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Volume 7, Issue 12

Subacute endocarditis with glomerulonephritis: a diagnostic and therapeutic challenge in blood culture–negative infective endocarditis Open Access

Abstract

species are increasingly recognized as a significant cause of blood culture–negative infective endocarditis. Their diagnosis is often challenging, leading to delays and suboptimal treatment outcomes.

This report includes a concise literature review and a case involving a 77-year-old male with a history of bovine aortic valve replacement. The patient presented with lethargy, fever, unintentional weight loss and acute kidney injury. Despite repeated blood cultures and extensive diagnostic evaluations yielding negative results, the definitive diagnosis was achieved post-surgery when valve PCR identified species, likely linked to cat exposure. The patient was successfully treated with an extended course of doxycycline and rifampicin, leading to clinical resolution.

This case highlights the diagnostic complexities of endocarditis, including negative blood cultures, subacute clinical presentation and its ability to mimic autoimmune glomerulonephritis, leading to unnecessary immunosuppressive therapy. It underscores the need for improved diagnostic approaches and clinician awareness to identify at-risk populations, such as those with cat exposure or poor hygiene, ensuring the correct diagnostic investigation for an early antibiotic intervention.

  • Received:
  • Accepted:
  • Published Online:
Keyword(s): Bartonella henselae , cat-scratch disease , glomerulonephritis and infective endocarditis
© 2025 The Authors
  • This is an open-access article distributed under the terms of the Creative Commons Attribution License. This article was made open access via a Publish and Read agreement between the Microbiology Society and the corresponding author’s institution.
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2025-12-18
2026-02-14

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Subacute Bartonella endocarditis with glomerulonephritis: a diagnostic and therapeutic challenge in blood culture–negative infective endocarditis
Access Microbiology 7, 001051.v3 (2025); https://doi.org/10.1099/acmi.0.001051.v3
/content/journal/acmi/10.1099/acmi.0.001051.v3
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