Blood cultures were performed but were negative. White blood cell count of 13 K with 70% segs.
Laboratory workup revealed elevation in Bartonella IgG titers of >1600. PCR of the valve tissue confirming the diagnosis of Bartonella henselae endocarditis.
The patient was referred for aortic valve replacement and received a bileaflet mechanical valve without complication. His fever, myalgias, and arthralgias were resolved.
Discussion