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Case Reports
. 2020 Dec 31;5(4):256-260.
doi: 10.3138/jammi-2020-0013. eCollection 2020 Dec.

Bartonella quintana infective endocarditis in northern Alberta: A case report

David Ryan Kleinman  1 , John C Lam  2 , Julinor Bacani  3 , Gregory Tyrrell  4 , Shannon Lee Turvey  2
Affiliations
Case Reports

Bartonella quintana infective endocarditis in northern Alberta: A case report

David Ryan Kleinman et al. J Assoc Med Microbiol Infect Dis Can. .

Abstract
in English, French

We present a case of Bartonella quintana infective endocarditis requiring valvular surgery in an Indigenous patient from northern Alberta that was identified months after initial presentation to hospital with undifferentiated laboratory abnormalities. Syndromes caused by B. quintana are often challenging to diagnose due to their non-specific presentation and the difficulty in detecting this organism using traditional culture methods. Additionally, risk factors for B. quintana include marginal housing and alcohol use disorder, which often impede access to health care. Indigenous patients in northern Canada often face worse health outcomes compared with other regions owing to poor economic conditions, substandard housing, and limited access to health care resources. Given that risk factors for B. quintana are prevalent throughout northern Canada and that this infection is difficult to diagnose, we surmise that the prevalence of B. quintana infection is underestimated in northern Canada.

Les auteurs présentent un cas d’endocardite infectieuse à Bartonella quintana exigeant une chirurgie valvulaire chez un patient autochtone du nord de l’Alberta, dépisté des mois après la première consultation à l’hôpital, alors que les anomalies de laboratoires étaient indifférenciées. Les syndromes causés par le Bartonella quintana sont souvent difficiles à diagnostiquer à cause de leur présentation non spécifique et de la difficulté à déceler cet organisme au moyen des méthodes de culture classiques. De plus, les facteurs de risque de Bartonella quintana incluent des logements inférieurs aux normes et des troubles de l’usage de l’alcool, qui nuisent souvent à l’accès aux soins. Les patients autochtones du nord du Canada présentent souvent des résultats cliniques pires que ceux d’autres régions à cause des mauvaises conditions économiques, des logements inférieurs aux normes et de l’accès limité aux ressources de santé. Puisque les facteurs de risque de Bartonella quintana prévalent dans tout le nord du Canada et que cette infection est difficile à diagnostiquer, les auteurs postulent que la prévalence d’infection à Bartonella quintana est sous-estimée dans cette région.

Keywords: Bartonella quintana; bacterial; bactérien; endocardite; endocarditis; populations vulnérables; vulnerable populations.

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Conflict of interest statement

The authors have nothing to disclose.

Figures

Figure 1:
Figure 1:
(a) Gross valve specimen; (b) H&E stain of the valve; (c) Gram stain of the valve, with faint pink weakly staining Gram-negative bacilli; (d) Warthin–Starry stain of the valve, with silver staining revealing a high organism burden within the specimen; (e) Giemsa stain confirming the burden of B. quintana within the valve; (f) electron microscopy showing B. quintana at 8000x magnification H&E = Hematoxylin and eosin
See this image and copyright information in PMC

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