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PubMedDate not supplied

Unraveling mysteries associated with cat-scratch disease, bacillary angiomatosis, and related syndromes.

The search for the infectious agents responsible for cat-scratch disease, bacillary angiomatosis, and related syndromes has a long and often circuitous history. Recognition of the etiologic agents and a new understanding of the fundamental features of the epidemiology and natural history of modern day Bartonella (formerly Rochalimaea)-associated diseases culminate a multipartite story that combines clinical medicine, traditional microbiology, and novel technological approaches to solve a long-standing enigma.

AIDS-Related Opportunistic Infections↗
PubMed1997

Bartonella spp. as emerging human pathogens.

Members of the genus Bartonella (formerly Rochalimaea) were virtually unknown to modern-day clinicians and microbiologists until they were associated with opportunistic infections in AIDS patients about 6 years ago. Since that time, Bartonella species have been associated with cat scratch disease, bacillary angiomatosis, and a variety of other disease syndromes. Clinical presentation of infection with Bartonella ranges from a relatively mild lymphadenopathy with few other symptoms, seen in cat scratch disease, to life-threatening systemic disease in the immunocompromised patient. In some individuals, infection manifests as lesions that exhibit proliferation of endothelial cells and neovascularization, a pathogenic process unique to this genus of bacteria. As the spectrum of disease attributed to Bartonella is further defined, the need for reliable laboratory methods to diagnose infections caused by these unique organisms also increases. A brief summary of the clinical presentations associated with Bartonella infections is presented, and the current status of laboratory diagnosis and identification of these organisms is reviewed.

Animals↗
PubMed2002

Prevalence of Bartonella species causing bacteraemia in domesticated and companion animals in the United Kingdom.

Between October 1999 and February 2000, 691 blood samples examined routinely for either haematological or virological assessment were screened by culture for the presence of Bartonella species. They came from 615 animals: 360 cats, 211 dogs, 27 horses, 16 cattle and a gorilla. The samples were incubated for long periods on 10 per cent horse blood agar at 37 degrees C in an atmosphere containing 5 per cent carbon dioxide. Isolates were obtained from 35 samples from 34 (9.4 per cent) of the cats, but not from any of the other animals. Comparison of citrate synthase gene sequences from the isolates indicated that they were all Bartonella henselae. Analysis of 16S rRNA gene fragments indicated that 30 of the cats were infected solely with B henselae genotype II, two were infected solely with B henselae genotype I and two were infected with both genotypes.

Animals↗
PubMed2005

[Diseases produced by Bartonella].

The genus Bartonella is cause of a broad number of emerging and re-emerging infectious diseases. Clinical manifestations depend on the implicated Bartonella sp. and the immunity of the host. Because there is not a universal therapy for this infection, treatment should be chosen individually. Bartonella sp. is responsible of potentially serious clinical pictures (endocarditis, chronic bacteremia, bacillary angiomatosis, Carrion's disease, etc.), so clinical suspicion, a quick diagnosis and an early treatment provide a better resolution.

Anti-Bacterial Agents↗
PubMed2002

Inoculation with Bartonella henselae followed by feline herpesvirus 1 fails to activate ocular toxoplasmosis in chronically infected cats.

Infection by Toxoplasma gondii is very common in cats although most remain disease free. The factors that trigger development of uveitis in some cats infected with T gondii have not been elucidated, but infection by more than one organism may be contributory. In this study, cats chronically infected with T gondii were inoculated with Bartonella henselae followed by FHV-1 to test the hypothesis that immune stimulation by multiple infections will reactivate ocular toxoplasmosis. Anterior uveitis and chorioretinitis were not detected in the cats with chronic T gondii infection thus allowing rejection of the hypothesis using this experimental design.

Animals↗
PubMed2002

Unilateral neuroretinitis and periparillary serous retinal detachment in cat-scratch disease.

Cat-scratch disease is a self-limited infection characterized by subacute regional lymphadenitis, which is usually preceded by a history of being scratched by a cat infected with the Bartonella species. Neuroretinitis, retinochoroiditis, isolated papillitis and peripapillary angiomatosis are features of posterior segment involvement. However, vision loss is very rare. We report a patient with cat-scratch disease associated with unilateral neuroretinitis and peripapillary serous retinal detachment, and discuss its fluorescein and indocyanine green angiographic features.

Adolescent↗
PubMed1995

Detection of Bartonella (Rochalimaea) henselae bacteremia using BacT/Alert blood culture system.

Bartonella henselae was isolated from the blood of five febrile immunosuppressed patients using BacT/Alert (Organon Teknika, Durham, NC) automated microbial detection system. An immunofluorescence assay (using 1:1000 dilutions) was used to confirm identification of fastidious, pleomorphic, non-Gram staining, argyrophilic bacilli displaying rachety motility that had been presumptively identified as Bartonella spp. The practicality of identification of Bartonella henselae using goat antisera for use in a routine clinical microbiology laboratory was demonstrated by this study.

AIDS-Related Opportunistic Infections↗
PubMed2003

Experimental infection of human erythrocytes from alcoholic patients with Bartonella quintana.

Bartonella spp. are found in the erythrocytes of their specific natural hosts and B. quintana bacteremia is associated epidemiologically with lice, alcoholism, and homelessness. The aim of our study was to compare the growth and the number of bacteria per erythrocyte in vitro in laboratory-infected red blood cells from alcoholic patients versus normal blood donor erythrocytes. Enumeration of bacteria was performed either with plate counting or with a real-time PCR quantitative assay. Number of bacteria per cell was determined using immunofluorescence assay and laser confocal microscopy. Although the number of bacteria after 4 days of incubation was similar in the two groups of erythrocytes, we found that the distribution of bacteria per erythrocyte in the two groups was different. Erythrocytes from alcoholics contain significantly more bacteria per cell than erythrocytes from blood donors. Our results suggest that there is a link between alcoholism and infections of B. quintana that may be due to the macrocytosis of erythrocytes.

Alcoholism↗
PubMed2000

Patterns of infection of haemoparasites in the fat sand rat, Psammomys obesus, in Tunisia, and effect on the host.

Two bacterial and one protozoan blood parasite, belonging to the genera Bartonella, Borrelia and Babesia, were studied in a Tunisian population of Psammomys obesus. Seasonal changes in the abundance of the parasites and host were monitored in a longitudinal field survey lasting 17 months. Blood samples collected during eight rodent-trapping sessions, between September 1995 and January 1997, were examined microscopically. Bartonella sp. showed a seasonal pattern, with most transmission occurring in summer and autumn; most rodents (90%) were infected in August-September, when they were at low density and adult. Borrelia sp. showed low prevalences, with few seasonal fluctuations, and Babesia sp. showed an intermediate pattern, differing from one year to another. In the cohort of adult rats, infections with Bartonella sp. and Babesia sp. were less prevalent in winter than in the previous summer. Single and mixed infections were equally prevalent in females and males, and in sexually active and inactive adults. In addition, infection had no apparent effect on the weight of adult P. obesus. The observation that the proportion of erythrocytes infected with Bartonella sp. decreased with increasing host age is probably indicative of some acquired immunity to this micro-organism. The absence of detectable infections with Borrelia sp. in old rats indicates that the prevalence and/or intensity of infection declines with host age or that infected animals die selectively. However, there was no indication that any of these parasites combined sufficient pathogenicity and abundance to have any measurable effect on the rodent population.

Animals↗
PubMed1997

Bacillary angiomatosis: presentation of six patients, some with unusual features.

Bacillary angiomatosis (BA) is an unusual systemic vascular proliferation seen predominantly in patients with the acquired immunodeficiency syndrome. These vascular lesions are probably due to infection with a Bartonella species, most often B. henselae and, in some patients, B. quintana. BA is treatable and often curable, but without therapy, may be life-threatening. Clinically, the lesions, when superficial, are said to often resemble pyogenic granulomas, appearing polypoid histologically with an epidermal collarette. We now report six patients, three of whom showed lesions of BA morphologically and histologically distinct from the other patients reported to date. Two patients lesions appeared clinically as violaceous plaques and tumours resembling Kaposi's sarcoma; one of them had lesions histologically reminiscent of a papular angiokeratoma; and the other had lesions histologically suggestive of a combination of Kaposi's sarcoma and BA. Another patient presented with soft subcutaneous nodules which histologically showed extensive acute inflammation characteristic of an acute abscess, but which also displayed proliferating dilated small blood vessels with bulbous endothelial cells adjacent to numerous bacteria and also containing them. The Grocott-methenamine silver stain and the Warthin-Starry stain showed the organisms to better advantage in lesions of all six patients, although bacteria were also evident with the haematoxylin and eosin, periodic acid-Schiff and alcian blue stains.

AIDS-Related Opportunistic Infections↗
PubMed2006

Corpuscular antigenic microarray for the serodiagnosis of blood culture-negative endocarditis.

Blood culture-negative endocarditis is due to fastidious bacteria, including Coxiella burnetii and Bartonella spp. Diagnosis of such infection relies on serology and microimmunofluorescence is therefore the reference method. We developed a multiplex serology test featuring automatic incubation and reading and incorporating internal controls. Preliminary results indicate that this new serologic test is valuable for the rapid, automated serological diagnosis of blood culture-negative endocarditis.

Antigens, Bacterial↗
PubMed2005

Tickborne pathogen detection, Western Siberia, Russia.

Ixodes persulcatus (n = 125) and Dermacentor reticulatus (n = 84) ticks from Western Siberia, Russia, were tested for infection with Borrelia, Anaplasma/Ehrlichia, Bartonella, and Babesia spp. by using nested polymerase chain reaction assays with subsequent sequencing. I. persulcatus ticks were infected with Borrelia burgdorferi sensu lato (37.6% +/- 4.3% [standard deviation]), Anaplasma phagocytophilum (2.4% +/- 1.4%), Ehrlichia muris (8.8% +/- 2.5%), and Bartonella spp. (37.6% +/- 4.3%). D. reticulatus ticks contained DNA of B. burgdorferi sensu lato (3.6% +/- 2.0%), Bartonella spp. (21.4% +/- 4.5%), and Babesia canis canis (3.6% +/- 2.0%). Borrelia garinii, Borrelia afzelii, and their mixed infections were observed among I. persulcatus, whereas B. garinii NT29 DNA was seen in samples from D. reticulatus. Among the I. persulcatus ticks studied, no Babesia spp. were observed, whereas B. canis canis was the single subspecies found in D. reticulatus.

Anaplasma phagocytophilum↗
PubMed2002

In situ detection of Bartonella henselae cells.

A new in situ hybridization technique was developed for identification of Bartonella henselae cells in cell suspension or in tissue sections. Use of highly specific probes labeled with either fluorescein or digoxigenin allows discrimination between B. henselae and closely related B. quintana cells. No cross-hybridization with other Bartonella or non-Bartonella species was observed. Besides its specificity it showed higher sensitivity as compared to PCR based detection methods. Moreover, its application allows direct observation of B. henselae in infected tissues.

Animals↗
PubMed1996

Bacillary angiomatosis in an HIV seronegative patient on systemic steroid therapy.

Bacillary angiomatosis is an unusual systemic vascular proliferation seen predominantly in patients with the acquired immunodeficiency syndrome. These vascular lesions are due to infection with a Bartonella species, most commonly B. henselae, but sometimes B. quintana. It is treatable and often curable, but without therapy may be life-threatening. Clinically, the disorder often resembles several different vascular disorders, particularly pyogenic granuloma and Kaposi's sarcoma. We now report a clinically typical patient with bacillary angiomatosis who was HIV seronegative, but who had idiopathic thrombocytopenic purpura, was status-post splenectomy and to whom long-term systemic prednisone had been administered.

Adult↗
PubMed2004

Prevalence of Bartonella henselae in Italian stray cats: evaluation of serology to assess the risk of transmission of Bartonella to humans.

Bartonella henselae is the major etiological agent of cat scratch disease in humans. Cats act as the natural reservoir of B. henselae and can transmit the infection to humans by a bite or scratch. The prevalence of B. henselae in cat populations was evaluated by serological and bacteriological tests. A total of 769 stray cats from three urban and three rural areas in northern Italy were sampled between January 1999 and December 2000. The positive and the negative predictive values of serological tests with respect to bacteremic status were evaluated. Tests of a total of 140 cats (18%) resulted in detection of bacteremia. A total of 540 cats were tested by serology; 207 (38%) were seropositive. Of the 531 cats tested by both methods, the results for 65 (12.2%) showed both bacteremia detection and seropositivity. The molecular typing of the isolates showed that 20.6% of bacteremic cats were infected with B. henselae type I strain, 61.1% were infected with B. henselae type II, and 18.3% were coinfected with both. A statistically significant difference in antibody and bacteremia prevalences among geographical areas was detected. Statistical analysis showed no association between characteristics such as seroprevalence-bacteremic status, sex, general health status, and the presence of ectoparasites. The negative predictive value of serological test was 84.7%, and the positive predictive value was 31.8%. Receiving operator characteristic analysis of the data showed that serological tests had a low predictive value in relation to the bacteremic status of a cat; in surveys aimed at assessing the real risk of B. henselae infection in a human population, therefore, we suggest the use of blood culture as the reference test. Nevertheless, both blood culture assays and serological tests for Bartonella infection should be performed for a complete evaluation of the health status of cats.

Animals↗
PubMed1998

Two different genotypes of Bartonella henselae in children with cat-scratch disease and their pet cats.

Two genotypes (I and II) of Bartonella henselae are involved in cat-scratch disease (CSD). Lymph node biopsies were taken from 3 children suffering from CSD, and blood cultures were obtained from their pet cats. Cat-scratch disease was confirmed serologically, histologically and by detection of B. henselae DNA in all 3 lymph nodes by PCR. Bartonella henselae grew in all cats' blood cultures. The first 2 children were siblings. Both children and their pet cats were infected with B. henselae genotype II, and the third patient and her cat were infected with B. henselae genotype I. In all cases, there were no essential differences in the clinical manifestations of the infection caused by these 2 genotypes of B. henselae.

Adolescent↗