due to repeated mycotic aneurysms on antibiotics, he underwent surgical mitral valve replacement along with the full course of antibiotics and has been asymptomatic since.
巴尔通体属细菌于1993年首次被报道为心内膜炎的病因，目前认为其占所有确诊病例的3%至4%。巴尔通体心内膜炎的初始症状是非特异性的，如体重减轻、发热和疲劳。报道的巴尔通体心内膜炎导致真菌性动脉瘤的病例非常少。我们报告一例60岁男性，因真菌性动脉瘤继发蛛网膜下腔出血就诊。由于高度怀疑心内膜炎导致真菌性动脉瘤，他接受了经食管超声心动图检查，结果显示二尖瓣有赘生物。他的血培养结果为阴性，最终通过IgG滴度升高大于1:800确诊为汉赛巴尔通体感染。由于使用抗生素后真菌性动脉瘤反复出现，他接受了二尖瓣置换手术，并全程使用抗生素，此后一直无症状。
