Clinical characteristics and outcomes of adults with serologic positivity for Bartonella
| Patient no. | Clinical presentation/ test indication | Interpretation | B. henselae titre | B. quintana titre | Species identified* | Antimicrobial (duration of treatment, d) | Surgical treatment | Outcome (length of follow-up, mo) |
|---|---|---|---|---|---|---|---|---|
| 1 | AV/MV endocarditis (14 mm × 6 mm†), aortic root abscess, pulmonary and splenic emboli, arterial aneurysms | Confirmed B. quintana | 8192 | 8192 | B. quintana (16S AV) | Gentamicin (4), ceftriaxone (42), doxycycline (42) | AV/MV replacement | Survived (12) |
| 2 | MV endocarditis (18 mm × 7 mm†), intracranial aneurysm | Probable B. quintana | 8192 | 8192 | No | Ceftriaxone (43), vancomycin (21), daptomycin (22) | Endovascular coiling (MCA aneurysm) | Survived (6) |
| 3 | MV endocarditis (16 mm × 9 mm†), ruptured intracranial mycotic aneurysm | Probable B. quintana | 8192 | 8192 | No | Ceftriaxone (56), vancomycin (56), doxycycline (56), gentamicin (14) | Endovascular coiling (MCA aneurysm) | Survived (6) |
| 4 | AV/MV endocarditis (14 mm × 6 mm†), intracranial emboli | Probable B. quintana | 8192 | 8192 | No | Ceftriaxone (15), vancomycin (15) | None (declined) | Died |
| 5 | MV endocarditis (21 mm × 6 mm†), splenic emboli | Confirmed B. quintana | 8192 | 8192 | B. quintana (16S AV) | Gentamicin (14), doxycycline (42) | MV replacement | Survived (3) |
| 6 | Ectoparasitosis, cellulitis | Probable B. quintana | 512 | 256 | No | Doxycycline (7) | None | Survived (0) |
| 7 | Fever, rash, ectoparasitosis | Probable B. quintana | 64 | 256 | No | None | None | Survived (0) |
| 8 | Gastroduodenal artery hemorrhage | False-positive | 256 | Negative | – | None | Arterial embolization | Survived (0) |
| 9 | Ectoparasitosis, shin pain | Probable B. quintana | 64 | 256 | No | None | None | Survived (0) |
| 10 | PV endocarditis‡ | Probable B. henselae | 256 | Negative | No | None | None | Survived (0) |
| 11 | AV/PV endocarditis,‡ splenic infarcts | Confirmed B. quintana | 8192 | 8192 | B. quintana (16S AV) | Gentamicin (14), doxycycline (42) | AV replacement, PDA closure | Survived (12) |
| 12 | Axillary lymphadenopathy, fever | Probable B. henselae | 1024 | 512 | No | Azithromycin (5) | None | Survived (0) |
| 13 | Axillary lymphadenopathy, fever | Probable B. henselae | 512 | NA | No | Azithromycin (5) | None | Survived (0) |
| 14 | AV endocarditis‡ | Probable B. henselae | 4096 | 2048 | No | Doxycycline (42), rifampin (14) | AV replacement | Survived (6) |
| 15 | AV/MV/PV endocarditis,‡ ruptured intracranial aneurysm | Confirmed B. quintana | 4096 | NA | B. quintana (rpoB gene sequencing) | Ceftriaxone (42), doxycycline (42), gentamicin (14) | AV/MV replacement, PV repair, craniotomy, aneurysm clip | Died |
| 16 | AV/MV endocarditis,‡ aortic dissection | Confirmed B. quintana | 1024 | NA | B. quintana (16S AV) | Ceftriaxone (42), doxycycline (42) | AV/MV replacement | Survived (6) |
Note: 16S = 16S rRNA sequencing, AV = aortic valve, MCA = middle cerebral artery, MV = mitral valve, NA = not applicable, PDA = patent ductus arteriosus, PV = pulmonary valve.
↵* On explanted cardiac valves.
↵† Largest vegetation documented.
↵‡ Vegetation size was not documented in the available medical chart.