ABSTRACT
We report a case of Bartonella quintana endocarditis in a homeless man with congenital bicuspid aortic valve and significant cat exposure living in downtown San Diego, California.
Subject(s)
Bartonella quintana/isolation & purification , Endocarditis, Bacterial/microbiology , Trench Fever/pathology , Animals , Anti-Bacterial Agents/therapeutic use , Cat Diseases/microbiology , Cats , Endocarditis, Bacterial/therapy , Endocarditis, Bacterial/transmission , Fatal Outcome , Humans , Male , Middle Aged , Trench Fever/therapy , Trench Fever/transmission , ZoonosesABSTRACT
Bartonella quintana, a pathogen that is restricted to human hosts and louse vectors, was first characterized as the agent of trench fever. The disease was described in 1915 on the basis of natural and experimental infections in soldiers. It is now recognized as a reemerging pathogen among homeless populations in cities in the United States and Europe and is responsible for a wide spectrum of conditions, including chronic bacteremia, endocarditis, and bacillary angiomatosis. Diagnosis is based on serologic analysis, culture, and molecular biology. Recent characterization of its genome allowed the development of modern diagnosis and typing methods. Guidelines for the treatment of B. quintana infections are presented.
