Emerg Infect Dis. 2024 Dec;30(12):2494-2501. doi: 10.3201/eid3012.240433.
Bartonella quintana infection can lead to bacillary angiomatosis, peliosis hepatis, chronic bacteremia, and culture-negative endocarditis. Transmitted by the human body louse (Pediculus humanus humanus), B. quintana infection has become an emerging disease in recent decades among persons experiencing homelessness. By using retrospective laboratory surveillance, we identified 5 cases of left-sided, culture-negative B. quintana endocarditis among persons in New York, New York, USA, during January 1, 2020-November 23, 2023. Identifications were made by using molecular assays. All patients experienced unsheltered homelessness in the year before hospitalization. Of those patients, 4 experienced heart failure, 3 renal failure, and 2 embolic strokes; 2 died. Aortic valve replacement occurred in 4 cases. A history of possible body louse infestation was found in 4 cases. Clinicians should consider housing status and history of lice exposure in patients with suspected bartonellosis and have a low threshold for diagnostic testing and empiric treatment in patients experiencing homelessness.
巴尔通体 quintana 感染可导致杆菌性血管瘤病、肝血窦扩张症、慢性菌血症和培养阴性的心内膜炎。巴尔通体 quintana 感染由人体虱（人虱）传播，近几十年来，无家可归者中这种感染已成为一种新出现的疾病。通过使用回顾性实验室监测，我们在美国纽约市发现了 5 例左侧、培养阴性的巴尔通体 quintana 心内膜炎病例，时间为 2020 年 1 月 1 日至 2023 年 11 月 23 日。鉴定是通过分子检测进行的。所有患者在住院前一年都经历过无家可归。这些患者中，4 例出现心力衰竭，3 例出现肾功能衰竭，2 例出现脑栓塞；2 例死亡。4 例发生主动脉瓣置换术。4 例患者有潜在体虱感染史。临床医生应考虑疑似巴尔通体病患者的住房状况和虱子暴露史，并对无家可归者患者的诊断检测和经验性治疗设定较低的门槛。
