Outcome and treatment of Bartonella endocarditis

Arch Intern Med. 2003 Jan 27;163(2):226-30. doi: 10.1001/archinte.163.2.226.


Background: Endocarditis caused by Bartonella species is a potentially lethal infection characterized by a subacute evolution and severe valvular lesions.

Objectives: To evaluate the outcome of patients with Bartonella endocarditis and to define the best antibiotic regimen using the following measures: recovery, relapse, or death.

Methods: We performed a retrospective study on 101 patients who were diagnosed in our laboratory as having Bartonella endocarditis between January 1, 1995, and April 30, 2001. Bartonella infection was diagnosed using immunofluorescence with a 1:800 cutoff, polymerase chain reaction amplification of DNA, and/or culture findings of Bartonella species from whole blood, serum, and/or valvular biopsy specimens. A standardized questionnaire was completed by investigators for each patient.

Results: Twelve of the 101 patients died and 2 relapsed. Patients receiving an aminoglycoside were more likely to fully recover (P =.02), and those treated with aminoglycosides for at least 14 days were more likely to survive than those with shorter therapy duration (P =.02).

Conclusion: Effective antibiotic therapy for Bartonella endocarditis should include an aminoglycoside prescribed for a minimum of 2 weeks.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Aminoglycosides
  • Anti-Bacterial Agents / therapeutic use*
  • Bartonella Infections / drug therapy*
  • Endocarditis, Bacterial / drug therapy*
  • Heart Valve Diseases / microbiology
  • Humans
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome


  • Aminoglycosides
  • Anti-Bacterial Agents