Bartonella alsatica endocarditis in a French patient in close contact with rabbits

Bartonella species are Gram-negative bacilli that belong to the alpha 2 subgroup of Proteobacteria and are agents of blood culture-negative endocarditis (BCNE) [1]. Among the Bartonella species involved in BCNE, B. henselae and B. quintana are the main causative agents [1]. However, endocarditis due to other rare Bartonella spp. have been reported, including B. elizabethae, B. vinsonii subsp. berkhoffii, B. vinsonii subsp. arupensis, B. koehlerae and recently B. alsatica [2,3]. B. alsatica is a recently identified agent that causes bacteraemia in healthy wild rabbits in Alsace, France [4]. To the best of our knowledge there is only one case of infection with this species in humans, i.e, an endocarditis in a 74-year-old man who was in close contact with rabbits [2]. In the present study, we report the second human case of B. alsatica endocarditis in a French patient in close contact with rabbits, diagnosed using specific serogical methods, including microimmunofluorescence and Western blot with cross-adsorption studies.