Stroke as a manifestation of acute Bartonella henselae endocarditis]

Bartonella, a small gram-negative bacillus, causes a variety of diseases and presents with different clinical manifestations, one of which is infective endocarditis (IE). IE due to B. henselae is associated with a high risk of morbidity and mortality due to the destructive potential of the organism to the heart valves and due to the great risk of embolic complications.A 37-year-old male was admitted to our hospital due to sub-febrile fever and weakness. Investigation revealed he had IE caused by B. henselae. His mitral valve was severely damaged and he experienced a cerebrovascular event, caused by septic emboli. The severe damage to the mitral valve and the presence of septic emboli necessitated valvular replacement surgery. The case involved a therapeutic dilemma, due to the patient's neurological complications.Since B. henselae is an important pathogen associated with culture-negative IE, there should be a high index of suspicion for the presence of this pathogen in cases presenting with signs of infection associated with embolic events. This condition requires a careful diagnostic and therapeutic approach.