A 56-year-old male presented with persistent fever, weight loss, and night sweats, initially diagnosed with culture-negative endocarditis. Despite antibiotic therapy, his condition worsened, necessitating aortic and mitral valve replacement. Histopathology of the excised valves revealed vegetations. Subsequent 16S rRNA gene sequencing performed on the valve tissue definitively identified Bartonella quintana. This case highlights the critical role of molecular diagnostics, specifically 16S rRNA sequencing, in identifying fastidious organisms like Bartonella species in culture-negative endocarditis, guiding appropriate treatment, and improving patient outcomes.
Key note: Molecular diagnostics are crucial for identifying fastidious pathogens in culture-negative endocarditis.