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Aslan Tuncay S, Akkoc G, Yilmaz S, Dizi Isik A, Canizci Erdemli P, Parlak B, Buyuktas Aytac D, Abaci Capar MC, Almus E, Yapici O, Binici B, Ataizi Celikel C, Ocal Demir S. Unusual presentation of cat scratch disease: case report. Eur J Clin Microbiol Infect Dis 2024; 43:1661-1665. [PMID: 38913229 PMCID: PMC11271358 DOI: 10.1007/s10096-024-04872-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 06/14/2024] [Indexed: 06/25/2024]
Abstract
Cat scratch disease (CSD) is an infection caused by Bartonella henselae, presents with non-specific symptoms like lymphadenopathy, fever, and fatigue. It can progress to disseminated disease, leading to complications such as liver and splenic micro abscesses, osteomyelitis, encephalitis, and uveitis. Diagnosis is challenging due to varied presentations and limited tests. Treatment involves supportive care, with severe cases requiring antimicrobial therapy. In this report, we present a case of Cat scratch disease characterized by an atypical clinical manifestation, hepatosplenic and paravertebral involvement.
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Affiliation(s)
- Sevgi Aslan Tuncay
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Faculty of Medicine, Marmara University, Fevzi Cakmak, Muhsin Yazicioglu St, No:10, Floor: 6, Istanbul, Turkey
| | - Gulsen Akkoc
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Faculty of Medicine, Marmara University, Fevzi Cakmak, Muhsin Yazicioglu St, No:10, Floor: 6, Istanbul, Turkey.
| | - Seyhan Yilmaz
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Faculty of Medicine, Marmara University, Fevzi Cakmak, Muhsin Yazicioglu St, No:10, Floor: 6, Istanbul, Turkey
| | - Aylin Dizi Isik
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Faculty of Medicine, Marmara University, Fevzi Cakmak, Muhsin Yazicioglu St, No:10, Floor: 6, Istanbul, Turkey
| | - Pinar Canizci Erdemli
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Faculty of Medicine, Marmara University, Fevzi Cakmak, Muhsin Yazicioglu St, No:10, Floor: 6, Istanbul, Turkey
| | - Burcu Parlak
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Faculty of Medicine, Marmara University, Fevzi Cakmak, Muhsin Yazicioglu St, No:10, Floor: 6, Istanbul, Turkey
| | - Didem Buyuktas Aytac
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Faculty of Medicine, Marmara University, Fevzi Cakmak, Muhsin Yazicioglu St, No:10, Floor: 6, Istanbul, Turkey
| | - Meryem Cagla Abaci Capar
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Faculty of Medicine, Marmara University, Fevzi Cakmak, Muhsin Yazicioglu St, No:10, Floor: 6, Istanbul, Turkey
| | - Eda Almus
- Department of Radiology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Ozge Yapici
- Department of Radiology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Beyza Binici
- Department of Medical Pathology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Cigdem Ataizi Celikel
- Department of Medical Pathology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Sevliya Ocal Demir
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Faculty of Medicine, Marmara University, Fevzi Cakmak, Muhsin Yazicioglu St, No:10, Floor: 6, Istanbul, Turkey
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Caceres IP, Ruml A, Montejano R, Jalali O, Rosen T. Bacillary Angiomatosis in a Patient With HIV and Disseminated Mycobacterium avium Complex Infection. Cureus 2024; 16:e63392. [PMID: 39077245 PMCID: PMC11283915 DOI: 10.7759/cureus.63392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2024] [Indexed: 07/31/2024] Open
Abstract
Bartonella is a genus of arthropod-borne bacterial pathogens that typically cause persistent infections of erythrocytes and endothelial cells in mammalian hosts. The species that primarily infect humans are Bartonella henselae and Bartonella quintana. Depending on immune status, the clinical presentation of B. henselae may differ, manifesting as cat-scratch disease in immunocompetent individuals or bacillary angiomatosis (BA) and peliosis in immunocompromised patients. The cutaneous manifestations of BA are typically characterized by occasionally painful, angiomatous papules and nodules, often with a chronic, persistent course. Herein, we present a case of biopsy-confirmed B. henselae infection in a 32-year-old HIV-positive female with acquired immunodeficiency syndrome in the setting of disseminated Mycobacterium avium complex infection, an association that has been less frequently described. This case serves as an important reminder to consider uncommon opportunistic infectious etiologies when examining immunocompromised patients, as prompt diagnosis and treatment are essential in this patient population.
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Affiliation(s)
| | | | | | - Omid Jalali
- Dermatology, Baylor College of Medicine, Houston, USA
| | - Theodore Rosen
- Dermatology, Michael E. DeBakey Veterans Affairs Medical Center, Baylor College of Medicine, Houston, USA
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3
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Korleski J, Martinez-Sosa S, Shah A. 73-Year-Old Woman With Fatigue. Mayo Clin Proc 2024:S0025-6196(24)00030-2. [PMID: 38762817 DOI: 10.1016/j.mayocp.2023.12.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/16/2023] [Accepted: 12/19/2023] [Indexed: 05/20/2024]
Affiliation(s)
- Joon Korleski
- Resident in Internal Medicine, Mayo Clinic School of Graduate Medical Education, Rochester, MN
| | - Santiago Martinez-Sosa
- Resident in Internal Medicine, Mayo Clinic School of Graduate Medical Education, Rochester, MN
| | - Aditya Shah
- Advisor to residents and Consultant in Public Health, Infectious Diseases and Occupational Medicine.
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4
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Aubry A, Corvilain E, Ghelfenstein-Ferreira T, Camelena F, Meignin V, Berçot B, Le Goff J, Salmona M. Unmasking Bartonella henselae infection in the shadows of long COVID thanks to clinical metagenomics. Eur J Clin Microbiol Infect Dis 2024; 43:1025-1029. [PMID: 38472519 DOI: 10.1007/s10096-024-04801-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 03/07/2024] [Indexed: 03/14/2024]
Abstract
The diagnosis of long COVID often relies on symptoms post-COVID-19, occasionally lacking biological evidence. This case study illustrates how investigating long COVID uncovered an underlying bartonellosis through clinical metagenomics. Following mild COVID-19, a 26-year-old woman experienced persistent symptoms during 5 months, including axillary adenopathy. Pathological examination, 16 S rRNA PCR, and clinical metagenomic analysis were done on an adenopathy biopsy. The latter revealed Bartonella henselae DNA and RNA. Treatment with clarithromycin improved symptoms. This case underscores the relevance of clinical metagenomics in diagnosing hidden infections. Post-COVID symptoms warrant thorough investigation, and bartonellosis should be considered in polyadenopathy cases, regardless of a recent history of cat or flea exposures.
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Affiliation(s)
- Aurélien Aubry
- Virology Department, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France.
- Resistant Infectious Agents and Chemotherapy Research Unit, AGIR UR4294, Jules Verne University of Picardie, Amiens, 80000, France.
| | - Emilie Corvilain
- Clinical Immunology Department, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Théo Ghelfenstein-Ferreira
- Parasitology-Mycology Department, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - François Camelena
- Bacteriology Department, Saint Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- University Paris Cité, INSERM 1137, IAME, Paris, France
| | - Véronique Meignin
- Pathology Department, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Béatrice Berçot
- Bacteriology Department, Saint Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- University Paris Cité, INSERM 1137, IAME, Paris, France
| | - Jérôme Le Goff
- Virology Department, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
- University Paris Cité, Inserm U976, INSIGHT Team, Paris, France
| | - Maud Salmona
- Virology Department, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
- University Paris Cité, Inserm U976, INSIGHT Team, Paris, France
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5
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de Lorenzi-Tognon M, Schrenzel J. Simplified Spectrum Score (S 3) app for pathogen-agnostic antimicrobial drug spectrum ranking to assess for antimicrobial de-escalation events. Sci Rep 2024; 14:9776. [PMID: 38684841 PMCID: PMC11059348 DOI: 10.1038/s41598-024-60041-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 04/18/2024] [Indexed: 05/02/2024] Open
Abstract
Antimicrobial/antibiotic de-escalation (ADE) is a key feature of antimicrobial stewardship programs (ASP) that relies mainly on individual panels for determining ADE events based on subjective ranking of antibiotics' spectrum activity. The lack of consensus among ASP experts leads to reproducibility issues in the measure of this clinical outcome, making difficult to assess its real impact on patient care. The S3 score (Simplified Spectrum Score) app was developed to allow an objective ranking of antibiotics. Ranking was achieved by developing a database harboring pairs of bacteria-antibiotics for which each molecule was assigned a score based on published and clinically validated data from a recognized international committee. S3 score shows a strong correlation relationship and substantial agreement to a clinically validated spectrum score, and its framework enables any person to use it for ADE detection without assuming prior knowledge or training. In addition, its design enables regular updates and sustainability.
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Affiliation(s)
- Mikaël de Lorenzi-Tognon
- Bacteriology Laboratory, Division of Laboratory Medicine, Department of Diagnostics, Geneva University Hospitals, 4 Rue Gabrielle-Perret-Gentil, 1211, Geneva 14, Switzerland.
- Genomic Research Laboratory, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
| | - Jacques Schrenzel
- Bacteriology Laboratory, Division of Laboratory Medicine, Department of Diagnostics, Geneva University Hospitals, 4 Rue Gabrielle-Perret-Gentil, 1211, Geneva 14, Switzerland
- Genomic Research Laboratory, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Infectious Diseases, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland
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6
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Dong Y, Alhaskawi A, Zou X, Zhou H, Ezzi SHA, Kota VG, Abdulla MHAH, Olga A, Abdalbary SA, Lu H. Post-COVID reactivation of latent Bartonella henselae infection: a case report and literature review. BMC Infect Dis 2024; 24:422. [PMID: 38649899 PMCID: PMC11034019 DOI: 10.1186/s12879-024-09336-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 04/19/2024] [Indexed: 04/25/2024] Open
Abstract
Cat scratch disease (CSD) is caused by Bartonella henselae (B. henselae) and presents as lymphadenopathy following close contact with cats. However, in context of the global COVID-19 pandemic, clinical manifestations of CSD may vary, posing new challenges for healthcare professionals. Here we describe a case of a 54-year-old male with painful left upper arm mass, which gradually resolved until he was infected with COVID-19. The mass then rapidly progressed before admission. Meanwhile, pulmonary symptoms including pleural effusion emerged simultaneously. The cause was undetermined with routine blood culture and pathological test until the next generation sequencing (NGS) confirmed the presence of B. henselae. We believe this case is the first to report localized aggravation of CSD after COVID-19 infection and hopefully, offers treatment experience for clinicians worldwide.
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Affiliation(s)
- Yanzhao Dong
- Department of Orthopedics, The First Affiliated Hospital, Zhejiang University, #79 Qingchun Road, Hangzhou, Zhejiang Province, 310003, People's Republic of China
| | - Ahmad Alhaskawi
- Department of Orthopedics, The First Affiliated Hospital, Zhejiang University, #79 Qingchun Road, Hangzhou, Zhejiang Province, 310003, People's Republic of China
| | - Xiaodi Zou
- The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, 310003, People's Republic of China
| | - Haiying Zhou
- School of Biomedical Science, Faculty of Medicine, The Chinese University of Hong Kong, Rm 706, 7/F, Lo Kwee-Seong Integrated Biomedical Science Bldg, Shatin, New Territories, Hong Kong, China
| | - Sohaib Hasan Abdullah Ezzi
- Department of Orthopedics, Third Xiangya Hospital, Central South University, #138 Tongzi po Road, Changsha, Hunan Province, 410013, People's Republic of China
| | - Vishnu Goutham Kota
- Zhejiang University School of Medicine, #866 Yuhangtang Road, Hangzhou, Zhejiang Province, 3100058, People's Republic of China
| | | | - Alenikova Olga
- Department of Neurology, Republican Research and Clinical Center of Neurology and Neurosurgery, Skoriny, Minsk, Belarus
| | - Sahar Ahmed Abdalbary
- Department of Orthopedic Physical Therapy, Faculty of Physical Therapy, Nahda University in Beni Suef, Beni Suef, Egypt
| | - Hui Lu
- Department of Orthopedics, The First Affiliated Hospital, Zhejiang University, #79 Qingchun Road, Hangzhou, Zhejiang Province, 310003, People's Republic of China.
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Stroescu RF, Chisavu F, Steflea RM, Doros G, Bizerea-Moga TO, Vulcanescu DD, Marti TD, Boru C, Avram CR, Gafencu M. A Retrospective Analysis of Systemic Bartonella henselae Infection in Children. Microorganisms 2024; 12:666. [PMID: 38674610 PMCID: PMC11051763 DOI: 10.3390/microorganisms12040666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 03/20/2024] [Accepted: 03/25/2024] [Indexed: 04/28/2024] Open
Abstract
Systemic Bartonella henselae infection, also known as cat-scratch disease (CSD), presents a diagnostic challenge due to the variability of clinical manifestations and the potential for serological cross-reactivity with other organisms. This study aimed to retrospectively analyze the epidemiological, clinical, laboratory, and imaging characteristics of pediatric patients diagnosed with systemic B. henselae infection, to improve understanding and facilitate timely diagnosis and treatment. We conducted a 10-year retrospective study at the "Louis Turcanu" Children's Emergency Hospital and private clinics in Timisoara, Romania, reviewing records for confirmed cases of B. henselae infection from January 2014 to January 2024. The study adhered to the Declaration of Helsinki and received approval from the Institutional Review Board. Diagnostic criteria included contact with animals, prolonged fever, hematological and/or hepatosplenic manifestations, and positive serological tests for B. henselae. Nineteen pediatric patients were identified with a median age of 8.1 years. The majority were exposed to felines (94.7%), reflecting the disease's epidemiological profile. Clinical findings highlighted fever (47.4%), lymphadenopathy (78.9%), and less frequently, abdominal pain and headache (both 10.5%). Laboratory analyses revealed a mean hemoglobin of 12.6 mg/dL, WBC count of 13.1 × 103 cells/microliter, and platelet count of 340.6 × 103 per microliter. Significant findings included elevation in ESR and CRP in 47.4% and 21.1% of patients, respectively, and high seropositivity rates for B. henselae IgM (63.2%) and IgG (94.7%). Imaging studies demonstrated widespread lymphadenopathy and occasional splenomegaly and hepatic microabscesses. All patients received antibiotic therapy, with azithromycin being the most commonly used (94.7%). Co-infections with Epstein-Barr Virus, Cytomegalovirus, and Toxoplasma gondii were documented, indicating the complex infectious status of the patients. Systemic B. henselae infection in children predominantly manifests with fever and lymphadenopathy, with a significant history of exposure to felines. Laboratory and imaging findings support the diagnosis, which is further complicated by potential co-infections. Effective antibiotic therapy, primarily with azithromycin, underscores the need for comprehensive diagnostic and treatment strategies. This study emphasizes the importance of considering systemic B. henselae infection in pediatric patients with prolonged fever and contact with cats, to ensure timely and appropriate treatment.
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Affiliation(s)
- Ramona Florina Stroescu
- Department XI of Pediatrics—1st Pediatric Discipline, Center for Research on Growth and Developmental Disorders in Children, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania; (R.F.S.); (R.M.S.)
- 4th Pediatric Clinic, “Louis Turcanu” Children’s Clinical and Emergency Hospital, Iosif Nemoianu 2, 300011 Timisoara, Romania; (F.C.); (G.D.); (M.G.)
| | - Flavia Chisavu
- 4th Pediatric Clinic, “Louis Turcanu” Children’s Clinical and Emergency Hospital, Iosif Nemoianu 2, 300011 Timisoara, Romania; (F.C.); (G.D.); (M.G.)
- Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine “Victor Babes”, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - Ruxandra Maria Steflea
- Department XI of Pediatrics—1st Pediatric Discipline, Center for Research on Growth and Developmental Disorders in Children, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania; (R.F.S.); (R.M.S.)
- 4th Pediatric Clinic, “Louis Turcanu” Children’s Clinical and Emergency Hospital, Iosif Nemoianu 2, 300011 Timisoara, Romania; (F.C.); (G.D.); (M.G.)
| | - Gabriela Doros
- 4th Pediatric Clinic, “Louis Turcanu” Children’s Clinical and Emergency Hospital, Iosif Nemoianu 2, 300011 Timisoara, Romania; (F.C.); (G.D.); (M.G.)
- Department XI of Pediatrics—3rd Pediatric Discipline, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania
| | - Teofana-Otilia Bizerea-Moga
- Department XI of Pediatrics—1st Pediatric Discipline, Center for Research on Growth and Developmental Disorders in Children, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania; (R.F.S.); (R.M.S.)
- 4th Pediatric Clinic, “Louis Turcanu” Children’s Clinical and Emergency Hospital, Iosif Nemoianu 2, 300011 Timisoara, Romania; (F.C.); (G.D.); (M.G.)
| | - Dan Dumitru Vulcanescu
- Department of Microbiology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania;
- Multidisciplinary Research Center on Antimicrobial Resistance (MULTI-REZ), Microbiology Department, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania
| | - Teodora Daniela Marti
- Department of Medicine, “Vasile Goldis” University of Medicine and Pharmacy, 310414 Arad, Romania; (T.D.M.); (C.B.)
- Department of Microbiology, Emergency County Hospital, 310037 Arad, Romania
| | - Casiana Boru
- Department of Medicine, “Vasile Goldis” University of Medicine and Pharmacy, 310414 Arad, Romania; (T.D.M.); (C.B.)
| | - Cecilia Roberta Avram
- Department of Residential Training and Post-University Courses, “Vasile Goldis” Western University, 310414 Arad, Romania;
| | - Mihai Gafencu
- 4th Pediatric Clinic, “Louis Turcanu” Children’s Clinical and Emergency Hospital, Iosif Nemoianu 2, 300011 Timisoara, Romania; (F.C.); (G.D.); (M.G.)
- Department XI of Pediatrics—3rd Pediatric Discipline, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania
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López-Rueda S, Valente-Acosta B, Murillo-Zolezzi A, Moreno-Sánchez F, Hoyo-Ulloa I, Baquera-Heredia JJ. A Man in His Forties with Recurrent Cat-Scratch Disease. Case Rep Infect Dis 2024; 2024:4411133. [PMID: 38444733 PMCID: PMC10914428 DOI: 10.1155/2024/4411133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 02/05/2024] [Accepted: 02/22/2024] [Indexed: 03/07/2024] Open
Abstract
Cat-scratch disease (CSD) is a self-limited zoonotic infection transmitted by felines caused by the Gram-negative bacillus Bartonella henselae. It usually presents with lymphadenopathy and constitutional symptoms that resolve within eight weeks, with, or without antibiotic treatment. The diagnosis is made by serology, molecular diagnosis in a biopsy, or a positive culture. The recurrence or reactivation of B. henselae has rarely been reported. We present the case of a 45-year-old man with a history of CSD two years before who presented to the clinic with groin lymphadenopathy. The patient had a history of close contact with felines though no known risk exposure was reported. The diagnosis was made with a positive serology suggestive of recent infection along with histopathological changes suggestive of CSD. Subsequently, azithromycin was administered with complete resolution of symptoms.
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Affiliation(s)
- Sara López-Rueda
- The American British Cowdray Medical Center, Sur 136 116, Alvaro Obregon, Mexico City 01120, Mexico
| | - Benjamin Valente-Acosta
- The American British Cowdray Medical Center, Sur 136 116, Alvaro Obregon, Mexico City 01120, Mexico
| | - Adrian Murillo-Zolezzi
- The American British Cowdray Medical Center, Sur 136 116, Alvaro Obregon, Mexico City 01120, Mexico
| | - Francisco Moreno-Sánchez
- The American British Cowdray Medical Center, Sur 136 116, Alvaro Obregon, Mexico City 01120, Mexico
| | - Irma Hoyo-Ulloa
- The American British Cowdray Medical Center, Sur 136 116, Alvaro Obregon, Mexico City 01120, Mexico
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Pizzuti M, Bailey P, Derrick C, Albrecht B, Carr AL, Covington EW, Deri CR, Green SB, Hayes J, Hobbs ALV, Hornback KM, Keil E, Lukas JG, Seddon M, Taylor AD, Torrisi J, Bookstaver PB. Epidemiology and treatment of invasive Bartonella spp. infections in the United States. Infection 2024:10.1007/s15010-024-02177-1. [PMID: 38300353 DOI: 10.1007/s15010-024-02177-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 01/05/2024] [Indexed: 02/02/2024]
Abstract
OBJECTIVES Bartonella spp., renowned for cat-scratch disease, has limited reports of dissemination. Tissue and blood cultures have limitations in detecting this fastidious pathogen. Molecular testing (polymerase chain reaction, PCR) and cell-free DNA have provided an avenue for diagnoses. This retrospective observational multicenter study describes the incidence of disseminated Bartonella spp. and treatment-related outcomes. METHODS Inclusion criteria were diagnosis of bartonellosis via diagnosis code, serology testing of blood, polymerase chain reaction (PCR) of blood, 16/18S tests of blood or tissue, cultures of blood or tissue, or cell-free DNA of blood or tissue from January 1, 2014, through September 1, 2021. Exclusions were patients who did not receive treatment, insufficient data on treatment course, absence of dissemination, or retinitis as dissemination. RESULTS Patients were primarily male (n = 25, 61.0%), white (n = 28, 68.3%), with mean age of 50 years (SD 14.4), and mean Charlson comorbidity index of 3.5 (SD 2.1). Diagnosis was primarily by serology (n = 34, 82.9%), with Bartonella henselae (n = 40, 97.6%) as the causative pathogen. Treatment was principally doxycycline with rifampin (n = 17, 41.5%). Treatment failure occurred in 16 (39.0%) patients, due to escalation of therapy during treatment (n = 5, 31.3%) or discontinuation of therapy due to an adverse event or tolerability (n = 5, 31.3%). CONCLUSIONS In conclusion, this is the largest United States-based cohort of disseminated Bartonella spp. infections to date with a reported 39% treatment failure. This adds to literature supporting obtaining multiple diagnostic tests when Bartonella is suspected and describes treatment options.
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Affiliation(s)
- Morgan Pizzuti
- Prisma Health Richland, 5 Richland Medical Park Drive, Columbia, SC, 29203, USA.
| | - Pamela Bailey
- Prisma Health Richland, 5 Richland Medical Park Drive, Columbia, SC, 29203, USA.
- University of South Carolina School of Medicine, 2 Richland Medical Park Drive, Suite 205, Columbia, SC, 29203, USA.
| | - Caroline Derrick
- Prisma Health Richland, 5 Richland Medical Park Drive, Columbia, SC, 29203, USA
| | | | | | | | - Connor R Deri
- Duke University Hospital, Durham, NC, USA
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, NC, USA
| | | | | | | | | | | | | | - Megan Seddon
- Sarasota Memorial Health Care System, Sarasota, FL, USA
| | - Alex D Taylor
- Atrium Health Wake Forest Baptist, Winston-Salem, NC, USA
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10
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Hirakawa J, Kawamura M, Hoshina T, Taniguchi M, Kondo H, Satake H, Nawata A, Tsuneoka H, Kusuhara K. A Pediatric Case of Disseminated Bartonella henselae Infection Accompanied by Multiple Intracranial Lesions. Pediatr Infect Dis J 2024; 43:e63-e65. [PMID: 37922477 DOI: 10.1097/inf.0000000000004153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2023]
Abstract
We report a pediatric case of disseminated Bartonella henselae infection accompanied by multiple intracranial lesions. The patient developed multiple intracranial lesions despite treatment with azithromycin and gentamicin. After switching to rifampicin, the clinical symptoms of the patient improved. Given its good penetration into the central nervous system, rifampicin may be recommended for the treatment of B. henselae infection accompanied by intracranial lesions.
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Affiliation(s)
| | | | | | | | | | | | - Aya Nawata
- Department of Pathology and Oncology, School of Medicine, University of Occupational and Environmental Health Japan, Kitakyushu, Japan
| | - Hidehiro Tsuneoka
- Department of Clinical Laboratory Science, Faculty of Health Science, Yamaguchi University Graduate School of Medicine, Ube, Japan
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11
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Repko A, Kim JY, Paulus R, Rayala B. Pleural and pericardial effusions with fever and altered mental status: an atypical presentation of bartonellosis. BMJ Case Rep 2024; 17:e255682. [PMID: 38286581 PMCID: PMC10826540 DOI: 10.1136/bcr-2023-255682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024] Open
Abstract
A male in his 60s presented to the emergency department (ED) with a 3-week history of fever and progressive confusion. Initial laboratory and radiographic workup was largely unremarkable except for moderate bilateral pleural effusions. The patient was admitted on broad-spectrum antibiotics and further workup for fever of unknown aetiology. The differential diagnosis was broadened to different zoonotic infections, and subsequent laboratory testing showed a markedly elevated Bartonella henselae IgG and Bartonella quintana IgG (1:4096 and 1:512, respectively) in addition to positive B. henselae IgM titre (>1:20). During hospitalisation, the patient became more hypoxic and was found to have enlarging pleural effusions as well as a new pericardial effusion. The patient was treated with intravenous then oral doxycycline 100 mg two times per day and oral rifampin 300 mg two times per day for 4 weeks with subsequent improvement in clinical status as well as both effusions. This case highlights a unique presentation of Bartonella and its rare manifestation of pleural and pericardial effusions.
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Affiliation(s)
- Alex Repko
- School of Medicine, VCOM, Blacksburg, Virginia, USA
| | - Ju Young Kim
- Family Medicine, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Ryan Paulus
- Family Medicine, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Brian Rayala
- Family Medicine, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
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12
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Kitamura M, Dasgupta A, Henricks J, Parikh SV, Nadasdy T, Clark E, Bazan JA, Satoskar AA. Clinicopathological differences between Bartonella and other bacterial endocarditis-related glomerulonephritis - our experience and a pooled analysis. FRONTIERS IN NEPHROLOGY 2024; 3:1322741. [PMID: 38288381 PMCID: PMC10823370 DOI: 10.3389/fneph.2023.1322741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/27/2023] [Indexed: 01/31/2024]
Abstract
Background Although Staphylococcus aureus is the leading cause of acute infective endocarditis (IE) in adults, Bartonella spp. has concomitantly emerged as the leading cause of "blood culture-negative IE" (BCNE). Pre-disposing factors, clinical presentation and kidney biopsy findings in Bartonella IE-associated glomerulonephritis (GN) show subtle differences and some unique features relative to other bacterial infection-related GNs. We highlight these features along with key diagnostic clues and management approach in Bartonella IE-associated GN. Methods We conducted a pooled analysis of 89 cases of Bartonella IE-associated GN (54 published case reports and case series; 18 published conference abstracts identified using an English literature search of several commonly used literature search modalities); and four unpublished cases from our institution. Results Bartonella henselae and Bartonella quintana are the most commonly implicated species causing IE in humans. Subacute presentation, affecting damaged native and/or prosthetic heart valves, high titer anti-neutrophil cytoplasmic antibodies (ANCA), mainly proteinase-3 (PR-3) specificity, fastidious nature and lack of positive blood cultures of these Gram-negative bacilli, a higher frequency of focal glomerular crescents compared to other bacterial infection-related GNs are some of the salient features of Bartonella IE-associated GN. C3-dominant, but frequent C1q and IgM immunofluorescence staining is seen on biopsy. A "full-house" immunofluorescence staining pattern is also described but can be seen in IE -associated GN due to other bacteria as well. Non-specific generalized symptoms, cytopenia, heart failure and other organ damage due to embolic phenomena are the highlights on clinical presentation needing a multi-disciplinary approach for management. Awareness of the updated modified Duke criteria for IE, a high index of suspicion for underlying infection despite negative microbiologic cultures, history of exposure to animals, particularly infected cats, and use of send-out serologic tests for Bartonella spp. early in the course of management can help in early diagnosis and initiation of appropriate treatment. Conclusion Diagnosis of IE-associated GN can be challenging particularly with BCNE. The number of Bartonella IE-associated GN cases in a single institution tends to be less than IE due to gram positive cocci, however Bartonella is currently the leading cause of BCNE. We provide a much-needed discussion on this topic.
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Affiliation(s)
- Mineaki Kitamura
- Department of Pathology, Division of Renal and Transplant Pathology, The Ohio State University Wexner Medical Center, Columbus, OH, United States
- Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Alana Dasgupta
- Department of Pathology, Division of Renal and Transplant Pathology, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Jonathan Henricks
- Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Samir V. Parikh
- Department of Internal Medicine, Division of Nephrology, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Tibor Nadasdy
- Department of Pathology, Division of Renal and Transplant Pathology, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Edward Clark
- Department of Internal Medicine, St. Vincent Hospital, Erie, PA, United States
| | - Jose A. Bazan
- Department of Internal Medicine, Division of Infectious Disease, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Anjali A. Satoskar
- Department of Pathology, Division of Renal and Transplant Pathology, The Ohio State University Wexner Medical Center, Columbus, OH, United States
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13
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Zhou T, Zheng Y, Zhang H, Liu Y. A case report of diagnosis of cat-scratch disease using metagenomic next-generation sequencing. Front Cell Infect Microbiol 2024; 13:1322651. [PMID: 38287977 PMCID: PMC10822884 DOI: 10.3389/fcimb.2023.1322651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/12/2023] [Indexed: 01/31/2024] Open
Abstract
Cat-scratch disease (CSD) is an anthropozoonotic infection caused by Bartonella henselae, and it is one of the most common causes of lymph node infections in children and adolescents. B. henselae, belonging to the genus Bartonella, is a common human pathogen of human beings. CSD commonly develops as a result of cat scratches and bites or when injured skin comes into contact with cat saliva. The manifestation of CSD clinically differs for each patient based on their immune system. Individuals who have healthy immune systems generally manifest minimal clinical symptoms and do not necessitate any form of treatment. However, patients who have hypo-immunity require prompt medical attention due to the potential manifestation of severe symptoms that affect multiple systems of the body. Long latency and atypical clinical manifestations are characteristics of CSD. Bartonella isolation and identification are challenging procedures that require specialized equipment. There is no gold standard method for CSD diagnosis, and misdiagnosis and missed diagnosis rates are typically high. We present the case of a middle-aged male patient who developed fever, chills, anal distension, dizziness, and muscle pain for 10 days. The patient had a documented history of cat bites 1 month prior to the onset of symptoms. Following admission, he underwent an examination to determine superficial lymphadenopathy and hypoimmunity. Additionally, he had a fever during the disease. As the patient refused a needle biopsy of lymph nodes, metagenomic next-generation sequencing (mNGS) was employed and B. henselae was detected in the peripheral blood. The patient was diagnosed with CSD and treated with a combination of azithromycin and doxycycline. The fever symptoms were alleviated, and the patient was ultimately discharged. As a result of this case, we suggest that mNGS be used as a crucial supplementary diagnostic tool for individuals with compromised immune systems who may have CSD, especially when conventional diagnostic methods are inconclusive.
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Affiliation(s)
- Tao Zhou
- Department of Infectious Disease Department, The Third People’s Hospital of Chengdu, Chengdu, China
| | - Yaqiu Zheng
- Digestive Endoscopy Center, Public Health Clinical Center of Chengdu, Chengdu, China
| | - Huizi Zhang
- Department of Geriatric, Bishan Hospital of Chongqing Medical University, Chongqing, China
| | - Yongfang Liu
- Department of Infectious Disease Department, The Third People’s Hospital of Chengdu, Chengdu, China
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14
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Takeda R, Kobayashi K, Kubotsu K, Umekawa Y. Atypical presentation of severe cat scratch disease: suspected from patient history and physical findings. BMJ Case Rep 2024; 17:e258905. [PMID: 38191221 PMCID: PMC10806908 DOI: 10.1136/bcr-2023-258905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024] Open
Affiliation(s)
- Riki Takeda
- Internal Medicine, General Incorporated Foundation Kurashiki Medical Center, Kurashiki, Okayama, Japan
| | - Keigo Kobayashi
- Internal Medicine, General Incorporated Foundation Kurashiki Medical Center, Kurashiki, Okayama, Japan
| | - Kosuke Kubotsu
- Internal Medicine, General Incorporated Foundation Kurashiki Medical Center, Kurashiki, Okayama, Japan
| | - Yasuhiro Umekawa
- Internal Medicine, General Incorporated Foundation Kurashiki Medical Center, Kurashiki, Okayama, Japan
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15
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Carujo A, Santos Silva A, Videira Santos F, Furtado MJ, Vasconcelos AL. Optic Neuritis and Vertebral Osteomyelitis: An Uncommon Presentation of Cat-Scratch Disease. Cureus 2024; 16:e52284. [PMID: 38357045 PMCID: PMC10865162 DOI: 10.7759/cureus.52284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2024] [Indexed: 02/16/2024] Open
Abstract
In cat-scratch disease (CSD), hematogenous spread may result in atypical presentations. Ocular manifestations develop in a minority of patients, with treatment being important in reducing long-term visual sequelae. Bone infection is rare. We present the case of a 52-year-old woman, with close contact with cats, reporting acute unilateral blurred vision and presenting papilledema, optic disc pallor, and peripapillary hemorrhage. Etiologic study of optic neuritis revealed an elevated positive Bartonella IgG; hence, treatment for CSD with doxycycline plus rifampin and corticosteroids was started. Concomitant lumbar pain of increasing intensity warranted magnetic resonance imaging, which revealed L3-L4 vertebral osteomyelitis with spondylodiscitis. Given the temporal link with CSD diagnosis and the significant clinical improvement since its treatment was started, an etiologic link was presumed and antibiotics were prolonged. This case stands out for the presence of distinct atypical CSD manifestations in the same patient. Further studies are needed to determine the optimal treatment for rare manifestations, particularly bone infection.
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Affiliation(s)
- António Carujo
- Infectious Diseases Department, Santo António University Hospital, Porto, PRT
| | - André Santos Silva
- Infectious Diseases Department, Santo António University Hospital, Porto, PRT
- Abel Salazar Biomedical Sciences Institute, University of Porto, Porto, PRT
| | | | - Maria João Furtado
- Ophthalmology Department, Santo António University Hospital, Porto, PRT
- Abel Salazar Biomedical Sciences Institute, University of Porto, Porto, PRT
| | - António Ludgero Vasconcelos
- Infectious Diseases Department, Santo António University Hospital, Porto, PRT
- Abel Salazar Biomedical Sciences Institute, University of Porto, Porto, PRT
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16
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Santos LSD, Drummond MR, Goulart IMB, França AFEDC, Souza EMD, Ferreira Velho PEN. Bartonella henselae as a putative trigger for chronic type 2 leprosy reactions. Braz J Infect Dis 2023; 27:103701. [PMID: 37980941 PMCID: PMC10709108 DOI: 10.1016/j.bjid.2023.103701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/20/2023] [Accepted: 10/31/2023] [Indexed: 11/21/2023] Open
Abstract
Leprosy reactions are an acute inflammatory phenomenon that can arise before diagnosis, during treatment, or after cure of leprosy. These reactions are considered one of the main diseases that cause physical disabilities. Immunosuppressive treatment for these immune responses makes these patients susceptible to coinfections, which can trigger new leprosy reactions. The main objective of this study was to evaluate the occurrence of infection by Bartonella sp. in blood samples from 47 patients who had untreatable episodes of type 2 leprosy reactions for more than six months, comparing them with a control group. Cultures and molecular methods (PCR) were used. Amplicons from species-specific reactions and sequencing showed a higher prevalence of Bartonella henselae infection in patients, 19/47 (40.4 %), compared to control, 9/50 (18.0 %), p = 0.0149. Five patients accepted treatment for coinfection, and all showed improvement in leprosy reactions with treatment for B. henselae infection. We conclude that these bacteria can trigger chronic reactions of type 2 leprosy and should be investigated in these patients. SUMMARY LINE: Patients who have chronic type 2 leprosy reactions are more susceptible to Bartonella henselae infection than controls: 19/47 (40.4 %) compared 9/50 (18.0 %), p = 0.0149.
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Affiliation(s)
- Luciene Silva Dos Santos
- Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Laboratório de Pesquisa Aplicada em Dermatologia e Infecção por Bartonella, Campinas, SP, Brazil.
| | - Marina Rovani Drummond
- Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Laboratório de Pesquisa Aplicada em Dermatologia e Infecção por Bartonella, Campinas, SP, Brazil
| | - Isabela Maria Bernardes Goulart
- Universidade Federal de Uberlândia, Centro Nacional de Referência em Dermatologia Sanitária e Hanseníase, Uberlândia, MG, Brazil
| | | | - Elemir Macedo de Souza
- Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Departamento de Medicina, Divisão de Dermatologia, Campinas, SP, Brazil
| | - Paulo Eduardo Neves Ferreira Velho
- Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Laboratório de Pesquisa Aplicada em Dermatologia e Infecção por Bartonella, Campinas, SP, Brazil; Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Departamento de Medicina, Divisão de Dermatologia, Campinas, SP, Brazil
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17
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Zeppelini CG, Oliveira DDE, Kosoy MY, Reis MG, Ko AI, Childs JE, Costa F. Bartonella in Norway rats (Rattus norvegicus) from the urban slum environment in Brazil. AN ACAD BRAS CIENC 2023; 95:e20220809. [PMID: 37909607 DOI: 10.1590/0001-3765202320220809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 07/09/2023] [Indexed: 11/03/2023] Open
Abstract
Bartonella are rodent-borne bacteria that cause varied human etiologies. Studies on synanthropic rodents are rare, causing gaps in epidemiological knowledge. We tested bloodclot samples from 79 rats from an urban slum in Salvador, Brazil through PCR targeting gltA gene. Nine samples (11.4%) were positive: six had 100% identity with Bartonella sp. isolate JF429580 and 99.5% with B. queenslandensis strain AUST/NH8; three were 100% identical to isolate JF429532 and 99.7% to B. tribocorum. This is the second report on urban rat Bartonella indicating bacterial circulation at detectable rates. Its presence in rats from vulnerable human settlements demands public health attention.
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Affiliation(s)
- Caio G Zeppelini
- Universidade Federal da Bahia, Instituto de Saúde Coletiva, Rua Basílio da Gama, s/n, Canela, 40110-040 Salvador, BA, Brazil
| | - Daiana DE Oliveira
- Universidade Federal da Bahia, Instituto de Saúde Coletiva, Rua Basílio da Gama, s/n, Canela, 40110-040 Salvador, BA, Brazil
- Fundação Oswaldo Cruz, Ministério da Saúde, Instituto Gonçalo Moniz, Rua Waldemar Falcão, 121, Candeal, 40296-710 Salvador, BA, Brazil
| | - Michael Y Kosoy
- KB One Health, 3244 Reedgrass Ct. Fort Collins, CO 80521, USA
| | - Mitermayer G Reis
- Fundação Oswaldo Cruz, Ministério da Saúde, Instituto Gonçalo Moniz, Rua Waldemar Falcão, 121, Candeal, 40296-710 Salvador, BA, Brazil
- Yale University, School of Public Health, Division of Epidemiology of Microbial Diseases, Laboratory of Epidemiology and Public Health, 60 College St, New Haven, CT 06510, USA
- Universidade Federal da Bahia, Faculdade de Medicina, Av. Reitor Miguel Calmon, s/n, Vale do Canela, 40110-100 Salvador, BA, Brazil
| | - Albert I Ko
- Fundação Oswaldo Cruz, Ministério da Saúde, Instituto Gonçalo Moniz, Rua Waldemar Falcão, 121, Candeal, 40296-710 Salvador, BA, Brazil
- Yale University, School of Public Health, Division of Epidemiology of Microbial Diseases, Laboratory of Epidemiology and Public Health, 60 College St, New Haven, CT 06510, USA
| | - James E Childs
- Yale University, School of Public Health, Division of Epidemiology of Microbial Diseases, Laboratory of Epidemiology and Public Health, 60 College St, New Haven, CT 06510, USA
| | - Federico Costa
- Universidade Federal da Bahia, Instituto de Saúde Coletiva, Rua Basílio da Gama, s/n, Canela, 40110-040 Salvador, BA, Brazil
- Yale University, School of Public Health, Division of Epidemiology of Microbial Diseases, Laboratory of Epidemiology and Public Health, 60 College St, New Haven, CT 06510, USA
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18
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Delgado V, Ajmone Marsan N, de Waha S, Bonaros N, Brida M, Burri H, Caselli S, Doenst T, Ederhy S, Erba PA, Foldager D, Fosbøl EL, Kovac J, Mestres CA, Miller OI, Miro JM, Pazdernik M, Pizzi MN, Quintana E, Rasmussen TB, Ristić AD, Rodés-Cabau J, Sionis A, Zühlke LJ, Borger MA. 2023 ESC Guidelines for the management of endocarditis. Eur Heart J 2023; 44:3948-4042. [PMID: 37622656 DOI: 10.1093/eurheartj/ehad193] [Citation(s) in RCA: 240] [Impact Index Per Article: 240.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/26/2023] Open
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19
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Deng YP, Fu YT, Yao C, Shao R, Zhang XL, Duan DY, Liu GH. Emerging bacterial infectious diseases/pathogens vectored by human lice. Travel Med Infect Dis 2023; 55:102630. [PMID: 37567429 DOI: 10.1016/j.tmaid.2023.102630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/02/2023] [Accepted: 08/08/2023] [Indexed: 08/13/2023]
Abstract
Human lice have always been a major public health concern due to their vector capacity for louse-borne infectious diseases, like trench fever, louse-borne relapsing fever, and epidemic fever, which are caused by Bartonella quintana, Borrelia recurrentis, and Rickettsia prowazekii, respectively. Those diseases are currently re-emerging in the regions of poor hygiene, social poverty, or wars with life-threatening consequences. These louse-borne diseases have also caused outbreaks among populations in jails and refugee camps. In addition, antibodies and DNAs to those pathogens have been steadily detected in homeless populations. Importantly, more bacterial pathogens have been detected in human lice, and some have been transmitted by human lice in laboratories. Here, we provide a comprehensive review and update on louse-borne infectious diseases/bacterial pathogens.
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Affiliation(s)
- Yuan-Ping Deng
- Research Center for Parasites & Vectors, College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan, China
| | - Yi-Tian Fu
- Research Center for Parasites & Vectors, College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan, China; Department of Parasitology, Xiangya School of Basic Medicine, Central South University, Changsha, Hunan, China
| | - Chaoqun Yao
- Department of Biomedical Sciences and One Health Center for Zoonoses and Tropical Veterinary Medicine, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis.
| | - Renfu Shao
- Centre for Bioinnovation, School of Science, Technology and Engineering, University of the Sunshine Coast, Sippy Downs, Australia
| | - Xue-Ling Zhang
- Research Center for Parasites & Vectors, College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan, China
| | - De-Yong Duan
- Research Center for Parasites & Vectors, College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan, China
| | - Guo-Hua Liu
- Research Center for Parasites & Vectors, College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan, China.
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20
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Charles K, Abraham A, Bassi R, Elsadek R, Cockey G. A Rare Case of Bartonella henselae Infective Endocarditis Causing an Embolic Cerebrovascular Accident. Cureus 2023; 15:e41364. [PMID: 37546133 PMCID: PMC10399704 DOI: 10.7759/cureus.41364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2023] [Indexed: 08/08/2023] Open
Abstract
Bartonella is a facultative intracellular Gram-negative aerobic rod that is an important cause of culture-negative endocarditis that only accounts for 3% of all infective endocarditis (IE) cases. Throughout the literature, there have been very few documented cases of an embolic stroke caused by Bartonella henselae (B. henselae) IE. Following a comprehensive review of the literature, it appears that only a small number of articles have reported on the correlation between cerebrovascular accidents (CVAs) and Bartonella IE. Here, we present a case of a 42-year-old male with a cerebral embolic event as a complication of B. henselae IE.
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Affiliation(s)
- Kipson Charles
- Internal Medicine, University of Central Florida College of Medicine, Graduate Medical Education/Hospital Corporation of America (HCA) Florida, North Florida Hospital, Gainesville, USA
| | - Andrew Abraham
- Internal Medicine, University of Central Florida College of Medicine, Graduate Medical Education/Hospital Corporation of America (HCA) Florida, North Florida Hospital, Gainesville, USA
| | - Raghav Bassi
- Internal Medicine, University of Central Florida College of Medicine, Graduate Medical Education/Hospital Corporation of America (HCA) Florida, North Florida Hospital, Gainesville, USA
| | - Rabab Elsadek
- Internal Medicine, University of Central Florida College of Medicine, Graduate Medical Education/Hospital Corporation of America (HCA) Florida, North Florida Hospital, Gainesville, USA
| | - George Cockey
- Internal Medicine, University of Central Florida College of Medicine, Graduate Medical Education/Hospital Corporation of America (HCA) Florida, North Florida Hospital, Gainesville, USA
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21
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Jin X, Gou Y, Xin Y, Li J, Sun J, Li T, Feng J. Advancements in understanding the molecular and immune mechanisms of Bartonella pathogenicity. Front Microbiol 2023; 14:1196700. [PMID: 37362930 PMCID: PMC10288214 DOI: 10.3389/fmicb.2023.1196700] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 05/23/2023] [Indexed: 06/28/2023] Open
Abstract
Bartonellae are considered to be emerging opportunistic pathogens. The bacteria are transmitted by blood-sucking arthropods, and their hosts are a wide range of mammals including humans. After a protective barrier breach in mammals, Bartonella colonizes endothelial cells (ECs), enters the bloodstream, and infects erythrocytes. Current research primarily focuses on investigating the interaction between Bartonella and ECs and erythrocytes, with recent attention also paid to immune-related aspects. Various molecules related to Bartonella's pathogenicity have been identified. The present review aims to provide a comprehensive overview of the newly described molecular and immune responses associated with Bartonella's pathogenicity.
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Affiliation(s)
- Xiaoxia Jin
- Gansu Provincial Key Laboratory of Evidence Based Medicine and Clinical Translation and Lanzhou Center for Tuberculosis Research, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Yuze Gou
- Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences, Lanzhou, China
| | - Yuxian Xin
- Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences, Lanzhou, China
| | - Jingwei Li
- Gansu Provincial Key Laboratory of Evidence Based Medicine and Clinical Translation and Lanzhou Center for Tuberculosis Research, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Jingrong Sun
- Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences, Lanzhou, China
| | - Tingting Li
- Gansu Provincial Key Laboratory of Evidence Based Medicine and Clinical Translation and Lanzhou Center for Tuberculosis Research, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Jie Feng
- Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences, Lanzhou, China
- State Key Laboratory of Veterinary Etiological Biology, College of Veterinary Medicine, Lanzhou University, Lanzhou, China
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22
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Otufowora A, Lee C, Mohideen A, DeSena G, Pringle C, Guyer F, Sharma P, Baines T, Carr S. Cerebral venous sinus thrombosis and skull base osteomyelitis as manifestations of cat-scratch disease in a pediatric patient: A case report and literature review. Clin Case Rep 2023; 11:e7561. [PMID: 37361655 PMCID: PMC10288016 DOI: 10.1002/ccr3.7561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/18/2023] [Accepted: 06/02/2023] [Indexed: 06/28/2023] Open
Abstract
Cat-scratch disease (CSD) is caused by Bartonella henselae and usually presents with regional lymphadenopathy. Skull base osteomyelitis and cerebral venous sinus thrombosis are rarely reported, particularly in immunocompetent children. CSD should be considered in the differential diagnosis of any patient with persistent headaches in the setting of cat exposure.
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Affiliation(s)
- Ayodeji Otufowora
- Department of PediatricsCollege of Medicine, University of FloridaGainesvilleFloridaUSA
| | - Christine Lee
- Department of PediatricsCollege of Medicine, University of FloridaGainesvilleFloridaUSA
| | - Aneeb Mohideen
- Department of PediatricsCollege of Medicine, University of FloridaGainesvilleFloridaUSA
| | - Grace DeSena
- Department of PediatricsCollege of Medicine, University of FloridaGainesvilleFloridaUSA
| | - Charlene Pringle
- Department of PediatricsCollege of Medicine, University of FloridaGainesvilleFloridaUSA
| | - Freddie Guyer
- Department of PediatricsCollege of Medicine, University of FloridaGainesvilleFloridaUSA
| | - Priya Sharma
- Department of RadiologyCollege of Medicine, University of FloridaGainesvilleFloridaUSA
| | - Torrey Baines
- Department of PediatricsCollege of Medicine, University of FloridaGainesvilleFloridaUSA
| | - Silvana Carr
- Department of PediatricsCollege of Medicine, University of FloridaGainesvilleFloridaUSA
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Drummond MR, Dos Santos LS, de Almeida AR, Lins KDA, Barjas-Castro ML, Diniz PPVDP, Velho PENF. Comparison of molecular methods for Bartonella henselae detection in blood donors. PLoS Negl Trop Dis 2023; 17:e0011336. [PMID: 37262044 DOI: 10.1371/journal.pntd.0011336] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 04/25/2023] [Indexed: 06/03/2023] Open
Abstract
The Bartonella genus consists of neglected pathogens associated with potentially transfusional-transmitted and fatal human diseases. We aimed to evaluate Bartonella sp. prevalence in 500 blood donors and compare the results with the data already published about these samples. We used molecular diagnostic methods to detect Bartonella sp.-DNA from blood and liquid culture samples: (A) conventional PCR for two gene regions, the ITS targeting the genus Bartonella and the specific gltA Bartonella henselae; (B) nested PCR for the ftsZ gene and (C) qualitative real-time PCR for the gltA gene, both B. henselae specific. We obtained 30/500 (6%) DNA detections from the blood samples; 77/500 (15.4%) DNA detections from liquid culture samples and five (1%) samples had DNA detection from both. In total, we detected B. henselae DNA from 102/500 (20.4%) donors. The samples used in this study had already been submitted for Bartonella sp.-DNA detection using only a conventional PCR in liquid culture. Sixteen samples (3.2%) were positive previously, and from these 16 samples, 13 were negative in the new investigation. We concluded that the use of liquid culture combined with different molecular tests increases the possibility of detecting Bartonella sp.-DNA, but the tests do not avoid false-negative results. More than a fifth of blood donors had at least one PCR that detected Bartonella sp.-DNA among the eight molecular reactions performed now (four reactions in whole blood and four in liquid culture). Seven percent had B. henselae-DNA detection for two or more distinct regions. Considering the results obtained previously, the DNA of Bartonella spp. was detected or the agent isolated in 23% of analyzed blood donors. The results establish that the low bacteremia and the fastidious characteristics of the bacterium are challenges to laboratory diagnosis and can make it difficult to confirm the infection in patients with bartonelloses.
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Affiliation(s)
- Marina Rovani Drummond
- Applied Research in Dermatology and Bartonella Infection Laboratory, University of Campinas-UNICAMP; Campinas, Sao Paulo, Brazil
| | - Luciene Silva Dos Santos
- Applied Research in Dermatology and Bartonella Infection Laboratory, University of Campinas-UNICAMP; Campinas, Sao Paulo, Brazil
| | - Amanda Roberta de Almeida
- Applied Research in Dermatology and Bartonella Infection Laboratory, University of Campinas-UNICAMP; Campinas, Sao Paulo, Brazil
| | - Karina de Almeida Lins
- Applied Research in Dermatology and Bartonella Infection Laboratory, University of Campinas-UNICAMP; Campinas, Sao Paulo, Brazil
| | | | | | - Paulo Eduardo Neves Ferreira Velho
- Applied Research in Dermatology and Bartonella Infection Laboratory, University of Campinas-UNICAMP; Campinas, Sao Paulo, Brazil
- Division of Dermatology, Department of Medicine, UNICAMP, Campinas, Sao Paulo, Brazil
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Desai K, Dow D, Moorthy GS. Seven-Year-Old Female With Persistent Fever, Myalgias, and Acute Left Temple Edema. Clin Pediatr (Phila) 2023; 62:251-254. [PMID: 36757163 PMCID: PMC9968564 DOI: 10.1177/00099228221119536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Katha Desai
- Duke University School of Medicine, Durham, NC, USA
| | - Dorothy Dow
- Department of Pediatrics, Division of Pediatric Infectious Disease, Duke University Hospital, Durham, NC, USA
| | - Ganga S Moorthy
- Department of Pediatrics, Division of Pediatric Infectious Disease, Duke University Hospital, Durham, NC, USA
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Fusani L, Venturini E, Chiappini E, Galli L. Cat scratch disease in childhood: a 10-year experience of an Italian tertiary care children's hospital. World J Pediatr 2023; 19:189-193. [PMID: 36100799 DOI: 10.1007/s12519-022-00616-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 08/24/2022] [Indexed: 10/14/2022]
Affiliation(s)
- Lara Fusani
- Postgraduate School of Pediatrics, University of Florence, Meyer Children's Hospital, Florence, Italy
| | - Elisabetta Venturini
- Infectious Diseases Unit, Meyer Children's Hospital, Viale Pieraccini 24, Florence, Italy.
| | - Elena Chiappini
- Infectious Diseases Unit, Meyer Children's Hospital, Viale Pieraccini 24, Florence, Italy
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Luisa Galli
- Infectious Diseases Unit, Meyer Children's Hospital, Viale Pieraccini 24, Florence, Italy
- Department of Health Sciences, University of Florence, Florence, Italy
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26
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Huggins LG, Koehler AV, Gasser RB, Traub RJ. Advanced approaches for the diagnosis and chemoprevention of canine vector-borne pathogens and parasites-Implications for the Asia-Pacific region and beyond. ADVANCES IN PARASITOLOGY 2023; 120:1-85. [PMID: 36948727 DOI: 10.1016/bs.apar.2022.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Vector-borne pathogens (VBPs) of canines are a diverse range of infectious agents, including viruses, bacteria, protozoa and multicellular parasites, that are pernicious and potentially lethal to their hosts. Dogs across the globe are afflicted by canine VBPs, but the range of different ectoparasites and the VBPs that they transmit predominate in tropical regions. Countries within the Asia-Pacific have had limited prior research dedicated to exploring the epidemiology of canine VBPs, whilst the few studies that have been conducted show VBP prevalence to be high, with significant impacts on dog health. Moreover, such impacts are not restricted to dogs, as some canine VBPs are zoonotic. We reviewed the status of canine VBPs in the Asia-Pacific, with particular focus on nations in the tropics, whilst also investigating the history of VBP diagnosis and examining recent progress in the field, including advanced molecular methods, such as next-generation sequencing (NGS). These tools are rapidly changing the way parasites are detected and discovered, demonstrating a sensitivity equal to, or exceeding that of, conventional molecular diagnostics. We also provide a background to the armoury of chemopreventive products available for protecting dogs from VBP. Here, field-based research within high VBP pressure environments has underscored the importance of ectoparasiticide mode of action on their overall efficacy. The future of canine VBP diagnosis and prevention at a global level is also explored, highlighting how evolving portable sequencing technologies may permit diagnosis at point-of-care, whilst further research into chemopreventives will be essential if VBP transmission is to be effectively controlled.
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Affiliation(s)
- Lucas G Huggins
- Faculty of Veterinary and Agricultural Sciences, Melbourne Veterinary School, The University of Melbourne, Parkville, VIC, Australia.
| | - Anson V Koehler
- Faculty of Veterinary and Agricultural Sciences, Melbourne Veterinary School, The University of Melbourne, Parkville, VIC, Australia
| | - Robin B Gasser
- Faculty of Veterinary and Agricultural Sciences, Melbourne Veterinary School, The University of Melbourne, Parkville, VIC, Australia
| | - Rebecca J Traub
- Faculty of Veterinary and Agricultural Sciences, Melbourne Veterinary School, The University of Melbourne, Parkville, VIC, Australia
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27
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Limitations of Serological Diagnosis of Typical Cat Scratch Disease and Recommendations for the Diagnostic Procedure. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2023; 2023:4222511. [PMID: 36915870 PMCID: PMC10008113 DOI: 10.1155/2023/4222511] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 01/22/2023] [Accepted: 02/11/2023] [Indexed: 03/07/2023]
Abstract
Introduction Cat scratch disease (CSD) is the most common cause of bacterial infectious lymphadenopathy, especially in children, but its diagnosis still remains challenging. Serological assays are widely applied due to their simplicity and the non-invasive sampling. However, these techniques present several limitations, including not well-defined antigen preparation, assay conditions and cutoff titers, severe cross-reactions with other species and organisms, and the notably ranging seroprevalence in the normal population. The objective of this study is to review the literature in order to determine the best diagnostic procedure for the diagnosis of CSD. Methods Databases including PubMed, Medline, Google Scholar, and Google were searched to determine the best diagnostic procedure for the diagnosis of CSD. A total of 437 papers were identified and screened, and after exclusion of papers that did not fulfill the including criteria, 63 papers were used. Results It was revealed that sensitivities of serological assays varied from 10% to 100%. Indeed, more than half of the studies reported a sensitivity lower than 70%, while 71% of them had a sensitivity lower than 80%. Moreover, specificities of serological assays ranged from 15% to 100%, with 25 assays reporting a specificity lower than 90%. Conclusion It is considered that molecular assays should be the gold standard technique for CSD confirmation, and physicians are reinforced to proceed to lymph node biopsy in suspicious CSD cases.
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Sanford AC, Ugoji AC, Evans AK, Anderson MH. A Seven-Year-Old With Cervical Lymphadenitis and Multiple Animal Exposures. Clin Pediatr (Phila) 2022; 62:514-517. [PMID: 36345070 DOI: 10.1177/00099228221128662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Anna C Sanford
- Tulane University School of Medicine, New Orleans, LA, USA
| | | | - Adele K Evans
- Department of Otolaryngology Head & Neck Surgery, Louisiana State University Health Sciences Center and Children's Hospital New Orleans, New Orleans, LA, USA
| | - Margot H Anderson
- Tulane University School of Medicine and Children's Hospital New Orleans, New Orleans, LA, USA
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29
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Taber R, Pankowski A, Ludwig AL, Jensen M, Magsamen V, Lashnits E. Bartonellosis in Dogs and Cats, an Update. Vet Clin North Am Small Anim Pract 2022; 52:1163-1192. [DOI: 10.1016/j.cvsm.2022.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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30
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Kaya A, Kaya SY, Durmaz G, Mıkayılova N. A woman with lip lesion and submandibular lymphadenopathy. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2022; 40:517-518. [PMID: 36336381 DOI: 10.1016/j.eimce.2021.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 12/16/2021] [Indexed: 06/16/2023]
Affiliation(s)
- Abdurrahman Kaya
- Department of Infectious Disease, Istanbul Training and Research Hospital, Turkey.
| | - Sibel Yıldız Kaya
- Department of Infectious Disease, Medical School of Cerrahpasa, Istanbul University, Turkey
| | - Gamze Durmaz
- Department of Infectious Disease, Istanbul Training and Research Hospital, Turkey
| | - Nurlana Mıkayılova
- Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istanbul Medipol University, Turkey
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31
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Erythromycin Formulations—A Journey to Advanced Drug Delivery. Pharmaceutics 2022; 14:pharmaceutics14102180. [PMID: 36297615 PMCID: PMC9608461 DOI: 10.3390/pharmaceutics14102180] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/06/2022] [Accepted: 10/10/2022] [Indexed: 11/29/2022] Open
Abstract
Erythromycin (ERY) is a macrolide compound with a broad antimicrobial spectrum which is currently being used to treat a large number of bacterial infections affecting the skin, respiratory tract, intestines, bones and other systems, proving great value from a clinical point of view. It became popular immediately after its discovery in 1952, due to its therapeutic effect against pathogens resistant to other drugs. Despite this major advantage, ERY exhibits several drawbacks, raising serious clinical challenges. Among them, the very low solubility in water and instability under acidic conditions cause a limited efficacy and bioavailability. Apart from this, higher doses promote drug resistance and undesirable effects. In order to overcome these disadvantages, during the past decades, a large variety of ERY formulations, including nanoparticles, have emerged. Despite the interest in ERY-(nano)formulations, a review on them is lacking. Therefore, this work was aimed at reviewing all efforts made to encapsulate ERY in formulations of various chemical compositions, sizes and morphologies. In addition, their preparation/synthesis, physico-chemical properties and performances were carefully analysed. Limitations of these studies, particularly the quantification of ERY, are discussed as well.
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32
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Altman MT, Mullin RE, Felder K, Starkey J, Vaz LE, Scruggs BA. An Eye-Opening Case of Persistent Headaches and Fever in a Teenager. Clin Pediatr (Phila) 2022; 62:492-497. [PMID: 36199235 DOI: 10.1177/00099228221123828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Marcus T Altman
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
| | - Rachael E Mullin
- Department of Pediatrics, Doernbecher Children's Hospital, Oregon Health & Science University, Portland, OR, USA
| | - Kimberly Felder
- Division of Pediatric Infectious Diseases, Doernbecher Children's Hospital, Oregon Health & Science University, Portland, OR, USA
| | - Jay Starkey
- Department of Diagnostic Radiology, Oregon Health & Science University, Portland, OR, USA
| | - Louise E Vaz
- Department of Pediatrics, Doernbecher Children's Hospital, Oregon Health & Science University, Portland, OR, USA.,Division of Pediatric Infectious Diseases, Doernbecher Children's Hospital, Oregon Health & Science University, Portland, OR, USA
| | - Brittni A Scruggs
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA.,Vitreoretinal Surgery, Department of Ophthalmology, Mayo Clinic, Rochester, MN, USA
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Kaoual H, Zhioua Braham I, Oubay B, Mili Boussen I, Boukari M, Zhioua R. Imagerie multimodale d’une neurorétinite à Bartonella henselae sans griffure de chat. J Fr Ophtalmol 2022; 45:e388-e390. [DOI: 10.1016/j.jfo.2021.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 09/28/2021] [Accepted: 11/18/2021] [Indexed: 10/17/2022]
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34
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Steed D, Collins J, Farris AB, Guarner J, Yarar D, Friedman-Moraco R, Doane T, Pouch S, Marshall Lyon G, Woodworth MH. Haemophagocytic lymphohistiocytosis associated with bartonella peliosis hepatis following kidney transplantation in a patient with HIV. THE LANCET. INFECTIOUS DISEASES 2022; 22:e303-e309. [PMID: 35500593 PMCID: PMC9942922 DOI: 10.1016/s1473-3099(22)00276-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 10/28/2021] [Accepted: 04/22/2022] [Indexed: 02/04/2023]
Abstract
Bacillary peliosis hepatis is a well recognised manifestation of disseminated Bartonella henselae infection that can occur in immunocompromised individuals. Haemophagocytic lymphohistiocytosis is an immune-mediated condition with features that can overlap with a severe primary infection such as disseminated Bartonella spp infection. We report a case of bacillary peliosis hepatis and secondary haemophagocytic lymphohistiocytosis due to disseminated Bartonella spp infection in a kidney-transplant recipient with well controlled HIV. The patient reported 2 weeks of fever and abdominal pain and was found to have hepatomegaly. He recalled exposure to a sick dog but reported no cat exposures. Laboratory evaluation was notable for pancytopenia and cholestatic injury. The patient met more than five of eight clinical criteria for haemophagocytic lymphohistiocytosis. Pathology review of a bone marrow core biopsy identified haemophagocytosis. A transjugular liver biopsy was done, and histopathology review identified peliosis hepatis. Warthin-Starry staining of the bone marrow showed pleiomorphic coccobacillary organisms. The B henselae IgG titre was 1:512, and Bartonella-specific DNA targets were detected by peripheral blood PCR. Treatment with doxycycline, increased prednisone, and pausing the mycophenolate component of his transplant immunosuppression regimen resulted in an excellent clinical response. Secondary haemophagocytic lymphohistiocytosis can be difficult to distinguish from severe systemic infection. A high index of suspicion can support the diagnosis of systemic Bartonella spp infection in those who present with haemophagocytic lymphohistiocytosis, especially in patients with hepatomegaly, immunosuppression, and germane animal exposures.
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Affiliation(s)
- Danielle Steed
- Division of Hospital Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Jeffrey Collins
- Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA
| | - Alton B Farris
- Department of Medicine, and Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Jeannette Guarner
- Department of Medicine, and Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Dilek Yarar
- Kidney Specialists of Kentucky, Bowling Green, KY, USA
| | | | - Tristan Doane
- Department of Medicine, and Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Stephanie Pouch
- Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA
| | - G Marshall Lyon
- Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA
| | - Michael H Woodworth
- Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA.
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Wang J, Chen W, Wang M, Mi Q, Bo L, Yuan C, Cao Q. Cat Scratch Disease with Generalized Bone Lesions in an Immunocompetent Child. Emerg Microbes Infect 2022; 11:2433-2436. [PMID: 36154565 PMCID: PMC9621248 DOI: 10.1080/22221751.2022.2127378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A 9-year-old immunocompetent girl with prolonged fever for 1 month was suspected of having a malignancy because of generalized bone abnormalities identified by MRI. Histopathology of liver tissues indicated the diagnosis of cat-scratch disease (CSD). Results of NGS, immunofluorescence and immunochemical assay confirmed the causative agent was Bartonella henselae. Paediatricians should increase their awareness of CSD as a cause for bone lesions, except for malignancy.
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Affiliation(s)
- Jing Wang
- Department of Infectious Diseases, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiaotong University
| | - Wenjuan Chen
- Department of Infectious Diseases, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiaotong University
| | - Meng Wang
- School of Agriculture and Biology, Shanghai Jiaotong University
| | - Qiang Mi
- Department of Hematology Oncology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiaotong University
| | - Lijun Bo
- Department of Infectious Diseases, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiaotong University
| | - Congli Yuan
- School of Agriculture and Biology, Shanghai Jiaotong University.,Shanghai Key Laboratory of Veterinary Biotechnology, Shanghai, China
| | - Qing Cao
- Department of Infectious Diseases, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiaotong University
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36
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Li M, Yan K, Jia P, Wei E, Wang H. Metagenomic next-generation sequencing may assist diagnosis of cat-scratch disease. Front Cell Infect Microbiol 2022; 12:946849. [PMID: 36189365 PMCID: PMC9524480 DOI: 10.3389/fcimb.2022.946849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 08/26/2022] [Indexed: 11/28/2022] Open
Abstract
Bartonella henselae, the pathogen that causes cat-scratch disease (CSD), is relatively rare in the clinic. CSD usually causes mild clinical manifestations, which self-heal in a matter of weeks. However, in immunocompromised patients, CSD may cause systemic disorders that can lead to critical illness. Due to the diversity of symptom signs and the lack of a golden standard for diagnosis, identifying atypical CSD in a timely manner presents a challenge. Metagenomic next-generation sequencing (mNGS), is a promising technology that has been widely used in the detection of pathogens in clinical infectious diseases in recent years. mNGS can detect multiple pathogens quickly and accurately from any given source. Here, we present a case of atypical CSD, which was diagnosed using mNGS. The patient manifested a fever of unknown infectious origin, and routine antibiotic treatment was ineffective. mNGS was employed to test the patient’s peripheral blood, which led to the detection of B. henselae. This was rarely seen in previous CSD reports. We surmised that the patient presented with atypical CSD and thus a targeted therapy was recommended. Crucially, the patient recovered rapidly. Based on this case study findings, we recommend that CSD should be included in the differential diagnosis for fever of unknown origin and that mNGS may be helpful in the diagnosis of CSD.
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37
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Drummond MR, dos Santos LS, Fávaro RS, Stucchi RSB, Boin IDFSF, Velho PENF. Cryptogenic hepatitis patients have a higher Bartonella sp.-DNA detection in blood and skin samples than patients with non-viral hepatitis of known cause. PLoS Negl Trop Dis 2022; 16:e0010603. [PMID: 35849566 PMCID: PMC9292087 DOI: 10.1371/journal.pntd.0010603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 06/23/2022] [Indexed: 11/21/2022] Open
Abstract
Background This study aimed to assess the prevalence of Bartonella sp.-DNA detection in blood and skin samples from patients with non-viral end-stage liver disease awaiting liver transplantation. Methodology/Principal findings Blood samples and healthy skin fragments from 50 patients were tested using microbiological and molecular methods. Fifteen patients had cryptogenic hepatitis (CH) and 35 had alcoholic, drug-induced or autoimmune liver disease. DNA was extracted from whole blood and liquid culture samples, isolates, and skin fragments. Thirteen of the 50 patients (26%) had Bartonella henselae DNA detection in their blood (9/50) and/or skin (5/50) samples. Colonies were isolated in 3/50 (6%) and infection was detected in 7/50 (14%) of the 50 patients. B. henselae-DNA detection was more prevalent in patients with CH than in other patients (p = 0.040). Of 39 patients followed-up for at least two years, a higher mortality rate was observed among patients with CH infected with B. henselae (p = 0.039). Conclusions/Significance Further studies assessing the role of B. henselae infection in the pathogenesis of hepatitis patients must be urgently conducted. One in four patients with end-stage liver disease awaiting liver transplantation for hepatitis of non-viral origin had documented B. henselae-DNA detection and cryptogenic hepatitis patients have a higher bacterium molecular detection than patients with non-viral hepatitis of known cause.
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Affiliation(s)
- Marina Rovani Drummond
- Applied Research in Dermatology and Bartonella Infection Laboratory, University of Campinas, UNICAMP, Campinas, São Paulo, Brazil
| | - Luciene Silva dos Santos
- Applied Research in Dermatology and Bartonella Infection Laboratory, University of Campinas, UNICAMP, Campinas, São Paulo, Brazil
| | | | | | | | - Paulo Eduardo Neves Ferreira Velho
- Applied Research in Dermatology and Bartonella Infection Laboratory, University of Campinas, UNICAMP, Campinas, São Paulo, Brazil
- Division of Dermatology, Department of Medicine, UNICAMP, Campinas, São Paulo, Brazil
- * E-mail:
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38
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Case Report: Treatment of Severe Neuroretinitis and other Sequelae Associated with Cat Scratch Disease. Optom Vis Sci 2022; 99:662-669. [PMID: 35849047 DOI: 10.1097/opx.0000000000001922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE Severe vision loss from Bartonella neuroretinitis can best be treated to improve visual outcomes with a combination of systemic corticosteroids and antibiotics. Topical ketorolac 0.5% and difluprednate 0.05% are presented as a new adjunct therapy to potentially improve visual outcomes. PURPOSE This case illustrates severe posterior pole complications that can occur with cat scratch disease disseminated to the eye. Combination therapy with antibiotics and corticosteroids results in better visual outcomes. Topical treatment might further enhance visual outcome by preventing inflammatory damage without significant immunosuppression. CASE REPORT A 17-year-old male presented with right eye vision loss. He had been hospitalized two weeks prior for optic neuritis and treated with intravenous methylprednisolone. After 3 days vision had improved from 20/200 to 20/40. After positive serology for Bartonella henselae was obtained, he was released and treated with oral rifampin, doxycycline and prednisone. Sixteen days later he regressed to 20/200 and many more ophthalmic complications were observed. After discontinuation of rifampin, oral prednisone was continued for an additional two weeks and doxycycline was continued for approximately 3 weeks. Topical drops ketorolac 0.5% BID and difluprednate 0.05% QID were used for over 6 weeks before tapering after vision returned to normal. CONCLUSIONS Bartonella neuroretinitis associated with preretinal hemorrhage, vitritis and subretinal hemorrhage can be successfully treated with a combination of systemic medications and topical drops. Monotherapy with doxycycline is effective and well tolerated. Rifampin can cause rapid metabolization and reduction in plasma levels of both prednisone and doxycycline and should be avoided with combined therapy. Oral prednisone and topical difluprednate are recommended to quell initial inflammation during the first few weeks. The anti-inflammatory effects of doxycycline and topical ketorolac used for longer duration may be beneficial in preventing tissue damage without systemic immunosuppression and result in better visual outcomes.
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Shi Y, Yang J, Qi Y, Xu J, Shi Y, Shi T, Liu C, Ma X. Detection of Bartonella vinsonii subsp. berkhoffii in a HIV patient using metagenomic Next Generation Sequencing. Emerg Microbes Infect 2022; 11:1764-1767. [PMID: 35736664 PMCID: PMC9295814 DOI: 10.1080/22221751.2022.2094287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Bartonella species are fastidious, aerobic bacteria that are transmitted by blood-sucking arthropods. Bartonella spp. are responsible for cat scratch disease, Carrion’s disease, bacillary angiomatosis and trench fever. On the other hand, Bartonella vinsonii is rarely reported in the literature and there exist a few reports of systemic infection caused by Bartonella vinsonii in patients with acquired immunodeficiency syndrome. A 31-year-old male (diagnosed with AIDS six years ago) had persistent fever and ulceration in the right knee. The elevated levels of inflammatory markers suggested an infectious aetiology. Despite the negative findings of blood culture, metagenomic Next-Generation Sequencing of plasma detected Bartonella vinsonii. The polymerase chain reaction of whole blood and Sanger sequencing confirmed the mNGS findings. Immunohistochemical staining had later suggested bacillary angiomatosis, which was consistent with Bartonella infection. Following antibiotic treatment, the ulcers subsided significantly, but a high fever persisted. The patient died due to sudden respiratory failure.
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Affiliation(s)
- Yuru Shi
- Infection hospital area of the First Affiliated Hospital of University of science and technology of China, Hefei, China
| | - Jing Yang
- Infection hospital area of the First Affiliated Hospital of University of science and technology of China, Hefei, China
| | - Yingjie Qi
- Infection hospital area of the First Affiliated Hospital of University of science and technology of China, Hefei, China
| | - Junlan Xu
- Infection hospital area of the First Affiliated Hospital of University of science and technology of China, Hefei, China
| | - Yingqi Shi
- Medical Department, Hangzhou Matridx Biotechnology Co., Ltd, Hangzhou, China
| | - Tiantian Shi
- Medical Department, Hangzhou Matridx Biotechnology Co., Ltd, Hangzhou, China
| | - Chao Liu
- Medical Department, Hangzhou Matridx Biotechnology Co., Ltd, Hangzhou, China
| | - Xiaoling Ma
- Infection hospital area of the First Affiliated Hospital of University of science and technology of China, Hefei, China
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40
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Gattoussi S, Romdhane BB, Seneclauze A, Rougier MB, Korobelnik JF. Choroidal granulomas due to Bartonella henselae infection: A case series. Eur J Ophthalmol 2022; 32:3498-3502. [PMID: 35450442 DOI: 10.1177/11206721221091376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To report a case series of 3 patients with choroidal granulomas due to Bartonella henselae infection in order to raise awareness about this etiology in the differential diagnosis of choroidal granulomas. METHODS, PATIENTS A retrospective case series of patients with choroidal granulomas due to Bartonella henselae infection who consulted between 2018 and 2020. Data were collected from the medical records (demographics, visual acuity (VA), laboratory tests, treatment, imaging). RESULTS Patients were a 48-year old man, a 14-year old girl and a 31-year old man. They all had a choroidal granuloma seen on optical coherence tomography (OCT) and angiography. The laboratory work-up revealed a positive serology for Bartonella henselae in all patients. CONCLUSION On multimodal imaging choroidal granulomas in B Henselae appeared as single or multiple, uni or bilateral round yellowish lesions. Fluorescein and indocyanine green angiography of the granuloma showed respectively a late staining and a hypofluorescence. On EDI-OCT choroidal granuloma appeared as a round hyporeflective lesion in the choroid with a retinal elevation. The exclusion of other diagnosis, the natural course and the serology must lead the ophthalmologist to evoke the diagnosis.
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Affiliation(s)
- Sarra Gattoussi
- Department of Ophthalmology, Bordeaux Hospital, Bordeaux, France.,27086Univ. Bordeuax, INSERM, BPH, Bordeaux, France
| | | | | | - M B Rougier
- Department of Ophthalmology, Bordeaux Hospital, Bordeaux, France.,27086Univ. Bordeuax, INSERM, BPH, Bordeaux, France
| | - J F Korobelnik
- Department of Ophthalmology, Bordeaux Hospital, Bordeaux, France.,27086Univ. Bordeuax, INSERM, BPH, Bordeaux, France
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41
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The Passenger Domain of Bartonella bacilliformis BafA Promotes Endothelial Cell Angiogenesis via the VEGF Receptor Signaling Pathway. mSphere 2022; 7:e0008122. [PMID: 35379004 PMCID: PMC9044958 DOI: 10.1128/msphere.00081-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Bartonella bacilliformis is a Gram-negative bacterial pathogen that provokes pathological angiogenesis and causes Carrion’s disease, a neglected tropical disease restricted to South America. Little is known about how B. bacilliformis facilitates vasoproliferation resulting in hemangioma in the skin in verruga peruana, the chronic phase of Carrion’s disease. Here, we demonstrate that B. bacilliformis extracellularly secrets a passenger domain of the autotransporter BafA exhibiting proangiogenic activity. The B. bacilliformis-derived BafA passenger domain (BafABba) increased the number of human umbilical endothelial cells (HUVECs) and promoted tube-like morphogenesis. Neutralizing antibody against BafABba detected the BafA derivatives from the culture supernatant of B. bacilliformis and inhibited the infection-mediated hyperproliferation of HUVECs. Moreover, stimulation with BafABba promoted phosphorylation of vascular endothelial growth factor receptor 2 (VEGFR2) and extracellular-signal-regulated kinase 1/2 in HUVECs. Suppression of VEGFR2 by anti-VEGFR2 antibody or RNA interference reduced the sensitivity of cells to BafABba. In addition, surface plasmon resonance analysis confirmed that BafABba directly interacts with VEGFR2 with lower affinity than VEGF or Bartonella henselae-derived BafA. These findings indicate that BafABba acts as a VEGFR2 agonist analogous to the previously identified B. henselae- and Bartonella quintana-derived BafA proteins despite the low sequence similarity. The identification of a proangiogenic factor produced by B. bacilliformis that directly stimulates endothelial cells provides an important insight into the pathophysiology of verruga peruana. IMPORTANCEBartonella bacilliformis causes life-threatening bacteremia or dermal eruption known as Carrion’s disease in South America. During infection, B. bacilliformis promotes endothelial cell proliferation and the angiogenic process, but the underlying molecular mechanism has not been well understood. We show that B. bacilliformis induces vasoproliferation and angiogenesis by producing the proangiogenic autotransporter BafA. As the cellular/molecular basis for angiogenesis, BafA stimulates the signaling pathway of vascular endothelial growth factor receptor 2 (VEGFR2). Identification of functional BafA protein from B. bacilliformis in addition to B. henselae and B. quintana, the causes of cat scratch disease and trench fever, raises the possibility that BafA is a common virulence factor for human-pathogenic Bartonella.
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Érythème noueux compliquant une maladie des griffes du chat : une association et des implications thérapeutiques à connaître. Rev Med Interne 2022; 43:316-319. [DOI: 10.1016/j.revmed.2022.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 01/12/2022] [Accepted: 01/22/2022] [Indexed: 11/23/2022]
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43
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Kaya A, Kaya SY, Durmaz G, Mıkayılova N. A woman with lip lesion and submandibular lymphadenopathy. Enferm Infecc Microbiol Clin 2022. [DOI: 10.1016/j.eimc.2021.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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44
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Patel R, Koran K, Call M, Schnee A. A case of Bartonella henselae native valve endocarditis presenting with crescentic glomerulonephritis. IDCases 2021; 27:e01366. [PMID: 34984170 PMCID: PMC8692998 DOI: 10.1016/j.idcr.2021.e01366] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 11/29/2021] [Accepted: 12/15/2021] [Indexed: 11/19/2022] Open
Abstract
Bartonella endocarditis is often an elusive diagnosis, usually derived from evaluating multiple laboratory tests and assessment of presenting symptoms. Herein we describe a case of Bartonella henselae native mitral valve endocarditis with an initial presentation of volume overload and renal failure. The Bartonella organism is tedious to isolate from culture medium, causing most diagnoses to be delayed. Due to the destructive nature of B. henselae endocarditis, the need for rapid identification remains prudent. This therefore creates an opportunity for Next Generation Sequencing (NGS) to be used. We further summarize the varied presentations that may be associated with B. henselae endocarditis, and hope that this will heighten the clinicians' awareness of this entity when presented with acute onset renal failure and culture negative vegetations.
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Affiliation(s)
- Roshni Patel
- Prisma Health Infectious Disease Specialists, 890 West Faris Road, Suite 520, Greenville, SC 29605, USA
| | - Kansas Koran
- Prisma Health Infectious Disease Specialists, 890 West Faris Road, Suite 520, Greenville, SC 29605, USA
| | - Mark Call
- Prisma Health Infectious Disease Specialists, 890 West Faris Road, Suite 520, Greenville, SC 29605, USA
| | - Amanda Schnee
- Prisma Health Infectious Disease Specialists, 890 West Faris Road, Suite 520, Greenville, SC 29605, USA
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45
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Davis K, Battaglia L, Kumar B, Ojaimi S. Bartonella henselae masquerading as possible gamma-delta T-cell lymphoma in a paediatric patient with 22q11.2 deletion syndrome. BMJ Case Rep 2021; 14:e245592. [PMID: 34848411 PMCID: PMC8634235 DOI: 10.1136/bcr-2021-245592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2021] [Indexed: 11/04/2022] Open
Abstract
A 14-year-old boy with 22q11.2 deletion syndrome and a right ventricular to pulmonary artery xenograft conduit presented to an Australian tertiary children's hospital with prolonged fevers, weight loss, splenomegaly and a high proportion of gamma-delta T cells in peripheral blood and bone marrow, concerning for possible gamma-delta T-cell lymphoma. However, investigations did not reveal evidence of lymphoma or autoimmune disease. After 5 months of intermittent fever episodes and ongoing symptoms, he was found to have an extremely high Bartonella henselae titre (8192) on serological testing, with the organism also detected on blood PCR. After 6 months of oral azithromycin and rifampicin, with complete resolution of his symptoms 3 months into treatment, his blood PCR was negative and gamma-delta T cells in peripheral blood were decreasing. The B. henselae titre remained unchanged for some time, but decreased to 2048 around 1 year after treatment was started.
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Affiliation(s)
- Kimberly Davis
- Department of Paediatrics, Monash Children's Hospital, Clayton, Victoria, Australia
| | - Lauren Battaglia
- Department of Paediatrics, Monash Children's Hospital, Clayton, Victoria, Australia
| | - Beena Kumar
- Department of Anatomical Pathology, Monash Medical Centre, Clayton, Victoria, Australia
| | - Samar Ojaimi
- Department of Immunology, Monash Medical Centre, Clayton, Victoria, Australia
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46
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Affiliation(s)
- Brett W Dietz
- From the Divisions of Rheumatology (B.W.D., M.M.), HIV, Infectious Diseases, and Global Medicine (L.G.W.), and Infectious Diseases (J.E.K.), Department of Medicine, University of California, San Francisco, and the San Francisco Veterans Affairs Health System (B.W.D.) - both in San Francisco
| | - Lisa G Winston
- From the Divisions of Rheumatology (B.W.D., M.M.), HIV, Infectious Diseases, and Global Medicine (L.G.W.), and Infectious Diseases (J.E.K.), Department of Medicine, University of California, San Francisco, and the San Francisco Veterans Affairs Health System (B.W.D.) - both in San Francisco
| | - Jane E Koehler
- From the Divisions of Rheumatology (B.W.D., M.M.), HIV, Infectious Diseases, and Global Medicine (L.G.W.), and Infectious Diseases (J.E.K.), Department of Medicine, University of California, San Francisco, and the San Francisco Veterans Affairs Health System (B.W.D.) - both in San Francisco
| | - Mary Margaretten
- From the Divisions of Rheumatology (B.W.D., M.M.), HIV, Infectious Diseases, and Global Medicine (L.G.W.), and Infectious Diseases (J.E.K.), Department of Medicine, University of California, San Francisco, and the San Francisco Veterans Affairs Health System (B.W.D.) - both in San Francisco
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47
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Han HJ, Li ZM, Li X, Liu JX, Peng QM, Wang R, Gu XL, Jiang Y, Zhou CM, Li D, Xiao X, Yu XJ. Bats and their ectoparasites (Nycteribiidae and Spinturnicidae) carry diverse novel Bartonella genotypes, China. Transbound Emerg Dis 2021; 69:e845-e858. [PMID: 34695291 PMCID: PMC9543326 DOI: 10.1111/tbed.14357] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 10/15/2021] [Accepted: 10/17/2021] [Indexed: 11/28/2022]
Abstract
Bartonella species are facultative intracellular bacteria and recognized worldwide as emerging zoonotic pathogens. Bartonella were isolated or identified by polymerase chain reaction (PCR) in bats and their ectoparasites worldwide, whereas the association between them was scarce, especially in Asia. In this study, a retrospective analysis with frozen samples was carried out to identify the genetic diversity of Bartonella in bats and their ectoparasites and to investigate the relationships of Bartonella carried by bats and their ectoparasites. Bats and their ectoparasites (bat flies and bat mites) were collected from caves in Hubei Province, Central China, from May 2018 to July 2020. Bartonella were screened by PCR amplification and sequencing of three genes (gltA, rpoB, and ftsZ). Bats, bat flies, and bat mites carried diverse novel Bartonella genotypes with a high prevalence. The sharing of some Bartonella genotypes between bats and bat flies or bat mites indicated a potential role of bat flies and bat mites as vectors of bartonellae, while the higher genetic diversity of Bartonella in bat flies than that in bats might be due to the vertical transmission of this bacterium in bat flies. Therefore, bat flies might also act as reservoirs of Bartonella. In addition, human‐pathogenic B. mayotimonesis was identified in both bats and their ectoparasites, which expanded our knowledge on the geographic distribution of this bacterium and suggested a potential bat origin with bat flies and bat mites playing important roles in the maintenance and transmission of Bartonella.
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Affiliation(s)
- Hui-Ju Han
- State Key Laboratory of Virology, School of Public Health, Wuhan University, Wuhan, China
| | - Ze-Min Li
- State Key Laboratory of Virology, School of Public Health, Wuhan University, Wuhan, China
| | - Xia Li
- Microbiological Laboratory, Yantai Center for Disease Control and Prevention, Yantai, China
| | - Jian-Xiao Liu
- Clinical Laboratory, Xingtai Third Hospital, Xingtai, China
| | - Qiu-Ming Peng
- State Key Laboratory of Virology, School of Public Health, Wuhan University, Wuhan, China
| | - Rui Wang
- State Key Laboratory of Virology, School of Public Health, Wuhan University, Wuhan, China
| | - Xiao-Lan Gu
- State Key Laboratory of Virology, School of Public Health, Wuhan University, Wuhan, China
| | - Yuan Jiang
- State Key Laboratory of Virology, School of Public Health, Wuhan University, Wuhan, China
| | - Chuan-Min Zhou
- State Key Laboratory of Virology, School of Public Health, Wuhan University, Wuhan, China
| | - Dan Li
- State Key Laboratory of Virology, School of Public Health, Wuhan University, Wuhan, China
| | - Xiao Xiao
- Institute of Epidemiology Research, Hubei University of Chinese Medicine, Wuhan, China
| | - Xue-Jie Yu
- State Key Laboratory of Virology, School of Public Health, Wuhan University, Wuhan, China
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Edvinsson M, Norlander C, Nilsson K, Mårtensson A, Skoog E, Olsen B. Bartonella spp. seroprevalence in tick-exposed Swedish patients with persistent symptoms. Parasit Vectors 2021; 14:530. [PMID: 34641972 PMCID: PMC8507314 DOI: 10.1186/s13071-021-05043-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 09/28/2021] [Indexed: 01/10/2023] Open
Abstract
Background Bartonella spp. are emerging pathogens transmitted by arthropod vectors, possibly including ticks. We have investigated signs of bartonellosis in Swedish patients with presumed tick-bite exposure and symptom duration of at least 6 months. Methods Serological testing for Bartonella henselae and Bartonella quintana was performed in 224 patients. Symptoms, tick exposure, evidence of co-infection and previous treatments were evaluated. Seropositive patients were compared to a matched group (twofold larger and negative serology) from the same study cohort. Results Seroprevalence was 7% for B. henselae and 1% for B. quintana, with one patient testing positive to both agents. Tick bites were reported by 63% of the patients in the seropositive group and 88% in the seronegative group and presumed tick exposure was more common in the seronegative group. Animal contact was equally common in both groups, along with reported symptoms. The most common symptoms were fatigue, muscular symptoms, arthralgia and cognitive symptoms. Exposure to co-infections was evenly distributed in the seropositive and seronegative groups. Conclusions Antibodies to Bartonella were more common in this cohort of patients than in cohorts of healthy Swedish blood donors in previous studies but lower than those in blood donors from southern Europe. Positive Bartonella serology was not linked to any specific symptom, nor to (suspected) tick-bite exposure. Graphical abstract ![]()
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Affiliation(s)
- Marie Edvinsson
- Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Uppsala, Sweden.
| | - Camilla Norlander
- Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Uppsala, Sweden
| | - Kenneth Nilsson
- Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Uppsala, Sweden.,Department of Medical Sciences, Section of Clinical Microbiology, Uppsala University, Uppsala, Sweden
| | - Andreas Mårtensson
- Department of Women's and Children's Health, International Maternal and Child Health (IMCH), Uppsala University, Uppsala, Sweden
| | - Elisabet Skoog
- Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Uppsala, Sweden
| | - Björn Olsen
- Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Uppsala, Sweden
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Chen G, Li Z, Ding G. Lymphadénopathie associée à la maladie des griffes du chat. CMAJ 2021; 193:E1547-E1548. [PMID: 34607852 PMCID: PMC8568087 DOI: 10.1503/cmaj.202663-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Guifeng Chen
- Département de pédiatrie (Chen, Li), Premier hôpital du Peuple de Jiashan, Jiashan, Zhejiang, Chine; Département de pneumologie (Ding), Hôpital pédiatrique de Shanghai, Université Jiao Tong de Shanghai, Shanghai, Chine
| | - Zhongjie Li
- Département de pédiatrie (Chen, Li), Premier hôpital du Peuple de Jiashan, Jiashan, Zhejiang, Chine; Département de pneumologie (Ding), Hôpital pédiatrique de Shanghai, Université Jiao Tong de Shanghai, Shanghai, Chine
| | - Guodong Ding
- Département de pédiatrie (Chen, Li), Premier hôpital du Peuple de Jiashan, Jiashan, Zhejiang, Chine; Département de pneumologie (Ding), Hôpital pédiatrique de Shanghai, Université Jiao Tong de Shanghai, Shanghai, Chine.
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50
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Buragamadagu B, Song C, GuhaRoy S, Madison G. Isolated hepatosplenic abscess from cat scratch disease in a patient with HIV. Proc AMIA Symp 2021; 34:593-594. [PMID: 34456481 DOI: 10.1080/08998280.2021.1927424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Bartonella henselae infection, or cat scratch disease, typically is a self-limiting disease presenting as lymphadenopathy and fever after a bite or scratch from a cat. The most commonly reported presentation in immunocompromised patients includes bacillary angiomatosis and peliosis hepatitis, which resemble Kaposi's sarcoma. Isolated hepatosplenic abscess without diffuse lymphadenopathy or vasoproliferative disease is seldom reported in adult immunocompromised patients. Although several advances have been made in identifying the organism and antibodies with serological tests, biopsy, and polymerase chain reaction, there is little information about treatment. We report a case of an isolated hepatosplenic abscess without lymphadenopathy or vasoproliferative disease caused by B. henselae in an adult immunocompromised patient with HIV.
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Affiliation(s)
| | - Chen Song
- Department of Internal Medicine, Mercy Catholic Medical Center, Darby, Pennsylvania
| | - Shambo GuhaRoy
- Department of Radiology, Mercy Catholic Medical Center, Darby, Pennsylvania
| | - Gul Madison
- Department of Infection Control and Antimicrobial Stewardship, Mercy Catholic Medical Center, Darby, Pennsylvania
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