A Case of Culture-Negative Endocarditis Due to Bartonella henselae and Cat Scratch Disease. 2023

Elias O U Eteshola, and Cristina M Font, and Kwame Dapaah-Afriyie
Warren Alpert Medical School of Brown University, Providence, R.

This report describes the case of a 73-year-old female with a history of a prosthetic mitral valve and breast cancer who presented with fever and confusion. Brain imaging revealed multiple ischemic infarcts, and abdominal imaging demonstrated splenic infarcts. Workup with transesophageal echocardiogram revealed a vegetation on the aortic valve, but several blood cultures had no bacterial growth. Further history revealed a recent exposure to a stray cat, and the patient was found to have positive antibodies for Bartonella henselae, the organism implicated in cat scratch disease. She was treated with the appropriate course of antibiotics, and she made a full recovery to her baseline functional status. This report emphasizes the importance of a comprehensive patient history and a broad differential diagnosis.

UI MeSH Term Description Entries
D002372 Cat-Scratch Disease A self-limiting bacterial infection of the regional lymph nodes caused by AFIPIA felis, a gram-negative bacterium recently identified by the Centers for Disease Control and Prevention and by BARTONELLA HENSELAE. It usually arises one or more weeks following a feline scratch, with raised inflammatory nodules at the site of the scratch being the primary symptom. Cat Scratch Disease,Inoculation Lymphoreticulosis,Bartonella henselae Infection,Cat Scratch Fever,Catscratch Disease,Inoculative Lymphoreticulosis,Bartonella henselae Infections,Cat Scratch Diseases,Cat Scratch Fevers,Cat-Scratch Diseases,Catscratch Diseases,Fever, Cat Scratch,Infection, Bartonella henselae,Infections, Bartonella henselae,Inoculation Lymphoreticuloses,Inoculative Lymphoreticuloses,Lymphoreticuloses, Inoculation,Lymphoreticuloses, Inoculative,Lymphoreticulosis, Inoculation,Lymphoreticulosis, Inoculative,Scratch Disease, Cat,Scratch Diseases, Cat,Scratch Fever, Cat
D002415 Cats The domestic cat, Felis catus, of the carnivore family FELIDAE, comprising over 30 different breeds. The domestic cat is descended primarily from the wild cat of Africa and extreme southwestern Asia. Though probably present in towns in Palestine as long ago as 7000 years, actual domestication occurred in Egypt about 4000 years ago. (From Walker's Mammals of the World, 6th ed, p801) Felis catus,Felis domesticus,Domestic Cats,Felis domestica,Felis sylvestris catus,Cat,Cat, Domestic,Cats, Domestic,Domestic Cat
D004696 Endocarditis Inflammation of the inner lining of the heart (ENDOCARDIUM), the continuous membrane lining the four chambers and HEART VALVES. It is often caused by microorganisms including bacteria, viruses, fungi, and rickettsiae. Left untreated, endocarditis can damage heart valves and become life-threatening. Infective Endocarditis,Endocarditides,Endocarditides, Infective,Endocarditis, Infective,Infective Endocarditides
D004697 Endocarditis, Bacterial Inflammation of the ENDOCARDIUM caused by BACTERIA that entered the bloodstream. The strains of bacteria vary with predisposing factors, such as CONGENITAL HEART DEFECTS; HEART VALVE DISEASES; HEART VALVE PROSTHESIS IMPLANTATION; or intravenous drug use. Bacterial Endocarditides,Bacterial Endocarditis,Endocarditides, Bacterial
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D000900 Anti-Bacterial Agents Substances that inhibit the growth or reproduction of BACTERIA. Anti-Bacterial Agent,Anti-Bacterial Compound,Anti-Mycobacterial Agent,Antibacterial Agent,Antibiotics,Antimycobacterial Agent,Bacteriocidal Agent,Bacteriocide,Anti-Bacterial Compounds,Anti-Mycobacterial Agents,Antibacterial Agents,Antibiotic,Antimycobacterial Agents,Bacteriocidal Agents,Bacteriocides,Agent, Anti-Bacterial,Agent, Anti-Mycobacterial,Agent, Antibacterial,Agent, Antimycobacterial,Agent, Bacteriocidal,Agents, Anti-Bacterial,Agents, Anti-Mycobacterial,Agents, Antibacterial,Agents, Antimycobacterial,Agents, Bacteriocidal,Anti Bacterial Agent,Anti Bacterial Agents,Anti Bacterial Compound,Anti Bacterial Compounds,Anti Mycobacterial Agent,Anti Mycobacterial Agents,Compound, Anti-Bacterial,Compounds, Anti-Bacterial
D018416 Bartonella henselae A species of gram-negative bacteria that is the etiologic agent of bacillary angiomatosis (ANGIOMATOSIS, BACILLARY). This organism can also be a cause of CAT-SCRATCH DISEASE in immunocompetent patients. Rochalimaea henselae

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