1/4. Use of polymerase chain reaction for citrate synthase gene to diagnose bartonella quintana endocarditis.We describe aortic valve endocarditis caused by bartonella quintana in a 31-year-old man. The diagnosis was made on the basis of polymerase chain reaction amplification of the B quintana citrate synthase gene from cardiac valve tissue, the compatibility of histochemical stains of cardiac valve tissue, and serologic studies.- - - - - - - - - - ranking = 1keywords = amplification (Clic here for more details about this article) |
2/4. Duke criteria-negative endocarditis caused by bartonella quintana.Bartonella spp. were recently recognized as causative agents of culture-negative endocarditis. Molecular techniques, such as broad-range PCR, are now available to detect fastidious or slow-growing microorganisms, or those which cannot be cultured. Such microorganisms may be responsible for culture-negative endocarditis. alcoholism and homelessness are known risk factors for bartonella quintana endocarditis, even in patients without previous valvular disease. We report a case of B. quintana endocarditis diagnosed by PCR amplification on the excised heart valve, in a young non-alcoholic and immunocompetent patient with few clinical signs of infection who did not fulfill the Duke criteria.- - - - - - - - - - ranking = 1keywords = amplification (Clic here for more details about this article) |
3/4. Bartonella (Rochalimaea) quintana endocarditis in three homeless men.BACKGROUND. Bartonella (Rochalimaea) quintana is the agent of trench fever and is transmitted by the body louse. We searched for this organism in three alcoholic homeless men with endocarditis. methods. blood samples were cultured on a human endothelial cell line and on blood agar. bacteria were identified by sequencing the amplified 16S ribosomal rna gene. The presence of bartonella in tissue was assessed by Gram's staining, immunostaining, and polymerase-chain-reaction amplification. Serologic studies for antibodies to bartonella species were performed by indirect immunofluorescence and Western immunoblotting. RESULTS. B. quintana was isolated from one patient in the blood-agar culture and from the other two patients in the endothelial-cell culture. The organism was also identified by both immunostaining and molecular techniques in the valvular vegetations from the three patients and in a cervical lymph node from one patient. The 16S ribosomal rna gene sequences of the three isolates were almost identical to that of the prototype strain of B. quintana. High titers of antibodies to B. quintana were detected in all three patients, but so were cross-reacting antibodies to chlamydia species. In all three patients studies were repeatedly negative for antibodies to the human immunodeficiency virus. CONCLUSIONS. B. quintana is a cause of endocarditis in homeless patients and may be serologically misdiagnosed as a chlamydial infection.- - - - - - - - - - ranking = 1keywords = amplification (Clic here for more details about this article) |
4/4. Bartonella (Rochalimaea) quintana infection in a seronegative hemodialyzed patient.bartonella quintana is a reemerging pathogen responsible for trench fever, endocarditis, bacteremia, and bacillary angiomatosis. We previously reported the first case of a patient with B. quintana-induced chronic adenomegaly, and here we present a report on a second patient. A hemodialyzed patient with sjogren's syndrome presented with mediastinal adenomegalies and secondary pancytopenia. All diagnostic investigations remained negative, except that a Bartonella-like microorganism was isolated from a bone marrow biopsy. The isolate was identified as B. quintana by a specific mouse polyclonal antibody and by determination of a partial gltA (citrate synthase-encoding) gene and 16S rRNA gene sequences. dna of the pathogen was also detected in the adenomegaly and in the serum of the patient by PCR amplification of the gltA gene. Anti-B. quintana antibodies were never detected in the patient's serum throughout the 12-month follow-up but were detected in the serum of the patient's cat. The patient's outcome was favorable after treatment with gentamicin. Chronic adenomegaly in seronegative patients is a new clinical entity due to B. quintana.- - - - - - - - - - ranking = 1keywords = amplification (Clic here for more details about this article) |