• S Hipp, W von der Emde, C Kulke, M Schlotter, J Schmidt, J Kikhney, A G M Hopf, A Moter, E Eszlari, W Eichinger, and M Hinterseer.
• Medizinische Klinik - Innere Medizin, Klinikum Füssen, Kliniken Ostallgäu-Kaufbeuren, Stadtbleiche 1, 87629, Füssen, Deutschland. stephan.hipp@kliniken-oal-kf.de.
• Internist (Berl). 2022 Jan 1; 63 (1): 103-109.

AbstractA 24-year-old female patient from Sierra Leone was referred to the authors' hospital after several unclear intracerebral bleeding events and an echogenic structure on the aortic valve. The patient was receiving oral anticoagulation therapy due to paroxysmal atrial fibrillation and left ventricular noncompaction. Fluorescence in situ hybridization in combination with polymerase chain reaction and sequencing revealed infective endocarditis of the mitral and aortic valve caused by Bartonella quintana. In retrospect, the intracerebral bleeding events could be identified as septic emboli with secondary haemorrhagic transformation under anticoagulation therapy. The patient showed significant clinical improvement and no further bleeding events occurred after receiving biological mitral and aortic valve replacement and several weeks of doxycycline and gentamicin antibiotic therapy.© 2021. Springer Medizin Verlag GmbH, ein Teil von Springer Nature.

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