Abstract
Blood culture–negative endocarditis is common in Algeria. We describe the etiology of infective endocarditis in this country. Samples from 110 cases in 108 patients were collected in Algiers. Blood cultures were performed in Algeria. Serologic and molecular analysis of valves was performed in France. Infective endocarditis was classified as definite in 77 cases and possible in 33. Causative agents were detected by blood cultures in 48 cases. All 62 blood culture–negative endocarditis cases were tested by serologic or molecular methods or both. Of these, 34 tested negative and 28 had an etiologic agent identified. A total of 18 infective endocarditis cases were caused by zoonotic and arthropodborne bacteria, including Bartonella quintana (14 cases), Brucella melitensis (2 cases), and Coxiella burnetii (2 cases). Our data underline the high prevalence of infective endocarditis caused by Bartonella quintana in northern Africa and the role of serologic and molecular tools for the diagnosis of blood culture–negative endocarditis.
Highlights
Blood culture–negative endocarditis is common in Algeria
The rate of blood culture–negative endocarditis in Algeria is as high as 76% [2], which leads to difficulty in antimicrobial treatment
Endocarditis cases with fastidious agents escape microbiologic diagnosis classically applied in Algerian laboratories
Summary
Blood culture–negative endocarditis is common in Algeria. We describe the etiology of infective endocarditis in this country. All 62 blood culture–negative endocarditis cases were tested by serologic or molecular methods or both. Our data underline the high prevalence of infective endocarditis caused by Bartonella quintana in northern Africa and the role of serologic and molecular tools for the diagnosis of blood culture–negative endocarditis. New serologic and molecular tools, which have improved the etiologic diagnosis of infective endocarditis, have not been used to clarify the unknown role of fastidious bacteria [3,4,5,6,7,8,9,10,11]. The rate of blood culture–negative endocarditis in Algeria is as high as 76% [2], which leads to difficulty in antimicrobial treatment. The capital and largest city with ≈5 million inhabitants, has 7 hospitals, including 6 cardiology and 5 cardiac surgery wards These wards receive patients with endocarditis, either for diagnosis and
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