Bartonella henselae endocarditis in an elderly patient

About the Authors: Marina Rovani Drummond Affiliation: Applied Research in Dermatology and Bartonella Infection Laboratory, University of Campinas (UNICAMP) Medical School, Campinas, Sao Paulo, Brazil Amanda Roberta de Almeida Affiliation: Applied Research in Dermatology and Bartonella Infection Laboratory, University of Campinas (UNICAMP) Medical School, Campinas, Sao Paulo, Brazil Letícia Valandro Affiliation: Division of Dermatology, Department of Medicine, University of Campinas (UNICAMP) Medical School, Campinas, Sao Paulo, Brazil Maria Helena Postal Pavan Affiliation: Division of Infectious Diseases, Department of Medicine, University of Campinas (UNICAMP) Medical School, Campinas, Sao Paulo, Brazil Raquel Silveira Bello Stucchi Affiliation: Division of Infectious Diseases, Department of Medicine, University of Campinas (UNICAMP) Medical School, Campinas, Sao Paulo, Brazil Francisco Hideo Aoki Affiliation: Division of Infectious Diseases, Department of Medicine, University of Campinas (UNICAMP) Medical School, Campinas, Sao Paulo, Brazil Paulo Eduardo Neves Ferreira Velho * E-mail: pvelho@unicamp.br Affiliations Applied Research in Dermatology and Bartonella Infection Laboratory, University of Campinas (UNICAMP) Medical School, Campinas, Sao Paulo, Brazil, Division of Dermatology, Department of Medicine, University of Campinas (UNICAMP) Medical School, Campinas, Sao Paulo, Brazil ORCID logo http://orcid.org/0000-0001-7901-2351 Citation: Drummond MR, de Almeida AR, Valandro L, Pavan MHP, Stucchi RSB, Aoki FH, et al. During the investigation, Bartonella sp. cultures and molecular research were requested from a blood sample; a transthoracic echocardiogram showed aortic valve with mild thickening of a noncoronary leaflet, with a pedunculated image of 7x2 mm. The other valves had normal morphology and mobility. The use of antibiotics prior to culture collection is considered the main cause of negative diagnostic routine cultures of IE, hindering growth, even under appropriate conditions, of fastidious agents, such as B. henselae [8, 9]. [...]the use of molecular methods enables the etiological diagnosis of endocarditis previously considered idiopathic [10, 11]. The sensitivity of the method (conventional or nested PCR) is another variable in false-negative results [13, 17, 18]. Besides difficulties of molecular tests, serology is not considered a gold standard for diagnosis of infection.