Case Report: Bartonella quintana Endocarditis Outside of the Europe–African Gradient: Comprehensive Review of Cases within North America

John C. Lam Department of Medicine, University of Calgary, Calgary, Canada;

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Kevin Fonseca Department of Microbiology, Immunology, and Infectious Diseases, University of Calgary, Calgary, Canada;
Provincial Laboratory for Public Health, Calgary, Canada

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Kanti Pabbaraju Provincial Laboratory for Public Health, Calgary, Canada

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Bonnie L. Meatherall Department of Medicine, University of Calgary, Calgary, Canada;

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Clinical syndromes associated with Bartonella quintana infection can be insidious and difficult to diagnose for multiple reasons. Clinically, B. quintana can manifest as asymptomatic bacteremia or with subtle subacute constitutional symptoms. Second, it is a fastidious organism that is difficult to identify using traditional culture methods. Last, the body lice vector of B. quintana transmission is likely not uncommon in most patients affected, who are homeless and of low socioeconomic status. Therefore, barriers in seeking medical care and financial constraints for medications are important considerations. The mainstay of literature surrounding B. quintana endocarditis is from Europe and the developing nations. Herein, we describe a case of native valve endocarditis secondary to B. quintana in a homeless male with preexisting valvular disease and undertake a comprehensive literature review of documented B. quintana endocarditis in North America.

Author Notes

Address correspondence to John C. Lam, Department of Medicine, Foothills Medical Center, Calgary T2N 4N1, Canada. E-mail: john.c.lam@ucalgary.ca

Authors’ addresses: John C. Lam and Bonnie L. Meatherall, Department of Medicine, Health Sciences Center, Calgary, Canada, E-mails: john.c.lam@ucalgary.ca and blmeathe@ucalgary.ca. Kevin Fonseca, Department of Immunology and Infectious Diseases, Provincial Laboratory for Public Health, Calgary, Canada, E-mail: kevin.fonseca@albertahealthservices.ca. Kanti Pabbaraju, Provincial Laboratory for Public Health, Calgary, Canada, E-mail: kanti.pabbaraju2@albertahealthservices.ca.

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