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Volume 14, Number 7—July 2008

Letter

Bartonella quintana and Coxiella burnetii as Causes of Endocarditis, India

Nandhakumar Balakrishnan*, Thangam Menon*, Pierre-Edouard Fournier†, and Didier Raoult†Comments to Author 
Author affiliations: *University of Madras, Taramani, Chennai, India; †Universite de la Mediterranee, Marseille, France;

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Table

Clinical findings and causative agent for 9 patients with blood culture–negative endocarditis, India, August 2005–December 2006*

Patient age, y/sex Underlying cardiac condition Echocardiographic findings IgG titer to Bartonella spp. IgG titer to Coxiella burnetii phase I Causative agent
25/F Right atrium fistula Vegetation attached to tricuspid valve 400 100 Bartonella quintana
46/M Rheumatic heart disease Vegetation attached
to anterior mitral
leaflet 0 800 Coxiella burnetii
14/M Rheumatic heart disease Vegetation attached to tip of anterior mitral leaflet 200 0 B. quintana
13/M Rheumatic heart disease Vegetation attached to anterior mitral leaflet 200 0 B. quintana
28/M Bicuspid aortic valve disease Vegetation attached to anterior coronary cusp of aortic valve 400 0 B. quintana
30/M Rheumatic heart disease Vegetation attached to both anterior and posterior mitral leaflet extending to chordae tendinae 200 0 B. quintana
50/F Rheumatic heart disease Vegetation attached to noncoronary cusp of aortic valve 400 0 Bartonella spp.
40/M Bicuspid aortic valve disease Calcified aortic valve 400 0 B. quintana
40/M Double chamber right ventricle and subaortic perimembranous ventricular septal defect Vegetation attached to right atrium anterior leaf of tricuspid valve and lateral cusp of pulmonary valve 800 0 B. quintana

*Ig, immunoglobulin.

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