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Kilduff S, Steinman B, Xie Y, Kiss-Farengo T, Foca M, Hayde N. Pet safety guidelines for pediatric transplant recipients. Pediatr Transplant 2024; 28:e14527. [PMID: 37550270 DOI: 10.1111/petr.14527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/06/2023] [Accepted: 03/13/2023] [Indexed: 08/09/2023]
Abstract
Approximately 70% (90.5 million) of United States (US) households own at least one pet. Dogs are the most common, making up about 38% of all household pets, followed by cats, which make up 25%. Other pets such as fish, birds, reptiles, and small animals such as hamsters, gerbils, and rabbits are less common household members. Pets are often considered a part of the family and there are significant medical and psychosocial benefits to pet ownership; however, the possibility of disease transmission exists related to the type of animal and infectious organism, and specific human risk factors. Immunocompromised individuals may be at increased risk of serious illness from zoonotic infections. During the transplant evaluation and routinely posttransplant, the multidisciplinary team should inquire about pet ownership and animal exposures to guide on potential risks. This review discusses the most common diseases seen in various household pets including dogs, cats, birds, fish, and some farm animals. We will also present guidelines for pet safety and include strategies to decrease the risk of infection while supporting the benefits of pet ownership after transplant.
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Affiliation(s)
- Stella Kilduff
- Division of Pediatric Nephrology, Children's Hospital at Montefiore, Bronx, New York, USA
| | - Benjamin Steinman
- Division of Pediatric Nephrology, Children's Hospital at Montefiore, Bronx, New York, USA
| | - Yuping Xie
- Division of Pediatric Nephrology, Children's Hospital at Montefiore, Bronx, New York, USA
| | - Tomas Kiss-Farengo
- Department of Social Work, Children's Hospital at Montefiore, Bronx, New York, USA
| | - Marc Foca
- Divison of Pediatric Infectious Diseases, Children's Hospital at Montefiore, Bronx, New York, USA
| | - Nicole Hayde
- Division of Pediatric Nephrology, Children's Hospital at Montefiore, Bronx, New York, USA
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2
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Morillas JA, Hassanein M, Syed B, Liaqat A, Bergfeld W, Sardiña LA, Fatica R, Lum J. Early post-transplant cutaneous bacillary angiomatosis in a kidney recipient: Case report and review of the literature. Transpl Infect Dis 2021; 23:e13670. [PMID: 34145690 DOI: 10.1111/tid.13670] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 05/19/2021] [Accepted: 06/01/2021] [Indexed: 11/26/2022]
Abstract
Bacillary angiomatosis (BA) is an uncommon systemic disease caused by Bartonella henselae (BH) or Bartonella quintana (BQ) that occurs primarily in immunocompromised hosts. Few cases of BA recipients have been reported in adult solid transplant recipients over the years, with most cases presenting years after transplant. We describe a case of a kidney transplant recipient who developed cutaneous BA very early in the post-transplant period despite not having any exposures. Retrospective testing of donor and recipient's serum was performed and raised the concern for possible donor-derived infection. A literature review encompassing 1990 to present was also performed in order to better understand the clinical presentation, diagnostics and therapeutic approach of this unusual disease. Combined serology, histopathology and molecular testing (polymerase chain reaction [PCR]) were useful in diagnosing BA in our patient as serology alone might be unreliable. Macrolides or doxycycline for at least 3 months is the recommended therapeutic strategy; however, the optimal duration of treatment is not well established in transplant recipients. In our patient, we decided to use doxycycline for 1 year due to gradual resolution of lesions and ongoing immunosuppression. Patient responded successfully without any documented relapse.
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Affiliation(s)
- Jose A Morillas
- Department of Infectious Diseases, Cleveland Clinic, Cleveland, OH, USA.,Transplantation Center, Cleveland Clinic, Cleveland, OH, USA
| | | | - Bushra Syed
- Department of Nephrology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Aimen Liaqat
- Department of Nephrology, Cleveland Clinic, Cleveland, OH, USA
| | - Wilma Bergfeld
- Department of Dermatology and Pathology, Cleveland Clinic, Cleveland, OH, USA
| | - Luis A Sardiña
- Department of Dermatology and Pathology, Cleveland Clinic, Cleveland, OH, USA
| | - Richard Fatica
- Department of Nephrology, Cleveland Clinic, Cleveland, OH, USA.,Transplantation Center, Cleveland Clinic, Cleveland, OH, USA
| | - Jessica Lum
- Department of Infectious Diseases, Cleveland Clinic, Cleveland, OH, USA.,Transplantation Center, Cleveland Clinic, Cleveland, OH, USA
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3
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James L, Keshwani N, Haffner D, Zahlanie Y, Golla S, Agharokh L. Scratching Past Lymphadenopathy: A Case of Bartonella henselae Encephalitis. Pediatr Ann 2020; 49:e359-e362. [PMID: 32785721 DOI: 10.3928/19382359-20200713-01] [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: 11/20/2022]
Abstract
A previously healthy 6-year-old boy presented with new onset seizure activity and altered mental status. His prehospital course included prolonged fever, vague abdominal complaints, and unusual behavior. Neurological testing was unrevealing, and his symptoms slowly improved without intervention. His primary pediatrician had ordered serum antibody titers to Bartonella henselae for testing of prolonged fever in the setting of exposure to a kitten; these were found to be positive for both immunoglobulin G and immunoglobulin M. Further examination for organ involvement revealed splenic and liver micro-abscesses. After completion of his antibiotic course, the patient returned to his cognitive and neurologic baseline with resolution of his abdominal abscesses. This case emphasizes the importance of obtaining a thorough exposure history when evaluating for infectious causes of encephalitis. [Pediatr Ann. 2020;49(8):e359-e362.].
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4
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Bright Red Papules in a HIV-Positive 20-Year-Old Man: Challenge and Answer. Am J Dermatopathol 2020; 41:621. [PMID: 31335424 DOI: 10.1097/dad.0000000000000565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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5
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Maggi RG, Krämer F. A review on the occurrence of companion vector-borne diseases in pet animals in Latin America. Parasit Vectors 2019; 12:145. [PMID: 30917860 PMCID: PMC6438007 DOI: 10.1186/s13071-019-3407-x] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 03/21/2019] [Indexed: 02/07/2023] Open
Abstract
Companion vector-borne diseases (CVBDs) are an important threat for pet life, but may also have an impact on human health, due to their often zoonotic character. The importance and awareness of CVBDs continuously increased during the last years. However, information on their occurrence is often limited in several parts of the world, which are often especially affected. Latin America (LATAM), a region with large biodiversity, is one of these regions, where information on CVBDs for pet owners, veterinarians, medical doctors and health workers is often obsolete, limited or non-existent. In the present review, a comprehensive literature search for CVBDs in companion animals (dogs and cats) was performed for several countries in Central America (Belize, Caribbean Islands, Costa Rica, Cuba, Dominican Republic, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, Panama, Puerto Rico) as well as in South America (Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, French Guiana, Guyana (British Guyana), Paraguay, Peru, Suriname, Uruguay, Venezuela) regarding the occurrence of the following parasitic and bacterial diseases: babesiosis, heartworm disease, subcutaneous dirofilariosis, hepatozoonosis, leishmaniosis, trypanosomosis, anaplasmosis, bartonellosis, borreliosis, ehrlichiosis, mycoplasmosis and rickettsiosis. An overview on the specific diseases, followed by a short summary on their occurrence per country is given. Additionally, a tabular listing on positive or non-reported occurrence is presented. None of the countries is completely free from CVBDs. The data presented in the review confirm a wide distribution of the CVBDs in focus in LATAM. This wide occurrence and the fact that most of the CVBDs can have a quite severe clinical outcome and their diagnostic as well as therapeutic options in the region are often difficult to access and to afford, demands a strong call for the prevention of pathogen transmission by the use of ectoparasiticidal and anti-feeding products as well as by performing behavioural changes.
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Affiliation(s)
- Ricardo G. Maggi
- Department of Clinical Sciences and the Intracellular Pathogens Research Laboratory, College of Veterinary Medicine, North Carolina State University, Raleigh, NC USA
| | - Friederike Krämer
- Institute of Parasitology, Faculty of Veterinary Medicine, Leipzig University, Leipzig, Germany
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6
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Sullivan KE, Bassiri H, Bousfiha AA, Costa-Carvalho BT, Freeman AF, Hagin D, Lau YL, Lionakis MS, Moreira I, Pinto JA, de Moraes-Pinto MI, Rawat A, Reda SM, Reyes SOL, Seppänen M, Tang MLK. Emerging Infections and Pertinent Infections Related to Travel for Patients with Primary Immunodeficiencies. J Clin Immunol 2017; 37:650-692. [PMID: 28786026 PMCID: PMC5693703 DOI: 10.1007/s10875-017-0426-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 07/21/2017] [Indexed: 12/18/2022]
Abstract
In today's global economy and affordable vacation travel, it is increasingly important that visitors to another country and their physician be familiar with emerging infections, infections unique to a specific geographic region, and risks related to the process of travel. This is never more important than for patients with primary immunodeficiency disorders (PIDD). A recent review addressing common causes of fever in travelers provides important information for the general population Thwaites and Day (N Engl J Med 376:548-560, 2017). This review covers critical infectious and management concerns specifically related to travel for patients with PIDD. This review will discuss the context of the changing landscape of infections, highlight specific infections of concern, and profile distinct infection phenotypes in patients who are immune compromised. The organization of this review will address the environment driving emerging infections and several concerns unique to patients with PIDD. The first section addresses general considerations, the second section profiles specific infections organized according to mechanism of transmission, and the third section focuses on unique phenotypes and unique susceptibilities in patients with PIDDs. This review does not address most parasitic diseases. Reference tables provide easily accessible information on a broader range of infections than is described in the text.
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Affiliation(s)
- Kathleen E Sullivan
- Division of Allergy and Immunology, The Children's Hospital of Philadelphia, 3615 Civic Center Blvd., Philadelphia, PA, 19104, USA.
| | - Hamid Bassiri
- Division of Infectious Diseases and Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 3501 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Ahmed A Bousfiha
- Clinical Immunology Unit, Infectious Department, Hopital d'Enfant Abderrahim Harouchi, CHU Ibn Rochd, Laboratoire d'Immunologie Clinique, d'Inflammation et d'Allergie LICIA, Faculté de Médecine et de Pharmacie, Université Hassan II, Casablanca, Morocco
| | - Beatriz T Costa-Carvalho
- Department of Pediatrics, Federal University of São Paulo, Rua dos Otonis, 725, São Paulo, SP, 04025-002, Brazil
| | - Alexandra F Freeman
- NIAID, NIH, Building 10 Room 12C103, 9000 Rockville, Pike, Bethesda, MD, 20892, USA
| | - David Hagin
- Division of Allergy and Immunology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, University of Tel Aviv, 6 Weizmann St, 64239, Tel Aviv, Israel
| | - Yu L Lau
- Department of Paediatrics & Adolescent Medicine, The University of Hong Kong, Rm 106, 1/F New Clinical Building, Pok Fu Lam, Hong Kong.,Queen Mary Hospital, 102 Pokfulam Road, Pok Fu Lam, Hong Kong
| | - Michail S Lionakis
- Fungal Pathogenesis Unit, Laboratory of Clinical Infectious Diseases, National Institute of Allergy & Infectious Diseases (NIAID), National Institutes of Health (NIH), 9000 Rockville Pike, Building 10, Room 11C102, Bethesda, MD, 20892, USA
| | - Ileana Moreira
- Immunology Unit, Hospital de Niños Ricardo Gutiérrez, Gallo 1330, 1425, Buenos Aires, Argentina
| | - Jorge A Pinto
- Division of Immunology, Department of Pediatrics, Federal University of Minas Gerais, Av. Alfredo Balena 190, room # 161, Belo Horizonte, MG, 30130-100, Brazil
| | - M Isabel de Moraes-Pinto
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Federal University of São Paulo, Rua Pedro de Toledo, 781/9°andar, São Paulo, SP, 04039-032, Brazil
| | - Amit Rawat
- Pediatric Allergy and Immunology, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shereen M Reda
- Pediatric Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Saul Oswaldo Lugo Reyes
- Immunodeficiencies Research Unit, National Institute of Pediatrics, Av Iman 1, Torre de Investigacion, Piso 9, Coyoacan, 04530, Mexico City, Mexico
| | - Mikko Seppänen
- Harvinaissairauksien yksikkö (HAKE), Rare Disease Center, Helsinki University Hospital (HUH), Helsinki, Finland
| | - Mimi L K Tang
- Murdoch Children's Research Institute, The Royal Children's Hospital, University of Melbourne, Melbourne, Australia
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7
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Picascia A, Pagliuca C, Sommese L, Colicchio R, Casamassimi A, Labonia F, Pastore G, Pagliarulo C, Cicatiello AG, Castaldo F, Schiano C, Maiello C, Mezza E, D'Armiento FP, Salvatore P, Napoli C. Seroprevalence of Bartonella henselae in patients awaiting heart transplant in Southern Italy. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2017; 50:239-244. [PMID: 26051222 DOI: 10.1016/j.jmii.2015.05.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 04/13/2015] [Accepted: 05/05/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND Bartonella henselae is the etiologic agent of cat-scratch disease. B. henselae infections are responsible for a widening spectrum of human diseases, although often symptomless, ranging from self-limited to life-threatening and show different courses and organ involvement due to the balance between host and pathogen. The role of the host immune response to B. henselae is critical in preventing progression to systemic disease. Indeed in immunocompromised patients, such as solid organ transplant patients, B. henselae results in severe disseminated disease and pathologic vasoproliferation. The purpose of this study was to determine the seroprevalence of B. henselae in patients awaiting heart transplant compared to healthy individuals enrolled in the Regional Reference Laboratory of Transplant Immunology of Second University of Naples. METHODS Serum samples of 38 patients awaiting heart transplant in comparison to 50 healthy donors were examined using immunfluorescence assay. RESULTS We found a B. henselae significant antibody positivity rate of 21% in patients awaiting heart transplant (p = 0.002). There was a positive rate of 8% (p > 0.05) for immunoglobulin (Ig)M and a significant value of 13% (p = 0.02) for IgG, whereas controls were negative both for IgM and IgG antibodies against B. henselae. The differences in comorbidity between cases and controls were statistically different (1.41 ± 0.96 vs 0.42 ± 0.32; p = 0.001). CONCLUSIONS Although this study was conducted in a small number of patients, we suggest that the identification of these bacteria should be included as a routine screening analysis in pretransplant patients.
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Affiliation(s)
- Antonietta Picascia
- Department of Molecular Medicine and Medical Biotechnology, Federico II University Medical School, Naples, Italy; U.O.C. Division of Immunohematology, Transfusion Medicine and Transplant Immunology, Regional Reference Laboratory of Transplant Immunology, Azienda Ospedaliera Universitaria, Second University of Naples, Naples, Italy.
| | - Chiara Pagliuca
- Department of Molecular Medicine and Medical Biotechnology, Federico II University Medical School, Naples, Italy; Department of Integrated Activities of Laboratory Medicine, Federico II University Medical School, Naples, Italy
| | - Linda Sommese
- U.O.C. Division of Immunohematology, Transfusion Medicine and Transplant Immunology, Regional Reference Laboratory of Transplant Immunology, Azienda Ospedaliera Universitaria, Second University of Naples, Naples, Italy
| | - Roberta Colicchio
- Department of Molecular Medicine and Medical Biotechnology, Federico II University Medical School, Naples, Italy; Institute of Diagnostic and Nuclear Development (SDN), Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Naples, Italy
| | - Amelia Casamassimi
- Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, Naples, Italy
| | - Francesco Labonia
- Department of Integrated Activities of Laboratory Medicine, Federico II University Medical School, Naples, Italy
| | - Gabiria Pastore
- Department of Sciences and Technologies, University of Sannio, Benevento, Italy
| | - Caterina Pagliarulo
- Department of Sciences and Technologies, University of Sannio, Benevento, Italy
| | | | - Francesco Castaldo
- Department of Molecular Medicine and Medical Biotechnology, Federico II University Medical School, Naples, Italy
| | - Concetta Schiano
- Institute of Diagnostic and Nuclear Development (SDN), Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Naples, Italy
| | - Ciro Maiello
- Department of Cardiothoracic Sciences, Monaldi Hospital, Second University of Naples, Naples, Italy
| | - Ernesto Mezza
- Department of Advanced Biomedical Sciences, Section of Pathology, Federico II University Medical School, Naples, Italy
| | - Francesco Paolo D'Armiento
- Department of Advanced Biomedical Sciences, Section of Pathology, Federico II University Medical School, Naples, Italy
| | - Paola Salvatore
- Department of Molecular Medicine and Medical Biotechnology, Federico II University Medical School, Naples, Italy
| | - Claudio Napoli
- U.O.C. Division of Immunohematology, Transfusion Medicine and Transplant Immunology, Regional Reference Laboratory of Transplant Immunology, Azienda Ospedaliera Universitaria, Second University of Naples, Naples, Italy; Institute of Diagnostic and Nuclear Development (SDN), Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Naples, Italy
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8
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Montague BT, Salas CM, Montague TL, Mileno MD. The immunosuppressed patient. Infect Dis (Lond) 2017. [DOI: 10.1002/9781119085751.ch28] [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: 11/09/2022] Open
Affiliation(s)
- Brian T. Montague
- Division of Infectious Diseases; University of Colorado; Aurora Colorado USA
| | | | | | - Maria D. Mileno
- Warren Alpert Medical School; Brown University; Providence Rhode Island USA
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9
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Verma SK, Martin A, Montero JA. Atypical Cat Scratch Disease With Hepatosplenic Involvement. Clin Gastroenterol Hepatol 2017; 15:e5-e6. [PMID: 27484614 DOI: 10.1016/j.cgh.2016.07.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 07/20/2016] [Accepted: 07/26/2016] [Indexed: 02/07/2023]
Affiliation(s)
- Sean K Verma
- Division of Infectious Disease and International Medicine, Department of Internal Medicine, University of South Florida, Tampa, Florida
| | - Angel Martin
- Division of Infectious Disease and International Medicine, Department of Internal Medicine, University of South Florida, Tampa, Florida
| | - Jose A Montero
- Division of Infectious Disease and International Medicine, Department of Internal Medicine, University of South Florida, Tampa, Florida
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10
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Chaudhry A, Chaudhry M, Papadimitriou J, Drachenberg C. Bartonella henselaeinfection-associated vasculitis and crescentic glomerulonephritis leading to renal allograft loss. Transpl Infect Dis 2015; 17:411-7. [DOI: 10.1111/tid.12376] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 01/14/2015] [Accepted: 02/16/2015] [Indexed: 01/28/2023]
Affiliation(s)
- A.R. Chaudhry
- Department of General Surgery; Sinai Hospital of Baltimore; Baltimore Maryland USA
| | - M.R. Chaudhry
- Department of Pathology; University of Maryland School of Medicine; Baltimore Maryland USA
| | - J.C. Papadimitriou
- Department of Pathology; University of Maryland School of Medicine; Baltimore Maryland USA
| | - C.B. Drachenberg
- Department of Pathology; University of Maryland School of Medicine; Baltimore Maryland USA
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11
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Orsag J, Flodr P, Melter O, Tkadlec J, Sternbersky J, Hruby M, Klicova A, Zamboch K, Krejci K, Zadrazil J. Cutaneous bacillary angiomatosis due toBartonella quintanain a renal transplant recipient. Transpl Int 2015; 28:626-31. [DOI: 10.1111/tri.12539] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 10/01/2014] [Accepted: 01/30/2015] [Indexed: 12/29/2022]
Affiliation(s)
- Jiri Orsag
- Department of Internal Medicine III - Nephrology, Rheumatology and Endocrinology; Faculty of Medicine and Dentistry; Palacky University and University Hospital; Olomouc Czech Republic
| | - Patrik Flodr
- Department of Clinical and Molecular Pathology; Faculty of Medicine and Dentistry; Palacky University; Olomouc Czech Republic
| | - Oto Melter
- Department of Medical Microbiology; 2nd Faculty of Medicine; Charles University; Prague Czech Republic
| | - Jan Tkadlec
- Department of Medical Microbiology; 2nd Faculty of Medicine; Charles University; Prague Czech Republic
| | - Jan Sternbersky
- Department of Dermatology and Venerology; Faculty of Medicine and Dentistry; Palacky University; Olomouc Czech Republic
| | - Miroslav Hruby
- Department of Internal Medicine III - Nephrology, Rheumatology and Endocrinology; Faculty of Medicine and Dentistry; Palacky University and University Hospital; Olomouc Czech Republic
| | - Anna Klicova
- Department of Internal Medicine III - Nephrology, Rheumatology and Endocrinology; Faculty of Medicine and Dentistry; Palacky University and University Hospital; Olomouc Czech Republic
| | - Kamil Zamboch
- Department of Internal Medicine III - Nephrology, Rheumatology and Endocrinology; Faculty of Medicine and Dentistry; Palacky University and University Hospital; Olomouc Czech Republic
| | - Karel Krejci
- Department of Internal Medicine III - Nephrology, Rheumatology and Endocrinology; Faculty of Medicine and Dentistry; Palacky University and University Hospital; Olomouc Czech Republic
| | - Josef Zadrazil
- Department of Internal Medicine III - Nephrology, Rheumatology and Endocrinology; Faculty of Medicine and Dentistry; Palacky University and University Hospital; Olomouc Czech Republic
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12
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Poudel A, Lew J, Slayton W, Dharnidharka VR. Bartonella henselae infection inducing hemophagocytic lymphohistiocytosis in a kidney transplant recipient. Pediatr Transplant 2014; 18:E83-7. [PMID: 24829973 DOI: 10.1111/petr.12235] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Bartonella henselae (Bh) is the cause of cat-scratch fever. When infection is symptomatic, it typically presents with singular lymphadenitis and fever. Less commonly, the infection can become disseminated and cause endocarditis, osteomyelitis, and micro-abscesses in multiple sites including liver, spleen, eyes, and brain, especially in immunocompromised patients. Hemophagocytic lymphohistiocytosis (Hlh) is a rare and severe multisystem disorder that may be triggered by infections. In one prior case, Bh, like other infections, has induced Hlh, an immune-mediated disease that can be characterized by septic-like presentation with persistent fevers, hepatosplenomegaly, and pancytopenia. In an immunocompromised transplant recipient, the onset of Hlh can be difficult to discern from a severe presentation of Bh. We report a case of criteria-proven secondary Hlh occurring after Bh infection in an 11-yr-old girl who was 13 months post-renal transplant. The patient developed multi-organ failure, and her severe clinical presentation required a thorough evaluation for infectious and non-infectious possibilities including post-transplant lymphoproliferative disorder and rejection. Early recognition of Hlh allowed for better directed therapies, leading to recovery of the patient and resolution of both Bh and Hlh.
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Affiliation(s)
- Atul Poudel
- Department of Pediatrics; University of Florida; College of Medicine and Shands Children`s Hospital; Gainesville FL USA
| | - Judy Lew
- Department of Pediatrics; University of Florida; College of Medicine and Shands Children`s Hospital; Gainesville FL USA
| | - William Slayton
- Department of Pediatrics; University of Florida; College of Medicine and Shands Children`s Hospital; Gainesville FL USA
| | - Vikas R. Dharnidharka
- Department of Pediatrics; University of Florida; College of Medicine and Shands Children`s Hospital; Gainesville FL USA
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13
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Berghoff W. Chronic Lyme Disease and Co-infections: Differential Diagnosis. Open Neurol J 2012; 6:158-78. [PMID: 23400696 PMCID: PMC3565243 DOI: 10.2174/1874205x01206010158] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2012] [Revised: 06/22/2012] [Accepted: 07/02/2012] [Indexed: 12/22/2022] Open
Abstract
In Lyme disease concurrent infections frequently occur. The clinical and pathological impact of co-infections was first recognized in the 1990th, i.e. approximately ten years after the discovery of Lyme disease. Their pathological synergism can exacerbate Lyme disease or induce similar disease manifestations. Co-infecting agents can be transmitted together with Borrelia burgdorferi by tick bite resulting in multiple infections but a fraction of co-infections occur independently of tick bite. Clinically relevant co-infections are caused by Bartonella species, Yersinia enterocolitica, Chlamydophila pneumoniae, Chlamydia trachomatis, and Mycoplasma pneumoniae. In contrast to the USA, human granulocytic anaplasmosis (HGA) and babesiosis are not of major importance in Europe. Infections caused by these pathogens in patients not infected by Borrelia burgdorferi can result in clinical symptoms similar to those occurring in Lyme disease. This applies particularly to infections caused by Bartonella henselae, Yersinia enterocolitica, and Mycoplasma pneumoniae. Chlamydia trachomatis primarily causes polyarthritis. Chlamydophila pneumoniae not only causes arthritis but also affects the nervous system and the heart, which renders the differential diagnosis difficult. The diagnosis is even more complex when co-infections occur in association with Lyme disease. Treatment recommendations are based on individual expert opinions. In antibiotic therapy, the use of third generation cephalosporins should only be considered in cases of Lyme disease. The same applies to carbapenems, which however are used occasionally in infections caused by Yersinia enterocolitica. For the remaining infections predominantly tetracyclines and macrolides are used. Quinolones are for alternative treatment, particularly gemifloxacin. For Bartonella henselae, Chlamydia trachomatis, and Chlamydophila pneumoniae the combination with rifampicin is recommended. Erythromycin is the drug of choice for Campylobacter jejuni.
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Rostad CA, McElroy AK, Hilinski JA, Thompson MP, Drew CP, Denison AM, Zaki SR, Mahle WT, Rogers J, Abramowsky CR, Shehata B. Bartonella henselae-mediated disease in solid organ transplant recipients: two pediatric cases and a literature review. Transpl Infect Dis 2012; 14:E71-81. [PMID: 22862881 DOI: 10.1111/j.1399-3062.2012.00774.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Revised: 03/15/2012] [Accepted: 03/19/2012] [Indexed: 01/27/2023]
Abstract
Bartonella henselae, the etiologic agent of cat-scratch disease, causes a well-defined, self-limited syndrome of fever and regional lymphadenopathy in immunocompetent hosts. In immunocompromised hosts, however, B. henselae can cause severe disseminated disease and pathologic vasoproliferation known as bacillary angiomatosis (BA) or bacillary peliosis. BA was first recognized in patients infected with human immunodeficiency virus. It has become more frequently recognized in solid organ transplant (SOT) recipients, but reports of pediatric cases remain rare. Our review of the literature revealed only one previously reported case of BA in a pediatric SOT recipient. We herein present 2 pediatric cases, one of which is the first reported case of BA in a pediatric cardiac transplant recipient, to our knowledge. In addition, we review and summarize the literature pertaining to all cases of B. henselae-mediated disease in SOT recipients.
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Affiliation(s)
- C A Rostad
- Department of Pediatrics, Emory University, Atlanta, Georgia 30322, USA
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Velho PENF, Ericson ME. Cryptogenic hepatitis and bartonellosis. Dig Dis Sci 2012; 57:1107-8. [PMID: 22307338 DOI: 10.1007/s10620-012-2065-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Accepted: 01/16/2012] [Indexed: 12/09/2022]
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Moulin C, Kanitakis J, Ranchin B, Chauvet C, Gillet Y, Morelon E, Euvrard S. Cutaneous bacillary angiomatosis in renal transplant recipients: report of three new cases and literature review. Transpl Infect Dis 2012; 14:403-9. [PMID: 22316326 DOI: 10.1111/j.1399-3062.2011.00713.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Revised: 10/04/2011] [Accepted: 10/10/2011] [Indexed: 12/19/2022]
Abstract
Bacillary angiomatosis (BA) is a rare vasculoproliferative disorder due to Bartonella henselae (BH) or Bartonella quintana. It can involve many organs, including the skin, and has been mainly reported in patients with acquired immunodeficiency syndrome. In organ transplant recipients (OTR), this disorder remains misdiagnosed and therapeutic guidelines are nonexistent. We report 3 cases of BA with skin involvement in OTR and review similar cases from the literature. BA manifests on the skin with violaceous lesions mimicking Kaposi sarcoma, and is associated with fever, lymphadenopathy, and liver, spleen, or lung nodules. Bartonellosis infections in OTR are due to BH, the agent causing cat-scratch disease (CSD), but BA comprises histologically a prominent vascular proliferation, which is usually lacking in CSD. Cultures and serologic tests are poorly reliable for the diagnosis, which relies on demonstration of BH within the lesions. A history of cat exposure exists in most cases and pediatric OTR are at higher risk. Prevention consists of regular use of a flea-control product in cats and prompt cleaning of scratches. Our cases highlight several original features of this rare condition, which could potentially improve the management of BA in OTR.
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Affiliation(s)
- C Moulin
- Department of Dermatology, Edouard Herriot Hospital Group, Hospices Civils de Lyon, Lyon, France
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VanderHeyden TR, Yong SL, Breitschwerdt EB, Maggi RG, Mihalik AR, Parada JP, Fimmel CJ. Granulomatous hepatitis due to Bartonella henselae infection in an immunocompetent patient. BMC Infect Dis 2012; 12:17. [PMID: 22269175 PMCID: PMC3287964 DOI: 10.1186/1471-2334-12-17] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Accepted: 01/23/2012] [Indexed: 11/15/2022] Open
Abstract
Background Bartonella henselae (B. henselae) is considered a rare cause of granulomatous hepatitis. Due to the fastidious growth characteristics of the bacteria, the limited sensitivity of histopathological stains, and the non-specific histological findings on liver biopsy, the diagnosis of hepatic bartonellosis can be difficult to establish. Furthermore, the optimal treatment of established hepatic bartonellosis remains controversial. Case presentation We present a case of hepatic bartonellosis in an immunocompetent woman who presented with right upper quadrant pain and a five cm right hepatic lobe mass on CT scan. The patient underwent a right hepatic lobectomy. Surgical pathology revealed florid necrotizing granulomatous hepatitis, favoring an infectious etiology. Despite extensive histological and serological evaluation a definitive diagnosis was not established initially. Thirteen months after initial presentation, hepatic bartonellosis was diagnosed by PCR studies from surgically excised liver tissue. Interestingly, the hepatic granulomas persisted and Bartonella henselae was isolated from the patient's enriched blood culture after several courses of antibiotic therapy. Conclusion The diagnosis of hepatic bartonellosis is exceedingly difficult to establish and requires a high degree of clinical suspicion. Recently developed, PCR-based approaches may be required in select patients to make the diagnosis. The optimal antimicrobial therapy for hepatic bartonellosis has not been established, and close follow-up is needed to ensure successful eradication of the infection.
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Affiliation(s)
- Thomas R VanderHeyden
- Department of Internal Medicine, Division of Gastroenterology, Hepatology and Nutrition, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL 60153, USA.
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Bartonella infection in immunocompromised hosts: immunology of vascular infection and vasoproliferation. Clin Dev Immunol 2011; 2012:612809. [PMID: 22162717 PMCID: PMC3227422 DOI: 10.1155/2012/612809] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Revised: 09/27/2011] [Accepted: 09/29/2011] [Indexed: 01/07/2023]
Abstract
Most infections by genus Bartonella in immunocompromised patients are caused by B. henselae and B. quintana. Unlike immunocompetent hosts who usually develop milder diseases such as cat scratch disease and trench fever, immunocompromised patients, including those living with HIV/AIDS and posttransplant patients, are more likely to develop different and severe life-threatening disease. This paper will discuss Bartonella's manifestations in immunosuppressed patients and will examine Bartonella's interaction with the immune system including its mechanisms of establishing infection and immune escape. Gaps in current understanding of the immunology of Bartonella infection in immunocompromised hosts will be highlighted.
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Holmes NE, Opat S, Kelman A, Korman TM. Refractory Bartonella quintana bacillary angiomatosis following chemotherapy for chronic lymphocytic leukaemia. J Med Microbiol 2010; 60:142-146. [PMID: 20947664 DOI: 10.1099/jmm.0.015867-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Bacillary angiomatosis is a well-recognized infection with cutaneous and systemic manifestations caused by Bartonella henselae or Bartonella quintana and occurs in immunocompromised patients. We report a case of B. quintana bacillary angiomatosis following fludarabine-based chemotherapy for chronic lymphocytic leukaemia that was refractory to standard treatment and was complicated by lymphadenopathy and osteomyelitis.
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Affiliation(s)
- Natasha E Holmes
- Department of Infectious Diseases, Southern Health, 246 Clayton Road, Clayton, VIC 3168, Australia
| | - Stephen Opat
- Department of Haematology, Southern Health, 246 Clayton Road, Clayton, VIC 3168, Australia
| | - Anthony Kelman
- Department of Anatomical Pathology, Southern Health, 246 Clayton Road, Clayton, VIC 3168, Australia
| | - Tony M Korman
- Department of Medicine, Monash University, Clayton, VIC 3168, Australia.,Department of Infectious Diseases, Southern Health, 246 Clayton Road, Clayton, VIC 3168, Australia
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Disseminated Infection With Bartonella henselae in a Lung Transplant Recipient. J Heart Lung Transplant 2009; 28:736-9. [PMID: 19560704 DOI: 10.1016/j.healun.2009.03.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2008] [Revised: 03/05/2009] [Accepted: 03/09/2009] [Indexed: 11/21/2022] Open
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Feng S, Kasten RW, Werner JA, Hodzic E, Barthold SW, Chomel BB. Immunogenicity of Bartonella henselae P26 in cats. Vet Immunol Immunopathol 2009; 132:251-6. [PMID: 19500857 DOI: 10.1016/j.vetimm.2009.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2009] [Revised: 04/28/2009] [Accepted: 05/11/2009] [Indexed: 11/18/2022]
Abstract
Cat scratch disease (CSD) has an estimated prevalence of approximately 200,000 persons in the USA, and approximately 22,000 new cases occur annually. Cats are the natural carriers of Bartonella henselae, the agent for CSD. Zoonotic transmission of B. henselae can result in CSD in immunocompetent humans and bacillary angiomatosis in immunosuppressed humans. Infection in cats often goes undetected. Development of a vaccine to prevent feline infection is warranted to reduce the prevalence of infection in the feline population and to decrease the potential for zoonotic transmission. One of the immunoreactive proteins identified from our previous study was P26. In this study, we demonstrated that B. henselae recombinant P26 (rP26) was immunogenic in cats. Four cats immunized with rP26 and four control cats were challenged with B. henselae type I and blood samples were collected for culture, PCR, and serology. Immunization with rP26 did not provide protection against B. henselae infection in cats at the doses used in this study. However, p26 PCR proved to be more sensitive for detection of infection in cats compared to gltA PCR. Furthermore, ELISA using rP26 as the substrate was more sensitive than ELISA using B. henselae type I outer membrane proteins.
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Affiliation(s)
- Sunlian Feng
- Center for Comparative Medicine, Schools of Medicine and Veterinary Medicine, University of California, One Shields Avenue, Davis, CA 95616, United States.
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Bouza E, Loeches B, Muñoz P. Fever of Unknown Origin in Solid Organ Transplant Recipients. Infect Dis Clin North Am 2007; 21:1033-54, ix-x. [DOI: 10.1016/j.idc.2007.09.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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