A case of Heart Transplant After Bartonella henselae Infective Endocarditis Associated with an Implantable Cardioverter-Defibrillator

Abstract Introduction To our knowledge, only one case of acute Bartonella henselae infective endocarditis treated with heart transplantation as salvage therapy has been published. There is a paucity of literature on management of Bartonella henselae endocarditis in the pre-transplant and post-transplant periods. Case Presentation A 63-year-old Caucasian man with past medical history of heart failure with reduced ejection fraction with implantable cardioverter-defibrillator and HeartMate II left-ventricular assist device was diagnosed with presumptive Bartonella henselae infective endocarditis after presenting with infectious glomerulonephritis. He successfully underwent heart transplant with device removal and was able to discontinue chronic suppressive doxycycline therapy without recurrence of infective endocarditis. Conclusion There remains a paucity of literature on Bartonella henselae endocarditis treated with orthotopic heart transplant and this case report represents the second known case. Our case is also unique in that the patient had endocarditis associated with an implantable cardioverter-defibrillator. We hope it may serve as another resource to guide diagnosis and treatment of Bartonella henselae endocarditis associated with or without cardiac hardware, as well as monitoring for recurrent disease after transplant.