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Acute Infective Endocarditis and Its Mimics in the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
It is important to recognize that chronic forms of IE culture-negative infective endocarditis may be admitted to the CCU because of acute clinical deterioration. They may well be misdiagnosed as mimics of IE or as a variant of NIE. A well-obtained epidemiological history is the first step in arriving at the correct diagnosis. For example, Bartonella spp. IE infects those exposed to cats (B. henselae) or the homeless with lice infection (Bartonella quintana). Legionella IE primarily infects prosthetic valves implanted in facilities with a history of outbreaks of Legionalla [7]. The NIE or HCIE has to be considered in older patients whose symptoms developed after 72 hours of hospitalization or that developed within 60 days of hospitalization, during which a procedure was performed with significant potential for producing a BSI [8,9].
Trimethoprim and Trimethoprim–Sulfamethoxazole (Cotrimoxazole)
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Jason A. Trubiano, M. Lindsay Grayson
Contrary to the findings of early limited studies, most strains of Bordetella pertussis are not susceptible to TMP and CoT in concentrations that are achievable in vivo (Zackrisson et al., 1983; Mortensen and Rodgers, 2000). Nonetheless, CoT for 7 days has been suggested in a recent Cochrane review to be an alternative eradication therapy for B. pertussis (Altunaiji et al., 2005, 2007). The activity of CoT against B. parapertussis is lower than against B. pertussis (Mortensen and Rodgers, 2000). Pasteurella multocida is quite susceptible (Mortensen et al., 1998). CoT has modest activity against Bartonella quintana, B. henselae, and some other less common Bartonella species (Maurin et al., 1995). Brucella spp., including B. melitensis, are highly susceptible to CoT (Robertson et al., 1973; Turkmani et al., 2006; Marianelli et al., 2007), although much higher MIC values in the resistant range will be obtained on some media (López-Merino et al., 2004).
Bacterial and Atypical Mycobacterial Infections
Published in Clay J. Cockerell, Antoanella Calame, Cutaneous Manifestations of HIV Disease, 2012
Kumar Krishnan, Antoanella Calame, Clay J. Cockerell
First identified in 1983, bacillary angiomatosis (BA) is a vascular infection caused by Bartonella species. It is a rare cutaneous disease that presents most commonly in moderately immunocompromised HIV-positive patients, such as those with CD4 cell counts of less than 200 × 106/l. Some studies suggest that the incidence of BA within the HIV-positive population is approximately 0.1%. The etiological agents have been identified as both Bartonella henselae, the organism responsible for cat scratch disease, and Bartonella quintana, the causative organism of trench fever. The skin as well as many different visceral organs may be involved, but the most common extracutaneous site of involvement is the liver, with peliosis hepatis. Bacteremia and sepsis are also complications.24
Clinical Features and Multimodal Imaging in Atypical Posterior Uveitis Secondary to Bartonella Henselae Infection
Published in Ocular Immunology and Inflammation, 2022
Zachary A. Koretz, Anna Apostolopoulou, Edwin Chen, Oliver Beale, Peter Veldkamp, John Alex Viehman, José-Alain Sahel, Jay Chhablani, Kunal K. Dansingani, Marie-Hélène Errera, Gabrielle R. Bonhomme
Blood cultures, urinalysis, and CSF studies were all unrevealing. Infectious workup eventually returned with a positive Bartonella henselae IgM titer of 1:20 (positive ≥ 1:20) and an equivocal IgG titer of 1:128 (positive ≥ 1:256) by indirect immunofluorescence assay (IFA). The remainder of her infectious work-up was entirely negative, including: Lyme, HIV, syphilis, hepatitis B and C, Quantiferon TB Gold, Bartonella quintana and Brucella IgM and IgG, Toxoplasma IgM and IgG, Histoplasma urine antigen, Cryptococcus antigen, Blastomyces antibody, West Nile virus IgM, CMV IgM, and EBV IgM. Immune-mediated causes of posterior uveitis were considered, including: sarcoidosis, systemic lupus erythematosus, Behcet’s disease, and vasculitides, but all of the relevant blood tests and corresponding clinical history were negative. Specifically, the following tests were negative or non-reactive: ANA, ANCA, rheumatoid factor, anti-CCP, cryoglobulin screen, antimitochondrial antibody, anti-smooth muscle antibody, anti-RNP, anti-SSA, and anti-SSB, SCL-70, antiphospholipid IgG, and ribosomal P antibody. Her ACE level, HLA-B27 and complement levels (C3 and C4) were all within normal limits.
Cat Scratch Disease: Not a Benign Condition
Published in Ocular Immunology and Inflammation, 2018
Sandra Barros, Gabriel Costa de Andrade, Cecilia Cavalcanti, Heloisa Nascimento
Bartonela henselae has been demonstrated to be the principal cause of CSD; however, other agents have also been reported such as Bartonella quintana, Bartonella grahamii, and Bartonella elizabethae,4,5 especially in atypical disease or when serology is negative. It is transmitted to humans through a cat scratch, cat bite, cat saliva, or cat flea bite (mainly Ctenocephalides felis) although Ixodes ricinus plays a major role in Western Europe.6–8