Remarkable recovery of a multicomplicated infective endocarditis due to Bartonella henselae a case report

Culture-negative infective endocarditis poses a substantial challenge in medical practice, accounting for 75 % of infective endocarditis cases in developed countries. This condition stems from diverse causative agents, with Bartonella emerging as the most prevalent culprit. Owing to limited comprehensive studies and established guidelines, the diagnosis of this condition remains intricate and often relies on anecdotal case reports and small series. We present a compelling case of a 60-year-old male patient who presented with severe chest pain, dyspnea, fever, and an array of additional symptoms. The clinical presentation eventually led to a diagnosis of infective endocarditis, which was unveiled through acute coronary syndrome concomitant with nephrotic syndrome, renal failure, and pancytopenia. Despite the initiation of the initial treatment regimen, the patient exhibited an inadequate response. Subsequent investigations revealed an underlying Bartonella henselae infection. Administration of doxycycline elicited notable improvements in both the patient's clinical status and pertinent laboratory parameters. This case underscores the significance of broadening the scope of diagnostic considerations to encompass less common agents such as Bartonella in cases of culture-negative infective endocarditis. • Emphasize the importance of considering rare pathogens in culture-negative cases for appropriate management. • Recognize the diagnostic and therapeutic challenges in culture-negative infective endocarditis. • Identify Bartonella henselae infection through evaluation of treatment response and further investigations.