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. 2005 Feb;11(2):216-24.
doi: 10.3201/eid1102.040668.

Bacterial zoonoses and infective endocarditis, Algeria

Akila Benslimani  1 , Florence Fenollar, Hubert Lepidi, Didier Raoult
Affiliations

Bacterial zoonoses and infective endocarditis, Algeria

Akila Benslimani et al. Emerg Infect Dis. 2005 Feb.

Abstract

Blood culture-negative endocarditis is common in Algeria. We describe the etiology of infective endocarditis in this country. Samples from 110 cases in 108 patients were collected in Algiers. Blood cultures were performed in Algeria. Serologic and molecular analysis of valves was performed in France. Infective endocarditis was classified as definite in 77 cases and possible in 33. Causative agents were detected by blood cultures in 48 cases. All 62 blood culture-negative endocarditis cases were tested by serologic or molecular methods or both. Of these, 34 tested negative and 28 had an etiologic agent identified. A total of 18 infective endocarditis cases were caused by zoonotic and arthropodborne bacteria, including Bartonella quintana (14 cases), Brucella melitensis (2 cases), and Coxiella burnetii (2 cases). Our data underline the high prevalence of infective endocarditis caused by Bartonella quintana in northern Africa and the role of serologic and molecular tools for the diagnosis of blood culture-negative endocarditis.

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Figures

Figure 1
Figure 1
Map of Algeria. Courtesy of Wikipedia Encyclopedia (http://en.wikipedia.org/wiki).
Figure 2
Figure 2
Western blot performed with a serum sample from a patient with an endocarditis caused by Bartonella quintana. Molecular masses (in kilodaltons) are given to the left of the panels. A) Untreated serum sample analyzed with B. quintana (lane 1), B. henselae (lane 2), B. elizabethae (lane 3), B. vinsonii subsp. arupensis (lane 4), and B. vinsonii subsp. berkhoffii (lane 5) antigens. B) B. quintana–adsorbed serum sample analyzed with B. quintana (lane 1), B. henselae (lane 2), B. elizabethae (lane 3), B. vinsonii subsp. arupensis (lane 4), and B. vinsonii subsp. berkhoffii (lane 5) antigens. C) B. henselae–adsorbed serum analyzed with B. quintana (lane 1), B. henselae (lane 2), B. elizabethae (lane 3), B. vinsonii subsp. arupensis (lane 4), and B. vinsonii subsp. berkhoffii (lane 5) antigens.
Figure 3
Figure 3
A) Section of an aortic valve from a patient with Bartonella endocarditis. Note the extensive fibrosis of the connective valve tissue (arrowhead), the vegetation (*), and the low inflammatory infiltrate of the valve tissue (hematoxylin-phloxine-saffron, original magnification 100x). B) Resected valve with Bartonella quintana infection showing darkly stained bacilli consistent with Bartonella. Note the numerous clusters of argyrophilic bacteria present in the valvular vegetation (Warthin-Starry silver, original magnification 1,000x). C) Immunohistochemical detection of B. quintana in a resected valve from a patient with Bartonella endocarditis. Note the extracellular distribution of the bacterial colonies (*) in the valvular vegetation (polyclonal antibody and hematoxylin counterstain, original magnification 250x).
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