Bartonella endocarditis mimicking adult Still's disease

We describe the case of a 39-year-old Caucasian woman who was admitted to the University Hospital of Antwerp with a clinical picture suggestive of adult Still's disease. Even though a transoesophageal echocardiography showed endocarditis of the aortic valve, blood cultures remained negative. Ad...

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Bibliographic Details
Published in:	Acta clinica belgica (English ed. Online) Vol. 63; no. 3; pp. 190 - 192
Main Authors:	De Clerck, K F, Van Offel, J F, Vlieghe, E, Van Marck, E, Stevens, W J
Format:	Journal Article
Language:	English
Published:	England 01-05-2008
Subjects:	Adult Bartonella henselae - genetics Bartonella henselae - isolation & purification Bartonella Infections - diagnosis Bartonella Infections - microbiology Biopsy Diagnosis, Differential DNA, Bacterial - analysis Echocardiography, Transesophageal Endocarditis, Bacterial - diagnosis Endocarditis, Bacterial - microbiology Female Humans Polymerase Chain Reaction Still's Disease, Adult-Onset - diagnosis
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Summary:	We describe the case of a 39-year-old Caucasian woman who was admitted to the University Hospital of Antwerp with a clinical picture suggestive of adult Still's disease. Even though a transoesophageal echocardiography showed endocarditis of the aortic valve, blood cultures remained negative. Additional serological testing revealed a positive result for Bartonella henselae. Histology of the supraclavicular lymph node showed a reactive lymph node with a positive polymerase chain reaction (PCR) for Bartonella henselae. Prednisolone treatment was started in a dosage of 10 mg per day and rifampicin 600 mg/d in combination with doxycyclin 200 mg/d was given for 6 months. During therapy the patient gradually improved and signs of endocarditis disappeared on echocardiography.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3
ISSN:	1784-3286 2295-3337
DOI:	10.1179/acb.2008.030