Bartonella spp

[European Heart J 2009;30:2369-2413.]

Clinical

B. quintana  
- associated with alcoholism, homelessness, body lice.

 

B. henselae
- contact with cats, previous valvular disease
- valve surgery required in > 50% of patients


Diagnosis

  • Blood cultures – requires special blood culture media; only occasionally positive

  • Serology - antibody titre ≥ 1:800

  • Culture, immunohistology and PCR of surgical material


Therapy Dose Duration
Doxycycline 100mg PO bid 6 weeks
+    
Gentamicin 3mg/kg IV daily or 2 weeks
  1mg/kg IV q8h