Dual Peril: A rare case of simultaneous Bartonella and Brucella Endocarditis with unique epidemiological and clinical challenges

We present a unique case of simultaneous Bartonella and Brucella endocarditis, the first reported instance of this co-infection, highlighting significant diagnostic and therapeutic challenges. A 63-year-old female with a bioprosthetic mitral valve presented with progressive weakness, weight loss, an...

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Main Authors: Qusai Alqudah, Akankcha Alok, Vidya S. Kollu
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:IDCases
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Online Access:http://www.sciencedirect.com/science/article/pii/S2214250925000162
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author Qusai Alqudah
Akankcha Alok
Vidya S. Kollu
author_facet Qusai Alqudah
Akankcha Alok
Vidya S. Kollu
author_sort Qusai Alqudah
collection DOAJ
description We present a unique case of simultaneous Bartonella and Brucella endocarditis, the first reported instance of this co-infection, highlighting significant diagnostic and therapeutic challenges. A 63-year-old female with a bioprosthetic mitral valve presented with progressive weakness, weight loss, and a persistent dry cough. Evaluation revealed a large mitral valve vegetation, pulmonary nodules, and mediastinal adenopathy. Despite negative blood cultures and an inconclusive malignancy workup, the high clinical suspicion for culture-negative infective endocarditis prompted further serological testing, which confirmed Brucella IgM, IgG and Bartonella PCR positivity. She underwent successful redo mitral valve replacement, with pathology confirming the diagnosis. This case underscores the importance of detailed exposure history, as a kitten from a flea market emerged as a potential infection source. The coexistence of these pathogens highlights the complexity of culture-negative endocarditis and emphasizes the need for prompt, multidisciplinary management to mitigate poor outcomes.
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spelling doaj-art-84e85e0be0184efebc5f94dd52dac01f2025-08-20T02:52:58ZengElsevierIDCases2214-25092025-01-0139e0216110.1016/j.idcr.2025.e02161Dual Peril: A rare case of simultaneous Bartonella and Brucella Endocarditis with unique epidemiological and clinical challengesQusai Alqudah0Akankcha Alok1Vidya S. Kollu2University of Central Florida College of Medicine, Graduate Medical Education, 6850 Lake Nona Blvd., Orlando, FL 32827, USA; HCA Florida North Florida Hospital, Internal Medicine Residency Program, 6500 W Newberry Rd, Gainesville, FL 32605, USA; Correspondence to: 2801 NW 23RD Blvd, Gainesville, FL 32605, USA.University of Central Florida College of Medicine, Graduate Medical Education, 6850 Lake Nona Blvd., Orlando, FL 32827, USA; HCA Florida North Florida Hospital, Internal Medicine Residency Program, 6500 W Newberry Rd, Gainesville, FL 32605, USAHCA Florida North Florida Hospital, 6500 W Newberry Rd, Gainesville, FL 32605, USAWe present a unique case of simultaneous Bartonella and Brucella endocarditis, the first reported instance of this co-infection, highlighting significant diagnostic and therapeutic challenges. A 63-year-old female with a bioprosthetic mitral valve presented with progressive weakness, weight loss, and a persistent dry cough. Evaluation revealed a large mitral valve vegetation, pulmonary nodules, and mediastinal adenopathy. Despite negative blood cultures and an inconclusive malignancy workup, the high clinical suspicion for culture-negative infective endocarditis prompted further serological testing, which confirmed Brucella IgM, IgG and Bartonella PCR positivity. She underwent successful redo mitral valve replacement, with pathology confirming the diagnosis. This case underscores the importance of detailed exposure history, as a kitten from a flea market emerged as a potential infection source. The coexistence of these pathogens highlights the complexity of culture-negative endocarditis and emphasizes the need for prompt, multidisciplinary management to mitigate poor outcomes.http://www.sciencedirect.com/science/article/pii/S2214250925000162BartonellaBrucellaEndocarditisCulture-negative endocarditisInfective EndocarditisCase report
spellingShingle Qusai Alqudah
Akankcha Alok
Vidya S. Kollu
Dual Peril: A rare case of simultaneous Bartonella and Brucella Endocarditis with unique epidemiological and clinical challenges
IDCases
Bartonella
Brucella
Endocarditis
Culture-negative endocarditis
Infective Endocarditis
Case report
title Dual Peril: A rare case of simultaneous Bartonella and Brucella Endocarditis with unique epidemiological and clinical challenges
title_full Dual Peril: A rare case of simultaneous Bartonella and Brucella Endocarditis with unique epidemiological and clinical challenges
title_fullStr Dual Peril: A rare case of simultaneous Bartonella and Brucella Endocarditis with unique epidemiological and clinical challenges
title_full_unstemmed Dual Peril: A rare case of simultaneous Bartonella and Brucella Endocarditis with unique epidemiological and clinical challenges
title_short Dual Peril: A rare case of simultaneous Bartonella and Brucella Endocarditis with unique epidemiological and clinical challenges
title_sort dual peril a rare case of simultaneous bartonella and brucella endocarditis with unique epidemiological and clinical challenges
topic Bartonella
Brucella
Endocarditis
Culture-negative endocarditis
Infective Endocarditis
Case report
url http://www.sciencedirect.com/science/article/pii/S2214250925000162
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AT akankchaalok dualperilararecaseofsimultaneousbartonellaandbrucellaendocarditiswithuniqueepidemiologicalandclinicalchallenges
AT vidyaskollu dualperilararecaseofsimultaneousbartonellaandbrucellaendocarditiswithuniqueepidemiologicalandclinicalchallenges