Bartonella hensela in inflammatory bowel disease.
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Adolescent↗
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Bartonella infection in domestic cats and wild felids.
Bartonella are vector-borne, fastidious Gram-negative bacteria causing persistent bacteremia in their reservoir hosts. Felids represent a major reservoir for several Bartonella species. Domestic cats are the main reservoir of B. henselae, the agent of cat-scratch disease. Prevalence of infection is highest in warm and humid climates that are optimal for the survival of cat fleas, as fleas are essential for the transmission of the infection. Flea feces are the likely infectious substrate. Prevalence of B. henselae genotypes among cat populations varies worldwide. Genotype Houston I is more prevalent in the Far East and genotype Marseille is dominant in western Europe, Australia, and the western United States. Cats are usually asymptomatic, but uveitis, endocarditis, neurological signs, fever, necrotic lesions at the inoculation site, lymphadenopathy, and reproductive disorders have been reported in naturally or experimentally infected cats. Domestic cats are also the reservoir of B. clarridgeiae and co-infection has been demonstrated. B. koehlerae has been isolated from domestic cats, and was identified in cat fleas and associated with a human endocarditis case. B. bovis was isolated from a few cats in the United States and B. quintana DNA was recently identified in a cat tooth. Bartonella spp. have also been isolated from free-ranging and captive wild felids from North America and Africa. Whereas, B. henselae was identified in African lions and a cheetah, some strains specific to these wild cats have also been identified, leading to the concept of a B. henselae group including various subspecies, as previously described for B. vinsonii.
Animals↗
Infection and re-infection of domestic cats with various Bartonella species or types: B. henselae type I is protective against heterologous challenge with B. henselae type II.
Four Bartonella species have been isolated from domestic cats, of which two serotypes/genotypes of Bartonella henselae and possibly B. clarridgeiae are human pathogens, causing cat scratch disease (CSD).Our objectives were to evaluate infection and potential cross-protection during re-infection in domestic cats with various Bartonella species or types.Thirty-six cats were primarily inoculated with B. henselae type I (n=16), B. henselae type II (n=10), B. clarridgeiae (n=6) or B. koehlerae (n=4). They were challenged with B. henselae type I (n=15), B. henselae type II (n=13) or B. clarridgeiae (n=8). All 36 cats became bacteremic (1.25x10(2)-1.44x10(6)CFU/ml) and bacteremia lasted from 37 to 582 days. Duration of bacteremia for cats inoculated with B. henselae type I was shorter than for cats inoculated with either B. henselae type II (P=0.025) or B. clarridgeiae (P=0.011). After challenge, 26 cats became bacteremic. Among the nine cats primarily inoculated with B. henselae type I and challenged with B. henselae type II, six cats stayed abacteremic. The three bacteremic cats had a transient low-level bacteremia. No bacteremia was observed in three cats primarily inoculated with B. henselae type I and challenged with another strain of B. henselae type I. Bacteremia levels in the 26 cats were significantly lower than for primary inoculation (P=0.022) and its duration was shorter (P=0.012). Among the eight cats challenged with B. clarridgeiae, duration of bacteremia in the four cats primarily inoculated with B. henselae type I was shorter than in the four cats primarily inoculated with B. henselae type II (P=0.01). Bartonella clarridgeiae inoculated cats were more likely to have relapses for both primary and secondary infections. This is the first demonstration of cross-protection, evidenced by absence of bacteremia, in cats primarily infected with B. henselae type I and challenged with B. henselae type II, whereas no cross-protection was previously shown for cats primarily infected with B. henselae type II and challenged with B. henselae type I. Such results are of major importance for future feline Bartonella vaccine development.
Animals↗
Prevalence of Bartonella henselae antibodies in pet cats throughout regions of North America.
Cat exposure has been directly associated with the development of human Bartonella henselae infections, resulting in cat-scratch disease, bacillary angiomatosis, or bacteremia. The prevalence of serum antibody titers to B. henselae was determined for selected pet cats from 33 geographic locations throughout the United States and several areas in western Canada. Seroprevalences paralleled increasing climatic warmth (P < .02) and annual precipitation (P < .03). These warm, humid areas with the highest seroprevalence would also have the highest number of potential arthropod vectors. The southeastern United States, Hawaii, coastal California, the Pacific Northwest, and the south central plains had the highest average prevalences (54.6%, 47.4%, 40.0%, 34.3%, and 36.7%, respectively). Alaska, the Rocky Mountain-Great Plains region, and the Midwest had low average prevalences (5.0%, 3.7%, and 6.7%, respectively). Overall, 27.9% (175/628) of the cats tested were seropositive. The seroprevalence of B. henselae in cats varies throughout the United States and appears to be influenced by climate.
Animals↗
Histopathology of human lymph node tularemia caused by Francisella tularensis var palaearctica.
Histopathology of tularemia, caused by type-B strain, tuberculosis, and sarcoidosis were compared in lymph node biopsy specimens from ten patients with tularemia, 26 with tuberculosis, and 14 with sarcoidosis. In very early tularemia there were only reactive changes without necrosis. Abscess necrosis with or without epithelioid cell reaction was observed during the second week and caseous necrosis during the fourth week. Argyrophil fibers were absent from necrotic lesions in tularemia, but, often, also in tuberculosis. In most cases of tularemia and in half the cases of tuberculosis, the inflammatory process extended beyond the capsule of the lymph node. In some cases, tularemia could not be histologically differentiated from tuberculosis, but tularemia was always differentiated from sarcoidosis. Our series of lymph node tularemia seems to represent a milder disease than those cases published earlier. Tularemia should be considered in the differential diagnosis with tuberculosis, toxoplasmosis, and cat-scratch disease.
Epithelium↗
Bartonellosis in Ecuador: serosurvey and current status of cutaneous verrucous disease.
Human bartonellosis is a classically biphasic disease caused by infection with the alpha-2 Proteobacteria Bartonella bacilliformis, which is phylogenetically related to the etiologic agents of cat scratch disease, bacillary angiomatosis, and trench fever. In Ecuador, typical bartonellosis has remained endemic for the past century in highland provinces near the Peruvian border. During the past six years, public health officials have noted an increasing number of atypical cases in which monophasic verrucous cutaneous disease is the only clinical manifestation. Epidemiologic, immunologic, histopathologic, and molecular biological studies have confirmed the presence of sporadic, atypical bartonellosis in residents of the lowland province of Manabi, where archeologic evidence exists of bartonellosis in pre-Colombian times. Between 1987 and 1995, 11 cases of cutaneous bartonellosis were investigated and serologic studies were done on 224 persons from five villages, two lowland and three highland. In the lowland village of Pajan in the province of Manabi, there was a 21% seropositivity proportion in contacts of index cases. These combined data suggest that bartonellosis is significantly under-reported due to the existence of mild clinical disease, possibly associated with less virulent bacterial strains, which are now disseminating or re-emerging in previously disease-free areas.
Antibodies, Bacterial↗
[Infectious diseases as a cause and risk factor for cerebrovascular ischemia].
Cerebrovascular ischemia can be caused by infectious diseases which involve cerebral arteries or the heart, including infectious endocarditis, bacterial and fungal meningitis, neurosyphilis, neuroborreliosis, herpes zoster, the acquired immunodeficiency syndrome, cat scratch disease and other rare infectious diseases. Presently, there is increasing evidence that infection in general and mainly respiratory infection is a risk factor for ischemic stroke. Case reports and smaller case series reported an association of cerebrovascular ischemia and recent infection in children and younger adults. Two case control studies from Helsinki (54 patients under the age of 50) and from Heidelberg (197 patients aged 80 or less) identified recent infection as an important risk factor for ischemic stroke. Febrile, bacterial and respiratory infections were most important in this respect. In the study from Heidelberg, the neurological deficit was more severe and cardioembolism was more frequent in infection-associated stroke than in stroke without preceding infection. This review summarizes the association of infectious diseases and cerebrovascular ischemia and discusses potential pathogenetic mechanisms linking both diseases.
Adult↗
Bartonella infections and HIV disease.
Successful assessment and treatment of Bartonella in HIV-seropositive people depends on nursing's fundamental role in the management of these bacterial infections. Bartonella species are responsible for a variety of infections, including cat scratch disease and bacillary angiomatosis, which can be debilitating to people living with AIDS. This paper provides an overview of the clinical presentation and nursing management of Bartonella infection in PLWAs. The author discusses common diagnostic procedures, treatment strategies, and the nurse's role in caring for patients with a Bartonella infection.
Adult↗
Characterization of the genome composition of Bartonella koehlerae by microarray comparative genomic hybridization profiling.
Bartonella henselae is present in a wide range of wild and domestic feline hosts and causes cat-scratch disease and bacillary angiomatosis in humans. We have estimated here the gene content of Bartonella koehlerae, a novel species isolated from cats that was recently identified as an agent of human endocarditis. The investigation was accomplished by comparative genomic hybridization (CGH) to a microarray constructed from the sequenced 1.93-Mb genome of B. henselae. Control hybridizations of labeled DNA from the human pathogen Bartonella quintana with a reduced genome of 1.58 Mb were performed to evaluate the accuracy of the array for genes with known levels of sequence divergence. Genome size estimates of B. koehlerae by pulsed-field gel electrophoresis matched that calculated by the CGH, indicating a genome of 1.7 to 1.8 Mb with few unique genes. As in B. quintana, sequences in the prophage and the genomic islands were reported absent in B. koehlerae. In addition, sequence variability was recorded in the chromosome II-like region, where B. koehlerae showed an intermediate retention pattern of both coding and noncoding sequences. Although most of the genes missing in B. koehlerae are also absent from B. quintana, its phylogenetic placement near B. henselae suggests independent deletion events, indicating that host specificity is not solely attributed to genes in the genomic islands. Rather, the results underscore the instability of the genomic islands even within bacterial populations adapted to the same host-vector system, as in the case of B. henselae and B. koehlerae.
Bartonella↗
[Bacillary angiomatosis].
Bacillary angiomatosis (BA) is a recently described infection usually found in patients with human immunodeficiency virus disease. BA is caused by a Gram-negative coccobacillus. This organism is primarily responsible for skin lesions of the pseudo-botryomycoma type or inflammatory nodules, but it also produces fever, degradation of the general condition and visceral lesions involving the lymph nodes, the liver, the spleen and the bones. Histology shows vascular proliferation with turgid endothelial cells and mostly neutrophilic inflammatory infiltrates. BA is susceptible to many antibiotics. The authors describe the history of the disease and its clinical and histological features, discuss its differential diagnosis and principally deal with the relationship between BA and cat-scratch disease and between BA and verruca peruana. They also present the molecular biology technique which enables a genotypic diagnosis of the disease to be made, replacing a deficient phenotype.
AIDS-Related Opportunistic Infections↗
Animal-induced injuries and disease, neonatal jaundice, viral infections, and immunizations.
This section features recent information in four areas of interest to the practicing pediatrician: animal-induced injuries and disease, neonatal jaundice, viral infections, and immunizations. The focus is on areas of major current discussion: the clinical spectrum and etiology of cat-scratch disease, the debate on new neonatal bilirubin recommendations, viral etiology of previously recognized clinical diagnoses, new immunization recommendations, and new vaccines. In addition, isolated but thought-provoking papers in the four areas over the past year are briefly discussed. By paying careful attention to highlighted articles, the busy practitioner should be able to keep abreast of rapid new developments.
Animals↗
Fever without apparent source on clinical examination.
PURPOSE OF REVIEW: Episodes of acute illness associated with fever are common in children. Less common but also diagnostically challenging are episodes of prolonged fever in children. This article reports recent literature that has focused on the epidemiology, pathophysiology, clinical and laboratory evaluation, and treatment of both types of episodes. RECENT FINDINGS: A number of articles reviewed the epidemiology in several countries of bacteremia in children, including bacteremia caused by Streptococcus pneumoniae and Salmonella sp. Host susceptibility factors for bacterial illness, such as malnutrition, were reported. Diagnostic issues concerning bacteremia, including the technique of venipuncture and urine antigen testing, were of interest. A major study was published that reported a preventive approach through immunization to one type of bacteremia that caused by S. pneumoniae. Other studies addressed the issues of choice of therapy and duration of therapy in selected bacteremic disease, such as dental bacteremias and bacteremia, that were caused by Brucella melitensis. Lastly, several causes of prolonged fever (such as hemophagocytic syndrome and atypical cat scratch disease) were reported. SUMMARY: During the review period, studies addressed diverse issues related to acute and prolonged episodes of fever in children. There was a particular emphasis on the epidemiology, diagnosis, prevention, and treatment of bacteremic illness in children.
Age Factors↗
Prevalence of Bartonella henselae in cats in Catalonia, Spain.
Bartonella henselae, an emerging pathogen bacterium, is the main causative agent of the cat scratch disease. While the first clinical descriptions were associated with immunosupressed patients, it is now more frequently observed in patients with normal immune status (endocarditis and bacteremia). Cats were found to be the only known reservoir of B. henselae. In this paper, we report the results obtained in the first study made to investigate the prevalence of B. henselae bacteremia and antibodies in domestic cats in Catalonia, Spain. Serum samples from 115 cats were tested for antibodies to B. henselae by immunofluorescent antibody testing, and 29.6% had a titer >or= 1:64. Seven B. henselae strains were isolated using standard culture techniques and amplification by a polymerase chain reaction and subsequent sequencing was performed on the intergenic spacer region between the 16 and 23S ribosomal RNA genes. Of all factors concerning the studied bacteremia rate (age, sex, habitat, presence of antibodies, contact with animals, parasites), only the presence of antibodies to B. henselae was statistically significant.
Animals↗
[Presence of Bartonella henselae in cats: natural reservoir quantification and human exposition risk of this zoonoses in Chile].
BACKGROUND: The availability of a serologic test for cat scratch disease in humans has allowed the diagnosis of an increasing number of cases of this disease in Chile. AIM: To perform a serological survey for Bartonella henselae among cats in Chile. MATERIAL AND METHODS: Blood samples from 187 cats living in three Chilean cities were obtained. IgG antibodies against Bartonella henselae were measured using indirect immunofluorescence. Blood cultures were done in 60 samples. The presence of Bartonella henselae in positive cultures was confirmed by restriction fragment length polymorphism polymerase chain reaction (RFLP-PCR). RESULTS: The general prevalence of IgG antibodies against Bartonella henselae was 85.6%. No differences in this prevalence were found among cats younger or older than 1 year, or those infested or not infested with fleas. However domestic cats had a lower prevalence when compared with stray cats (73 and 90% respectively, p <0.01). Bartonella henselae was isolated in 41% of blood cultures. All the isolated were confirmed as Bartonella henselae by RFLP-PCR. CONCLUSIONS: This study found an important reservoir of Bartonella henselae in Chilean cats and therefore a high risk of exposure in humans who have contact with them.
Animals↗
Granulomatous hepatitis and necrotizing splenitis due to Bartonella henselae in a patient with cancer: case report and review of hepatosplenic manifestations of bartonella infection.
Bacillary angiomatosis and the related disorders of bacillary peliosis hepatis and bacillary splenitis are manifestations of infection with Bartonella henselae and Bartonella quintana in immunocompromised persons. B. henselae infection, but not B. quintana infection, is linked to contact with cats and is presumed to cause visceral cat-scratch disease. We reports a case of visceral infection by B. henselae in an adult patient with cancer who was receiving chemotherapy and had had no contact with a cat or dog. The patient--whose illness was eventually diagnosed on the basis of findings of histologic, polymerase chain reaction, and serological studies--was treated with doxycycline and rifampin, and the infection resolved. In addition, 41 cases of documented or suspected bartonella infection of the liver, spleen, or both in immunocompetent or immunocompromised hosts are reviewed.
Antineoplastic Agents↗
[Bartonellosis. II. Other Bartonella responsible for human diseases].
In addition to Bartonella henselae, five other Bartonella species were involved in human pathology. As for B. henselae, ectoparasites seem to be responsible for the transmission of most or all these bacterial species. B. bacilliformis is responsible for Carrion's disease that occurs in some valleys of Colombia, Ecuador and Peru. This disease is transmitted by biting of infected sandflies. The bacterial reservoir is constituted by humans only. That disease occurs either as an acute form with severe infectious hemolytic anemia (or Oroya fever), or as benign cutaneous tumors, also called verruga peruana. Healthy blood carriers of the bacterium exist. Trench fever was described during the First World War. This non-lethal disease is constituted of recurrent febrile attacks associated particularly with osseous pains. The causative agent of the disease is B. quintana, transmitted by the body louse. Humans seem to be the reservoir of that bacterium. In some patients, B. quintana can be responsible for endocarditis, bacillary angiomatosis and chronic or recurrent bacteremia. Other human infections due to Bartonella sp. have been described: B. vinsonii, isolated from blood of small rodents, and B. elizabethae, the reservoir of which is currently unknown, can be responsible for endocardites. B. clarridgeiae (isolated from blood of 5% of pet cats and 17% of stray cats) may be responsible for human cat scratch disease. All these bartonelloses are diagnosed by non-standard blood culture or by in vitro DNA amplification or by serological testing. Their treatment requires tetracyclines or chloramphenicol or macrolides.
Animals↗
[Epithelioid angiomatosis and HIV infection. A neoplastic or infectious proliferative disease?].
A case of "epithelioid angiomatosis" detected in a homosexual patient with positive seric HIV is presented. The skin lesions cytoplasm rich, closed y clumped together, with scanty stromal compound. Warthin-Starry staining [correction of tintions] did not show Bacillus causing "cat scratch disease". We review and analyse the features of this type of proliferation in patients infected with HIV.
Acquired Immunodeficiency Syndrome↗
[Kikuchi-Fujimoto necrotizing lymphadenitis. Report of 2 cases].
Kikuchi-Fujimoto disease (KFD) is a form of necrotizing lymphadenitis. The disease is a usually benign, self limited cause of lymph node enlargement affecting predominantly young women. Several other clinical manifestations have been described, though the only consistent findings are a macular eruption and a fever. Occasionally, the disease has presented as a fever of unknown origin. Lymph node specimens show areas of necrosis without neutrophilic infiltration. Lymphocyte mediated apoptotic mechanisms are responsible for the necrosis observed. Clinically, it should be differentiated from many different conditions, including infections such as cat scratch disease and rheumatological diseases like Still's disease and Systemic Lupus Erythematosus. Pathologically, it should be differentiated from lymphomas. KFD is widely known in the Far East, but very rare in Latin America. As a matter of fact, we have only detected four reported cases from Argentina, Brazil and Chile. We here describe two additional cases from Argentina. Both occurred in young women. One had a mediastinal compromise and a recurrent course, only observed in 4% of cases. The second one had a classical cervical presentation. The diagnosis in both was made by lymph node biopsy, although, in areas of great prevalence, an aspiration may be sufficient to establish the disease. We anticipate that the real prevalence of this unusual disease is highly underrepresented.
Adult↗