Bartonella henselae Endocarditis in Laos - 'The Unsought Will Go Undetected'

Title
Bartonella henselae Endocarditis in Laos - 'The Unsought Will Go Undetected'
Authors
Rattanavong, S; Fournier, PE; Chu, V; Frichitthavong, K; Kesone, P; Mayxay, M; Mirabel, M; Newton, PN
Keywords
RICKETTSIA; QUINTANA; FLEAS; CATS; DOGS
Issue Date
2014
Publisher
PLOS NEGLECT TROP D
Citation
PLOS NEGLECT TROP D;Plos Neglect. Trop. Dis.;DEC;2014;8;12
Abstract
Background: Both endocarditis and Bartonella infections are neglected public health problems, especially in rural Asia. Bartonella endocarditis has been described from wealthier countries in Asia, Japan, Korea, Thailand and India but there are no reports from poorer countries, such as the Lao PDR (Laos), probably because people have neglected to look. Methodology/Principal Findings: We conducted a retrospective (2006-2012), and subsequent prospective study (2012-2013), at Mahosot Hospital, Vientiane, Laos, through liaison between the microbiology laboratory and the wards. Patients aged >1 year admitted with definite or possible endocarditis according to modified Duke criteria were included. In view of the strong suspicion of infective endocarditis, acute and convalescent sera from 30 patients with culture negative endocarditis were tested for antibodies to Brucella melitensis, Mycoplasma pneumoniae, Bartonella quintana, B. henselae, Coxiella burnetii and Legionella pneumophila. Western blot analysis using Bartonella species antigens enabled us to describe the first two Lao patients with known Bartonella henselae endocarditis. Conclusions/Significance: We argue that it is likely that Bartonella endocarditis is neglected and more widespread than appreciated, as there are few laboratories in Asia able to make the diagnosis. Considering the high prevalence of rheumatic heart disease in Asia, there is remarkably little evidence on the bacterial etiology of endocarditis. Most evidence is derived from wealthy countries and investigation of the aetiology and optimal management of endocarditis in low income countries has been neglected. Interest in Bartonella as neglected pathogens is emerging, and improved methods for the rapid diagnosis of Bartonella endocarditis are needed, as it is likely that proven Bartonella endocarditis can be treated with simpler and less expensive regimens than nullconventional'' endocarditis and multicenter trials to optimize treatment are required. More understanding is needed on the risk factors for Bartonella endocarditis and the importance of vectors and vector control.
URI
http://hdl.handle.net/11267/2314
ISSN
1935-2735
Appears in Collections:
3.University of Health Sciences > Faculty of postgraduate > Journal articles
Files in This Item:

qrcode

Items in LAOSpace are protected by copyright, with all rights reserved, unless otherwise indicated.