Bordetella hinzii Endocarditis, A Clinical Case Not Previously Described

Abstract

Objective

To review infections by Bordetella hinzii.

Materials and methods

A 79-year-old male patient, with a chronic aortic valve biological prosthesis, presented to hospital because of fever. First examinations were normal. However, 72 hours later B. hinzii was isolated in blood cultures, and so meropenem was prescribed. Nevertheless, fever and B. hinzii bacteraemia were still present 7 days later.

Results

The transoesophageal echocardiogram revealed an enlarged image suggesting a periprosthetic abscess, confirmed with a PET-CT scan. The patient was sent for cardiac surgery, and biopsy samples confirmed the presence of B. hinzii.

Conclusion

There are very few cases of B. hinzii infection in humans. Ours is the first described case of B. hinzii endocarditis.

LEARNING POINTS

• Bordetella hinzii is commonly detected in poultry but very few cases have been described in humans since it was first isolated in 1994. Some type of immunosuppression is identified in 90% of patients.

• B. hinzii is frequently resistant to many antibiotics including β-lactams, macrolides, quinolones and cephalosporins. The diagnosis is often difficult using conventional phenotypic methods, so genotypic methods may be necessary for confirmation.

• Ours is the first described case of infection by B. hinzii with endocardial-vascular involvement. However, cases of endocarditis due to other Bordetella species such as B. holmesii have been documented.