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PubMed2004

[Nanobacteria--microbiological characteristics].

We have reviewed recent publications regarding the microbiological characteristic and pathogenicity of a novel infectious agent, the mineral-forming, sterile-filterable, slow-growing Gram-negative Nanobacteria, detected in bovine/human blood, kidney cyst fluid, urine and kidney stones. According to their 16S rDNA structure, nanobacteria belong to the alpha-2 Proteobacteria, subgroup, which includes the Brucella and Bartonella species. Their cell diameter is 0.2-0.5 microm (the smallest known cell-walled bacteria). Their most remarkable characteristic is the formation of carbonate apatite crystals of neutral pH and at physiologic phosphate and calcium concentrations. The extracellular mineralization forms a hard protective shelter for these hardy microorganisms, and enables them to survive conditions of physical stress that would be lethal to most other bacterial species. The Olavi Kajander group (Finland) suggests that the apatite produced by nanobacteria may play a key role in the formation of all kidney stones, by providing a central calcium phosphate deposit around which other crystalline components can collect. Nanobacteria seems to be a causative agent of diseases related to biomineralization processes.

Animals↗
PubMed2004

[Subcutaneous nodules with malignant presentation, but caused by infection].

Three patients, a woman aged 32, a boy aged 6.5 and a man aged 56 years, presented with a subcutaneous mass suggesting a malignancy: respectively a rubbery swelling, painful to the touch below the left scapula, a partly massive, partly soft swelling on the inside of the left upper leg, and a non-fluctuating mass near the right eighth rib, parasternally. Additional diagnostic investigation revealed an infectious cause: respectively Mycobacterium tuberculosis, Bartonella henselae and Salmonella typhi. Antimicrobial therapy was successful. Subcutaneous masses suspected of being a benign or malignant tumour are sometimes caused by an infection. The differential diagnosis is extensive. Sometimes the travel anamnesis yields helpful information. It is concluded that besides histopathological examination, microbiological investigation can play a major role in the evaluation of subcutaneous masses.

Adult↗
PubMed2005

[New etiologies responsible for infective endocarditis with negative blood cultures].

The prevalence of infective endocarditis with negative blood cultures varies in the different series from 5 to 25%. There are certain explanations of negative blood culture endocarditis: previous incorrect antibiotic therapy before obtaining blood samples (antibiotic treatment inhibits the growth of germs, and therefore bacteremia, without sterilizing the vegetations); infective endocarditis due to fastidious microorganism, that is of difficult cultivation and identification; infective endocarditis due to cell-dependent organism (e.g. Coxiella burnetii); infective endocarditis due to fungi; non-infectious involvement of the endocardium (at times with vegetations) during the course of certain disease. We underline three etiologies (Coxiella burnetii, Bartonella species and Whipple's disease bacterium) because their study have constituted the stimulus for the introduction into clinical evaluation of patients with suspected infective endocarditis of different diagnostic approaches, based on a correct sequential application of blood cultures, serodiagnosis and molecular microbiology.

Bartonella Infections↗
PubMed2005

[Lice and lice-borne diseases in humans].

Among the three lice which parasite the human being, the human body louse, Pediculus humanus humanus, is a vector of infectious diseases. It lives and multiplies in clothes and human infestation is associated with cold weather and a lack of hygiene. Three pathogenic bacteria are transmitted by the body louse: 1) Rickettsia prowazekii, the agent of epidemic typhus of which the most recent outbreak (and the largest since World War II) was observed during the civil war in Burundi; 2) Borrelia recurrentis, the agent of relapsing fever, historically responsible of massive outbreaks in Eurasia and Africa, which prevails currently in Ethiopia and neighboring countries; 3) Bartonella quintana, the agent of trench fever, bacillary angiomatosis, chronic bacteremia, endocarditis, and lymphadenopathy. Body louse infestation, associated with a decline in social and hygienic conditions provoked by civil unrest and economic instability, is reemergent worldwide. Recently, a forth human pathogen, Acinetobacter baumannii, has been associated to the body louse.

Animals↗
PubMed2005

[Cat-scratch disease].

OBJECTIVE: To study the etiology, epidemiology, clinical and pathological features, diagnose and treatment of cat-scratch disease(CSD). METHOD: The clinical information of 1 case was reported and the literatures were also reviewed. RESULT: Bartonella henselae was the primary pathogen of CSD. Almost all patients with CSD were in contact with animals, especially cat or dog before the occurrence of the disease. All the patients had the self-limited swelling of local lymph nodes and commonly a fever. The pathological feature was necrotic granulation-like micro abscessation, and a pleomorphous argyrophil G- bacillus could be showed by Warthin-Starry or Brown-Hopp stainings in the swelling lymph nodes. CONCLUSION: CSD is a self-limited bacterial infectious disease. And its clinical features,biopsy and special stainings of swelling lymph nodes are helpful to the final diagnosis. Gentamicin, rifadin, ciprofloxacin, clarithromycin, bactrim, mitramycin, or resection of swelling lymph nodes had good effects on treating CSD.

Bartonella henselae↗
PubMed2006

[A case of cat scratch disease in a patient with diabetes mellitus and chronic renal failure].

The article describes a case of cat scratch disease in a female patient with severe chronic pathology. This relatively rare disease was manifested by regional (in the site of microbial intrusion) lymphadenopathy, and general infectious syndrome. The presence of oncohematological process was excluded without biopsy; serologic examination with bartonella antibodies confirmed the diagnosis. Combined treatment with two antibiotics, rifampicin and doxycycline, was successful. The article stresses that general practitioners should be aware of this disease; timely diagnosis and specific treatment are of utter importance.

Anti-Bacterial Agents↗
PubMed2006

[A case of hepatosplenic cat scratch disease].

A 43-year-old man was admitted with idiopathic fever. Abdominal ultrasonogram demonstrated multiple hypoechoic lesions in the spleen. Abdominal CT scan showed multiple hypodense lesions in the liver and spleen. The patient had a cat in his house, and the presence of a very high serous antibody titer for Bartonella henselae led to the diagnosis of hepatosplenic cat scratch disease. It is important to consider this disease in the differential diagnosis of idiopathic fever when multiple lesions are detected in the liver and spleen.

Adult↗
PubMed1995

[Perinaud's oculoglandular syndrome as a manifestation of cat-scratch disease].

The first Danish case of Parinaud's oculoglandular syndrome, a manifestation of cat-scratch disease, is reported in a 35-year-old man presenting with an enlarged preauricular lymph node and an ipsilateral conjunctival granuloma. Surgical removal of the granulomatous lesion was followed by rapid healing. The diagnosis was verified by demonstrating a high antibody tire against Rochalimaea (Bartonella) henselae. On subsequent questioning the man gave a history of acquiring a kitten six weeks before his illness. The importance of eye examination in patients presenting with preauricular lymphadenopathy is emphasized.

Adult↗
PubMedDate not supplied

[The epidemiology of trench fever: a pilot study in homeless people in Marseilles].

Trench fever, cause by Bartonella quintana, disappeared decades ago. Between 1992 and 1994 about 20 cases were reported in industrialized countries [6, 7]. Some of these cases were associated with HIV infection [5], but most affected the homeless. The epidemiology of B. quintana is unknown in Europe, but infection and transmission are favoured by poor housing and hygiene. This paper describes the results of a seroprevalence survey among the homeless living in Marseille. The eight major non-profit organizations caring for the homeless in the city participated for the four winter months. Four of these organizations also provide health care. Each subject who came to be housed for more than one day were asked to complete a questionnaire and give a small blood sample by micropuncture. They were clearly informed about the aims of the research and were allowed to refuse participation freely. All blood samples were tested by the WHO collaborative center for ricketssiae using a previously tested and validated immunofluorescence technique. The subjects were scored positive if the IgG titer was above 1/100. Two hundred and twenty one subjects agreed to participate in the study. Most were of French origin (51.4%) and 40% under 40 years old. The seroprevalence was 1.8% (IC 95%: 0.05-3.55). None of the four positive subjects presented symptoms and clinical examination was normal. All four were over 40 years old; two were of French origin, 1 from Algeria and 1 from the Comoro Islands. One had an IgG titer above 1/3, 200, possibly reflecting recent contamination and/or severe infection. Statistical analysis revealed no significant association between seropositivity and housing or hygiene conditions. No socio-demographic data are available about the homeless in Marseille and indeed, there is no list of such individuals. It is therefore not possible to estimate the representativity of our sample. Nevertheless, we show that the homeless include infected individuals. Physicians who care for such subjects should prescribe B. quintana serological investigations, and organizations that take in these people should implement preventive action and health education programs. Any such policy must be designed so as to be acceptable to homeless people. This work should also encourage public health professionals to investigate more extensively infectious diseases among the homeless.

Adolescent↗
PubMed1997

Cat-scratch disease and related clinical syndromes.

Bartonella (Rochalimaea) henselae is a common cause of cat-scratch disease. This newly identified bacterium is also the cause of several other clinical syndromes, including bacillary angiomatosis, bacillary peliosis hepatitis and splenitis, and acute and relapsing bacteremia. A high percentage of young cats carry B. henselae. Fortunately, serious complications of B. henselae infections are rare in immunocompetent patients. Cat-scratch disease is usually a self-limited illness that does not necessarily require antibiotic therapy. Severe or persistent cases respond well to several antibiotics, including erythromycin and doxycycline. Cat-scratch disease should be included in the differential diagnosis of serious neurologic disease, particularly when regional lymphadenopathy develops suddenly in a previously healthy patient who owns a cat. Treatment of uncomplicated central nervous system disease is generally supportive. Antibiotic therapy is reserved for patients with atypical or severe involvement, including encephalopathy and retinitis. Other internal and cutaneous manifestations of B. henselae infection have recently been described. These potentially life-threatening infections respond well to antibiotic therapy, even in immunocompromised patients.

Angiomatosis, Bacillary↗
PubMedDate not supplied

Cat scratch disease in a child.

We report a case of a 9-year-old girl scratched on the right side of her neck by a kitten about one month prior to admission. She was well until three weeks later when she developed enlarged right neck masses, a pustula on the scratch site, right injected conjunctiva, headache, general malaise and fever, thus fulfilling the clinical criteria for CSD. Initially, she was treated by a practicing physician but the manifestations persisted for one week. After admission, leukocytosis and a mildly elevated erythrocyte sedimentary rate were noted. The serum IgG titer to Bartonella henselae was performed by means of indirect fluorescent antibody (IFA) test at the National Institute of Preventive Medicine. The serum titer of anti-B, henselae Ig G was 1:256 and greater (> or = 1:256). The positive serum titer(negative titer being < 1:64) to B, henselae, the organism thought to be responsible for CSD, also supports this diagnosis. She was treated with a 7-day course of intravenous gentamicin and the fever subsided within 24 hours. Following this, she improved clinically and was discharged one week later. One month after discharge, she remained well with no palpable neck masses.

Anti-Bacterial Agents↗
PubMed1997

[2 patients with atypical manifestations of cat-scratch disease].

In 2 boys aged 8 years and 10 months, respectively, uncommon manifestations of cat scratch disease were seen. The first patient had acute encephalopathy: coma and generalized tonic-clinic convulsions. The second patient was presented with fever and peripheral lymphadenopathy in combination with hypodense lesions in the liver on ultrasound. Diagnosis was established on the clinical picture and the positive results of serological testing of antibody titres for Bartonella henselae. Both patients recovered completely within 2 months.

Antibodies, Bacterial↗
PubMed1997

[Cat-scratch disease: historical, clinical, phylogenetic and taxonomic aspects].

The cat-scratch disease (CSD) is known as a nosological entity since 1950. It was diagnosed by the clinical symptoms, epidemiologic data, and the intracutaneous test of Hanger and Rose. The aetiologic agent is Bartonella (formerly Rochalimaea) henselae occurring in thirty to fifty percent of healthy cats. The gramnegative alpha-2-proteobacteria cause the CSD but also fever in healthy humans. Patients suffering from AIDS show bacillary angiomatosis, bacillary peliosis hepatis, endocarditis, and septicemia. There is an open question for other aetiologic agents causing CSD as cofactors. For example, Afipia felis is found to a certain extent from patients suffering from CSD. Furthermore, Rothia dentocariosa was isolated in lymphnodes of CSD patients, and also other grampositive rods may play an important role together with B. henselae in CSD.

AIDS-Related Opportunistic Infections↗
PubMed1997

[Cat scratch disease and associated infections].

Cat scratch disease (CSD) was first described in France by Debré et al. in 1950, yet the causative bacterial agent of CSD remained obscure until 1992, when Bartonella (formerly Rochalimaea) henselae was implicated in CSD by serological and microbiologic studies. B. henselae had been linked initially to bacillary angiomatosis (BA), but also bacillary peliosis, relapsing bacteremia and endocarditis. Cats are healthy carriers of B. henselae and B. clarridgeiae, and can be bacteremic for months to years. Cat to cat transmission of the organism involves the cat flea in absence of direct contact transmission. Present knowledge on the etiology, clinical features and epidemiological characteristics of cat scratch disease/bacillary angiomatosis are presented.

Angiomatosis, Bacillary↗
PubMed1997

[Rickettsioses: the epidemiological assessment].

Microbe of taxonomical families Rickettsiaceae aceal and Bartonellaceae of Rickettsiales order have caused not less than 14 nosological forms of disease among people in different parts of the world. About 8 of them--in Russia and in the former Soviet Republics. These diseases are not unequivocal from epidemiological point of view. Trench, Marseilles and other forms of fever, murine typhus, vesicules rickettsia, etc. have been liquidated and never recurred for 30-40 years. Prowazek's [correction of Provachek's] rickettsia in its two forms has lost its epidemiological meaning in Russia and is next to full disappearance. However, some types of fever still represent a definite threat to public health. Some diseases, like ehrlichiosis, Bartonella, tsutsugamushi fever have not yet been studied to the end in Russia.

Bartonella Infections↗
PubMed1997

[Tropical animal and human rickettsial infections].

Advances in molecular biology have provided tools that have greatly clarified our knowledge of rickettsial diseases. Most rickettsias have been reclassified in the alpha subgroup of proteobacteria. Four groups of rickettsias have been identified: the spotted fever group, the typhus group, Ehrlichia, and Bartonella. Although still considered as a rickettsia, Coxiella burnetti, the agent causing Q fever, has been reclassified separately in the gamma subdivision of proteobacteria. Recognition of rickettsial disease is still based mainly on clinical manifestations (rash, eschar, and scratching sores). Little progress has been made in serologic testing. Indirect immunofluorescence is the most common technique. Diagnostic techniques based on molecular biology are currently available in only a small number of laboratories. Treatment with tetracyclines is indicated but prophylaxis through proper hygiene is the most effective approach.

Animals↗
PubMed1998

[Infective endocarditis caused by unusual microorganisms].

All series of infective endocarditis had a variable proportion of cases without an etiologic agent because all cultures were negative. New microbiologic techniques have permitted the discovery of the role of many microorganisms in infective endocarditis. C. burnetii is an increasing causative agent of subacute infective endocarditis. In the diagnosis, to the detection of antiphase-I antibodies, immunohistochemical, molecular techniques and cellular cultures have been added. Total cure is difficult to obtain. The combination of doxicicline plus ciprofloxacin for at least 3 years has been proposed as the treatment of choice. Surgery must be reserved for patients with cardiac insufficiency. Less than 2% of cases of acute brucellosis are complicate with infective endocarditis. Infective endocarditis produces serious and rapid valvular destruction with high mortality rates if valve surgery is not performed. For medical treatment at least 3 active agents are required. Bartonella has recently been described as an etiologic agent of infective endocarditis. It mainly affects to homeless people living in poor hygienic conditions. The aortic valve is most commonly involved and, frequently, valve insufficiency requires valve replacement. Blood culture isolation needs long incubation periods. Parenteral nutrition, immunosuppression, wide spectrum antibiotic regimens, intravenous drug addiction and cardiovascular surgery are risk factors previously described in the development of fungal endocarditis. C. albicans and Aspergillus spp. are most frequent etiologic agents. Infective endocarditis should be suspected in any patient with systemic fungal disease. Blood cultures are often negative except for Candida spp. Peripheral emboli and large vegetations are frequent. Mortality is high, antifungal therapy combined with surgery is the treatment of choice. Legionella, Mycoplasma, Chlamydia, Mycobacteria, viruses are potential agents of infective endocarditis, and difficult to diagnose because of special culture requirements. Epidemiological clues, serologic and molecular techniques and blood cultures could identify them.

Anti-Bacterial Agents↗
PubMed1998

[Cat-scratch disease].

Cat-scratch disease is a subacute, regional lymphadenitis syndrome that occurs mainly in children. The causative agent is Bartonella henselae. After an incubation period ranging usually between 1 and 2 weeks, red papules develop at the site of cutaneous inoculation and persist until the development of lymphadenopathy with some malaise. Cases with complications have been observed including Parinaud oculoglandular syndrome, encephalopathy, a variety of exanthems and granumatous hepatitis. Diagnosis is based on serologic tests and, when necessary, antimicrobial treatment can be considered. Incision and drainage should not be done.

Amoxicillin-Potassium Clavulanate Combination↗