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. 2023 May 29;10(7):ofad293. doi: 10.1093/ofid/ofad293

Table 1.

Clinical Characteristics of Patients Diagnosed With Bartonella Endocarditis (N = 16)

Clinical Characteristics N = 16 (%)
Gender

  • Male sex

 12 (75)

  • Female sex

 4 (25)
Age in years, median (IQR) 57 (50–66)
Comorbidities/Risk Factors

  • Prosthetic cardiac valve

 10 (62.5)

  • Cat exposure

 10 (62.5)

  • Autoimmune disorder

 7 (43.8)

  • Chronic kidney disease (>3 months)

 6 (37.8)

  • Use of immunosuppression (>1 months)

 6 (37.8)

  • Diabetes mellitus

 4 (25)

  • HIV

 1 (6.3)

  • Alcohol abuse

 1 (6.3)
Time of illness, median, weeks (IQR) 24 (12–33)
Clinical Presentation

  • Fever

 14 (87.6)

  • Malaise

 13 (81.3)

  • Weight loss

 9 (56.3)

  • Volume overload

 4 (25)

  • Rash

 4 (25)
Laboratory Testing

  • Anemia

 15 (93.8)

  • Other cytopenias

 9 (56.3)

  • Renal failure

 9 (56.3)

  • Abnormal liver enzymes

 6 (37.5)
Immunology

  • PR3-ANCA positive/tested

 6/9 (66.7)

  • MPO-ANCA positive/tested

 1/9 (11.1)

  • Low complement positive/tested

 6/9 (66.7)
Imaging

  • Splenomegaly

 5 (31.3)

  • Embolic phenomena

 4 (25)

  • Hepatosplenomegaly

 2 (12.5)
Echocardiogram

  • Vegetation/mass

 13 (81.3)

  • Valvular dysfunction

 10 (62.5)

  • Perivalvular/root abscess

 4 (25)
Valvular Involvement

  • Aortic

 9 (56.3)

  • Mitral

 5 (31.3)

  • Pulmonary

 2 (12.5)

  • Tricuspid

 1 (6.3)
Bartonella spp Serologya

  • IgG ≥128

 16 (100)

  • IgG ≥800

 12 (75)
Bartonella spp Molecular Testing Positiveb

  • Blood positive/tested

 2/14 (14.3)

  • Valve positive/tested

 7/10 (70)
C burnetii testing positive/testedc 8/14 (57.1)
Duration of treatment, median, weeks (IQR) 7 (6–14)
Antibiotics

  • Doxycycline

 15 (93.8)

  • Gentamicin

 9 (56.3)

  • Rifampin

 8 (50)

  • Ceftriaxone

 6 (37.5)
Time between diagnosis and surgical management, median, days (IQR) 26 (4–98)
Surgical Management 10 (62.5)

  • Valve replaced/prosthetic valve

 6/10 (60)

  • Valve replaced/native valve

 3/6 (50)

  • Valve repair/native valve

 1/6 (16.7)
Outcomed
Combined surgical and medical (6/15)

  • Improvement/resolution

 5 (83.3)

  • Relapse/persistent disease

 0

  • Death

 1 (16.7)
Medical Only (9/15)

  • Improvement/resolution

 4 (44.4)

  • Relapse/persistent disease

 4 (44.4)

  • Death

 1 (11.2)

Abbreviations: ANCA, antineutrophil cytoplasmic antibodies; HIV, human immunodeficiency virus; IgG, immunoglobulin G; IQR, interquartile range; MPO, myeloperoxidase; PR3, proteinase antibody 3.

a

Serology using indirect immunofluorescence assay.

b

Molecular testing using real-time polymerase chain reaction (PCR) for Bartonella species deoxyribonucleic acid and PCR of a highly variable fragment of the 16S ribosomal ribonucleic acid (rRNA) gene. Tests were developed and interpreted by Laboratory Medicine and Pathology at Mayo Clinic.

c

Serology using indirect immunofluorescence assay and molecular testing using PCR for Coxiella burnetii. Tests developed and/or interpreted by Laboratory Medicine and Pathology at Mayo Clinic (Rochester, Minnesota).

d

Outcomes related to initial management in 15 patients who had follow-up information for 1-year postdiagnosis of Bartonella endocarditis.