ABSTRACT
Bartonella species are gram-negative coccobacilli that are globally recognized as significant pathogens causing zoonotic infections. Among Bartonella species, B. henselae, B. quintana, and B. bacilliformis are prominent pathogens causing infections in humans, often manifesting as infective endocarditis. Bartonella endocarditis can pose diagnostic challenges due to its indolent presentation and limitations of standard microbiological culture techniques to identify the organism. We report a case of a 23-year-old male, who initially presented with the manifestations of hepatosplenic T-cell lymphoma, later diagnosed with blood culture-negative endocarditis caused by B. henselae. The patient had a complicated clinical course including pancytopenia, hepatosplenomegaly, and severe aortic valve regurgitation. Despite negative blood cultures, diagnostic clues included persistent fevers and bicuspid aortic valve with abscess. High Bartonella IgG titers (>1:800) supported the diagnosis. This case underscores the importance of considering Bartonella species in patients with suspected endocarditis, particularly in those with predisposing factors and negative blood cultures. Diagnosis relies heavily on serologic assays due to low sensitivity of conventional culture methods. Treatment involves a multidisciplinary approach with antibiotics and surgical intervention for optimal outcomes. Timely recognition and management are crucial to mitigate the high mortality associated with Bartonella endocarditis, and we hope this article offers insight for clinicians.
Subject(s)
Bartonella henselae , Endocarditis, Bacterial , Lymphoma, T-Cell , Humans , Male , Bartonella henselae/isolation & purification , Endocarditis, Bacterial/microbiology , Endocarditis, Bacterial/diagnosis , Endocarditis, Bacterial/drug therapy , Lymphoma, T-Cell/complications , Lymphoma, T-Cell/diagnosis , Young Adult , Splenic Neoplasms/complications , Cat-Scratch Disease/diagnosis , Cat-Scratch Disease/complications , Cat-Scratch Disease/drug therapy , Liver NeoplasmsABSTRACT
Gamma-hydroxybutyrate (GHB) is a sedative often abused for its euphoric and relaxant effects. This case report looks to discuss a case of GHB intoxication in a 57-year-old gentleman, which resulted in an 11-day hospitalization due to withdrawal effects of his GHB dependence. His hospitalization and care primarily followed usual supportive care treatments; however, a novel use of baclofen to further expedite patient sedation reversal was done. This case report looks to explore the management of this patient's GHB toxicity and eventual resolution of symptoms using baclofen.