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Bartonella Causes Infection in the Heart’s Inner Lining and Valves

Bartonella Species, an Emerging Cause of Blood-Culture-Negative Endocarditis
Editor’s Note: Endocarditis is an infection of the heart’s valves or inner lining. It occurs when germs get into the bloodstream and settle inside the heart, often on a valve. The infection is usually caused by bacteria like Bartonella and Borrelia. In rare cases, it is caused by fungi.
Since the reclassification of the genus Bartonella in 1993, the number of species has grown from 1 to 45 currently designated members. Likewise, the association of different Bartonella species with human disease continues to grow, as does the range of clinical presentations associated with these bacteria.
Among these, blood-culture-negative endocarditis stands out as a common, often undiagnosed, clinical presentation of infection with several different Bartonella species. The limitations of laboratory tests resulting in this underdiagnosis of Bartonella endocarditis are discussed.
The varied clinical picture of Bartonella infection and a review of clinical aspects of endocarditis caused by Bartonella are presented. We also summarize the current knowledge of the molecular basis of Bartonella pathogenesis, focusing on surface adhesins in the two Bartonella species that most commonly cause endocarditis, B. henselae and B. quintana.
We discuss evidence that surface adhesins are important factors for autoaggregation and biofilm formation by Bartonella species. Finally, we propose that biofilm formation is a critical step in the formation of vegetative masses during Bartonella-mediated endocarditis and represents a potential reservoir for persistence by these bacteria.
Source: By Okaro U1, Addisu A2, Casanas B2, Anderson B3. Bartonella Species, an Emerging Cause of Blood-Culture-Negative Endocarditis. Clin Microbiol Rev. [1]2017 Jul;30(3):709-746. doi: 10.1128/CMR.00013-17.