Revolutionizing endocarditis diagnosis: AI meets metagenomics for rare Bartonella detection

<i>Bartonella</i> endocarditis is notoriously challenging to diagnose due to its insidious onset, nonspecific symptoms, and the limitations of conventional culture-based techniques. Artificial intelligence (AI)-driven metagenomic next-generation sequencing (mNGS) represents a transformative diagnostic approach by integrating machine learning algorithms with culture-independent sequencing data to improve accuracy and sensitivity. This technique overcomes barriers such as culture bottlenecks and post-surgical sample limitations, achieving high diagnostic specificity while enabling the detection of rare or novel pathogens. Despite challenges including limited reference databases, contamination risks, and cost-related barriers in low-resource settings, AI-enhanced metagenomics offers a promising path toward faster and more precise diagnosis of <i>Bartonella</i> endocarditis. Its integration into clinical workflows, supported by continuous algorithm development, cost optimization, and standardized protocols, has the potential to improve patient outcomes in rare infectious diseases.