Subacute Bartonella quintana bacteremia following immunomodulatory therapy: a diagnostic challenge.
Sascha D Grossmann, Lea Herrmann, Niklas Kühn et al.
✦ AI-curated · Sources linked
Case in brief
A patient with newly diagnosed dermatomyositis presented with generalized myopathy, persistent low-grade fever, and suspected endocarditis. Despite intermittent positive blood cultures, conventional microbiological methods were inconclusive. The definitive diagnosis of subacute Bartonella quintana infection was achieved through nanopore sequencing. Treatment with doxycycline and anti-inflammatory therapy resulted in rapid clinical improvement.
What made this case unusual
The case illustrates the diagnostic challenge posed by Bartonella quintana due to its fastidious growth and immune evasion, which can lead to mismanagement.
Diagnostic / clinical pearl
Clinicians should consider nanopore sequencing as a valuable tool for diagnosing fastidious pathogens like Bartonella quintana, especially when standard microbiological methods fail.
Why it matters
This case emphasizes the need for advanced diagnostic techniques in managing complex infections, particularly in immunocompromised patients.