11 December 2023
: Case report 
The Silent Threat: Bartonella quintana Endocarditis Unveiling Heart Failure and Severe Pulmonary Hypertension
Challenging differential diagnosis, Rare coexistence of disease or pathology
Daniel Boctor
1ABCDEF*, Brian Bakke1ABCDEF, John S. Chorba12ABCDEF
DOI: 10.12659/AJCR.942160
Am J Case Rep 2023; 24:e942160
Table 1. Class I American Association of Thoracic Surgery (AATS) recommendations for early valve replacement in infective endocarditis [14].
| Indication for surgery (regardless of completion of full antibiotic course) | AATS Class of recommendation | Present in this patient? |
|---|---|---|
| Severe heart failure in the setting of valve dysfunction | I | Yes |
| Left-sided endocarditis caused by highly resistant organisms (as well as Staphylococcus aureus or fungi) | I | No |
| Infective endocarditis causing complete heart block | I | No |
| Infective endocarditis causing annular or aortic abscess | I | No |
| Presence of a destructive or penetrating vegetation | I | No |
| Presence of persistent bacteremia or fever for at least 5 days | I | No |