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Bartonella clarridgeiae infection in a patient with aortic root abscess and endocarditis.

ABSTRACT: Introduction:Bartonella species are increasingly recognized as agents of culture-negative endocarditis. However, to date, almost all human cases have been associated with two members of the genus, Bartonella henselae and Bartonella quintana. B. henselae infections are zoonotic, with domestic cats serving as reservoir hosts for the pathogen. Bartonella clarridgeiae also exploits cats as reservoir hosts, but its zoonotic potential is far less established. Case presentation:A 34-year-old male presented with palpitations after a history of aortic incompetence. During surgery for an aortic valve replacement, two vegetations were found on the aortic valve. PCR analysis of the vegetation demonstrated the presence of Bartonella species and so the patient was treated post-operatively with ceftriaxone and doxycycline, making a good recovery. Further PCR-based analysis of the patient's aortic vegetation confirmed the presence of B. clarridgeiae . Conclusion:This report expands the number of Bartonella species associated with endocarditis and provides clear evidence that B. clarridgeiae should be considered a zoonotic pathogen.

SUBMITTER: Logan JMJ

PROVIDER: S-EPMC7491929 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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<i>Bartonella clarridgeiae</i> infection in a patient with aortic root abscess and endocarditis.

Logan Julie M J JMJ Hall Jessica L JL Chalker Vicki J VJ O'Connell Brian B Birtles Richard J RJ

Access microbiology 20191010 10

<h4>Introduction</h4><i>Bartonella</i> species are increasingly recognized as agents of culture-negative endocarditis. However, to date, almost all human cases have been associated with two members of the genus, <i>Bartonella henselae</i> and <i>Bartonella quintana. B. henselae</i> infections are zoonotic, with domestic cats serving as reservoir hosts for the pathogen. <i>Bartonella clarridgeiae</i> also exploits cats as reservoir hosts, but its zoonotic potential is far less established.<h4>Cas ...[more]

PMID: 32974498

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Project description:Locally destructive infective endocarditis (IE) of the aortic valve complicated by abscess formation in the aortic root may seriously affect patients' outcomes. Surgical repair of such conditions is often challenging. This is a single-center observational analysis of consecutive patients treated surgically for IE between 2009 and 2019. We divided the cohort into two groups considering the presence of an aortic root abscess and compared the characteristics and postoperative outcomes of patients accordingly. Moreover, we examined three different procedures performed in abscess patients regarding operative data and postoperative results: an isolated surgical aortic valve replacement (AVR), AVR with patch reconstruction of the aortic root (AVR + RR) or the Bentall procedure. The whole cohort comprised 665 patients, including 140 (21.0%) patients with an aortic root abscess and 525 (78.9%) as the control group. The abscess group of patients received either AVR (66.4%), AVR + RR (17.8%), or the Bentall procedure (15.7%). The mean age in the whole cohort was 62.1 ± 14.8. The mean EuroSCORE II was 8.0 ± 3.5 in the abscess group and 8.4 ± 3.7 in the control group (p = 0.259). The 30-day and 1-year mortality rates were 19.6% vs. 11.3% (p = 0.009) and 40.1% vs. 29.6% (p = 0.016) in the abscess compared to the control group. The multivariable regression analysis did not reveal aortic root abscess as an independent predictor of mortality. Rather, age > 60 correlated with 30-day mortality and infection with Streptococcus spp. correlated with 1-year mortality. In the analysis according to the performed procedures, KM estimates exhibited comparable long-term survival (log-rank p = 0.325). IE recurrence was noticed in 12.3% of patients after AVR, 26.7% after AVR + RR and none after Bentall (p = 0.069). We concluded that patients with an aortic root abscess suffer worse short and long-term outcomes compared to other IE patients. The post-procedural survival among ARA patients did not significantly vary based on the procedures performed.

Dataset Information

Bartonella clarridgeiae infection in a patient with aortic root abscess and endocarditis.

Publications

<i>Bartonella clarridgeiae</i> infection in a patient with aortic root abscess and endocarditis.

Similar Datasets

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