What is the role of lab testing in the diagnosis of bartonellosis (Bartonella infection)-related bacteremia?

Updated: Jun 19, 2019
  • Author: Kassem A Hammoud, MD; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Answer

Laboratory studies include the following:

  • Patients typically exhibit increased leukocytes with occasional thrombocytopenia or albuminuria. Bacteremia is not usually detected.

  • Patients with prolonged bacteremia may have culture-negative endocarditis because Bartonella species do not grow on standard blood culture media. Special media must be used. B henselae and B quintana infections can cause culture-negative endocarditis. Bartonella alsatica was isolated from the valve of a patient with endocarditis. [33] Most cases of Bartonella endocarditis involve native valves, but infection of prosthetic valves is possible. [34]

  • Antibody titers are helpful in confirming the diagnosis.

As expected, persons with alcoholism and those who are homeless typically develop B quintana endocarditis (75% of cases), while persons with exposure to cats are more likely to harbor B henselae (25% of cases). Other Bartonella species are rarely implicated. Although many children are frequently exposed to cats, even those with catscratch disease rarely develop Bartonella endocarditis.


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