Journal Article

Bartonella quintana Endocarditis in Persons Experiencing Homelessness, New York, New York, USA, 2020–2023

Keller, Marina, Wroblewski, Danielle, Kupferman, Tania, Marx, Grace E., Rich, Shannan N., Reagan-Steiner, Sarah, Kodama, Rich, Corvese, Gabriella, Bullock, Hannah, Ackelsberg, Joel, Kuehnert, Matthew J., Gnanaprakasam, Rachel, Bhatnagar, Julu, Feldmesser, Marta, Juretschko, Stefan, Carnes, Marlene Deleon, Agladze, Mariam, Mitchell, Kara, Kleinman, George M.

2024

Overview

Bartonella quintana infection can lead to bacillary angiomatosis, peliosis hepatis, chronic bacteremia, and culture-negative endocarditis. Transmitted by the human body louse (Pediculus humanus humanus), B. quintana infection has become an emerging disease in recent decades among persons experiencing homelessness. By using retrospective laboratory surveillance, we identified 5 cases of left-sided, culture-negative B. quintana endocarditis among persons in New York, New York, USA, during January 1, 2020-November 23, 2023. Identifications were made by using molecular assays. All patients experienced unsheltered homelessness in the year before hospitalization. Of those patients, 4 experienced heart failure, 3 renal failure, and 2 embolic strokes; 2 died. Aortic valve replacement occurred in 4 cases. A history of possible body louse infestation was found in 4 cases. Clinicians should consider housing status and history of lice exposure in patients with suspected bartonellosis and have a low threshold for diagnostic testing and empiric treatment in patients experiencing homelessness.

• Publisher: U.S. National Center for Infectious Diseases,Centers for Disease Control and Prevention
• Subject: Acidosis / Adult / Aged / Alcohol use / Anemia / Animals / bacteria / bacterial infection / Bartonella / Bartonella quintana / Bartonella quintana - genetics / Bartonella quintana - isolation & purification / Care and treatment / Diagnosis / Distribution / Edema / Emergency medical care / Endocarditis / Endocarditis in Persons Experiencing Homelessness, New York, New York, USA, 2020–2023 / Endocarditis, Bacterial - diagnosis / Endocarditis, Bacterial - epidemiology / Endocarditis, Bacterial - microbiology / Female / Health aspects / Health surveillance / Homeless people / Homelessness / Hospitalization / Hospitals / Humans / Ill-Housed Persons / Infections / Kidney diseases / Laboratories / Lice / Male / Mental health / Middle age / Middle Aged / New York - epidemiology / Patients / Retrospective Studies / Trench Fever - diagnosis / Trench Fever - epidemiology / Trench Fever - microbiology / Vegetation / Verruga peruana