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Heinrich F, Rauch J, Bertram F, Kempf VAJ, Besier S, Kuta P, Renné T, Ondruschka B, Püschel K, Tappe D. Seroprevalence of arthropod-borne bacterial infections in homeless individuals in Hamburg in 2020. Infection 2023; 51:1819-1822. [PMID: 37289422 PMCID: PMC10665224 DOI: 10.1007/s15010-023-02059-y] [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: 01/12/2023] [Accepted: 05/30/2023] [Indexed: 06/09/2023]
Abstract
PURPOSE The number of homeless people in Germany is steadily increasing. Due to their often precarious living conditions, this specific population may be increasingly exposed to ectoparasites that can transmit various pathogens. To assess the prevalence and thus the risk of such infections, we analyzed the seropositivity of rickettsiosis, Q fever, tularemia and bartonellosis in homeless individuals. METHODS A total of 147 homeless adults from nine shelters in Hamburg, Germany, were included. The individuals underwent questionnaire-based interviewing, physical examination, and venous blood was drawn between May and June 2020. Blood samples were analyzed for antibodies against rickettsiae (Rickettsia typhi and R. conorii), Coxiella burnetii, Francisella tularensis and bartonellae. RESULTS AND CONCLUSION A very low seroprevalence of R. typhi and F. tularensis infection was found (0-1%), while antibodies against R. conorii and C. burnetii were more common (7% each), followed by a relatively high seroprevalence of 14% for bartonellosis. Q fever seroprevalence was associated with the country of origin, whereas bartonellosis seroprevalence was associated with the duration of homelessness. Preventive measures targeting ectoparasites, especially body lice, should be put in place continuously.
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Affiliation(s)
- Fabian Heinrich
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jessica Rauch
- Bernhard Nocht Institute for Tropical Medicine and National Reference Center for Tropical Pathogens, Hamburg, Germany.
| | - Franziska Bertram
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Volkhard A J Kempf
- Institute for Medical Microbiology and Infection Control and German Consiliary Laboratory for Bartonella, Frankfurt, Germany
| | - Silke Besier
- Institute for Medical Microbiology and Infection Control and German Consiliary Laboratory for Bartonella, Frankfurt, Germany
| | - Piotr Kuta
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas Renné
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Irish Centre for Vascular Biology, School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
- Center for Thrombosis and Hemostasis (CTH), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Benjamin Ondruschka
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Klaus Püschel
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dennis Tappe
- Bernhard Nocht Institute for Tropical Medicine and National Reference Center for Tropical Pathogens, Hamburg, Germany
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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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Vaca DJ, Dobler G, Fischer SF, Keller C, Konrad M, von Loewenich FD, Orenga S, Sapre SU, van Belkum A, Kempf VAJ. Contemporary diagnostics for medically relevant fastidious microorganisms belonging to the genera Anaplasma, Bartonella, Coxiella, Orientia, and Rickettsia. FEMS Microbiol Rev 2022; 46:6530194. [PMID: 35175353 PMCID: PMC9300619 DOI: 10.1093/femsre/fuac013] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/07/2022] [Accepted: 02/15/2022] [Indexed: 12/02/2022] Open
Abstract
Many of the human infectious pathogens—especially the zoonotic or vector-borne bacteria—are fastidious organisms that are difficult to cultivate because of their strong adaption to the infected host culminating in their near-complete physiological dependence on this environment. These bacterial species exhibit reduced multiplication rates once they are removed from their optimal ecological niche. This fact complicates the laboratory diagnosis of the disease and hinders the detection and further characterization of the underlying organisms, e.g. at the level of their resistance to antibiotics due to their slow growth. Here, we describe the current state of microbiological diagnostics for five genera of human pathogens with a fastidious laboratory lifestyle. For Anaplasma spp., Bartonella spp., Coxiella burnetii, Orientia spp. and Rickettsia spp., we will summarize the existing diagnostic protocols, the specific limitations for implementation of novel diagnostic approaches and the need for further optimization or expansion of the diagnostic armamentarium. We will reflect upon the diagnostic opportunities provided by new technologies including mass spectrometry and next-generation nucleic acid sequencing. Finally, we will review the (im)possibilities of rapidly developing new in vitro diagnostic tools for diseases of which the causative agents are fastidiously growing and therefore hard to detect.
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Affiliation(s)
- Diana J Vaca
- Institute of Medical Microbiology and Infection Control, Goethe University of Frankfurt, Germany
| | - Gerhard Dobler
- Department of Virology and Rickettsiology, Bundeswehr Institute of Microbiology, Germany
| | - Silke F Fischer
- National Consulting Laboratory for Coxiella burnetii, State Health Office Baden-Württemberg, Germany
| | | | - Maik Konrad
- National Consulting Laboratory for Coxiella burnetii, State Health Office Baden-Württemberg, Germany
| | | | | | | | | | - Volkhard A J Kempf
- Institute of Medical Microbiology and Infection Control, Goethe University of Frankfurt, Germany
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4
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Gonçalves JM, Cardoso TL, de Freitas SB, Woloski R, Neto ACPS, da Silva Pinto L, de Lemos ES, Hartwig DD. In silico analyses and design of chimeric proteins containing epitopes of Bartonella henselae antigens for the control of cat scratch disease. Appl Microbiol Biotechnol 2022; 106:8079-8091. [PMID: 36383248 PMCID: PMC9667432 DOI: 10.1007/s00253-022-12269-3] [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] [Received: 06/27/2022] [Revised: 10/24/2022] [Accepted: 10/31/2022] [Indexed: 11/17/2022]
Abstract
Bartonella henselae is a Gram-negative bacterium that causes cat scratch disease (CSD), as well as bacteremia, endocarditis, and other clinical presentations. CSD remains one of the most common infections caused by bacteria in the genus Bartonella, and it is transmitted to humans through a scratch or cat bite. Vaccination and more efficient diagnostic methods would represent a promising and sustainable alternative measure for CSD control in humans and animals. Here, we described the in silico analyses and design of three recombinant chimeric proteins (rC1, rC2, and rC3), for use in the control of CSD. The chimeras were constructed with epitopes identified from the sequences of the GroEL, 17 kDa, P26, BadA, Pap31, OMP 89, and OMP 43, previously described as the most important B. henselae antigens. The rC1, rC2, and rC3 were expressed and purified using a heterologous system based on Escherichia coli and reacted with antibodies present in the sera of humans naturally infected. The chimeric proteins were used to immunize mice using Freund adjuvant, and the humoral immune response was evaluated. Animals immunized with rC1 and rC3 showed a significant IgG antibodies response from the 28th day (P < 0.05), and the animals immunized with the rC2 from the 35th day (P < 0.05) remained until the 56th day of experimentation, with a titer of 1:3200 (P < 0.05), 1:1600 (P < 0.05) and 1:1600 (P < 0.05) from rC1, rC2, and rC3, respectively. Significant production of IgA and IgG1 isotype was detected in animals immunized with rC1 and rC2 proteins. Additionally, analysis using 13 serum samples from naturally infected patients showed that the proteins are recognized by antibodies present in sera, reinforcing the possibility of using these chimeras for CSD control. KEY POINTS: • The recombinant chimeras were expressed in Escherichia coli with 37 kDa (rC1), 35 kDa (rC2), and 38 kDa (rC3). • Animals immunized with rC1, rC2, and rC3 showed significant antibody response. • The chimeras were recognized by the sera of naturally infected patients.
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Affiliation(s)
- Jênifer Malheiros Gonçalves
- Laboratório de Bacteriologia E Bioensaios (LaBBio), Departamento de Microbiologia E Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Capão Do Leão, Rio Grande Do Sul Brazil ,Núcleo de Biotecnologia, Centro de Desenvolvimento Tecnológico (CDTec), Universidade Federal Pelotas, Capão Do Leão, Rio Grande Do Sul Brazil
| | - Thayná Laner Cardoso
- Laboratório de Bacteriologia E Bioensaios (LaBBio), Departamento de Microbiologia E Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Capão Do Leão, Rio Grande Do Sul Brazil
| | - Stella Buchhorn de Freitas
- Laboratório de Bacteriologia E Bioensaios (LaBBio), Departamento de Microbiologia E Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Capão Do Leão, Rio Grande Do Sul Brazil ,Núcleo de Biotecnologia, Centro de Desenvolvimento Tecnológico (CDTec), Universidade Federal Pelotas, Capão Do Leão, Rio Grande Do Sul Brazil
| | - Rafael Woloski
- Núcleo de Biotecnologia, Centro de Desenvolvimento Tecnológico (CDTec), Universidade Federal Pelotas, Capão Do Leão, Rio Grande Do Sul Brazil
| | - Amilton Clair Pinto Seixas Neto
- Laboratório de Bacteriologia E Bioensaios (LaBBio), Departamento de Microbiologia E Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Capão Do Leão, Rio Grande Do Sul Brazil
| | - Luciano da Silva Pinto
- Núcleo de Biotecnologia, Centro de Desenvolvimento Tecnológico (CDTec), Universidade Federal Pelotas, Capão Do Leão, Rio Grande Do Sul Brazil
| | - Elba Sampaio de Lemos
- Laboratório de Hantaviroses E Rickettsioses (LHR), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ Brazil
| | - Daiane Drawanz Hartwig
- Laboratório de Bacteriologia E Bioensaios (LaBBio), Departamento de Microbiologia E Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Capão Do Leão, Rio Grande Do Sul Brazil ,Núcleo de Biotecnologia, Centro de Desenvolvimento Tecnológico (CDTec), Universidade Federal Pelotas, Capão Do Leão, Rio Grande Do Sul Brazil ,Biology Institute, Federal University of Pelotas, Pelotas, RS CEP 96010–900 Brazil
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Laboratory Diagnosis of 37 Cases of Bartonella Endocarditis Based on Enzyme Immunoassay and Real-Time PCR. J Clin Microbiol 2021; 59:JCM.02217-20. [PMID: 33731411 DOI: 10.1128/jcm.02217-20] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 03/08/2021] [Indexed: 12/15/2022] Open
Abstract
Bartonella spp., mostly Bartonella quintana and B. henselae, are a common cause of culture-negative endocarditis. Serology using immunofluorescence assay (IFA) and PCR performed on cardiac tissues are the mainstays of diagnosis. We developed an enzyme immunoassay (EIA) and a novel multiplex real-time PCR assay, utilizing Bartonella genus-specific, B. henselae-specific, and B. quintana-specific SimpleProbe probes, for diagnosis of Bartonella endocarditis. We aimed to evaluate the performance of these assays. Thirty-seven patients with definite endocarditis, 18 with B. henselae, 18 with B. quintana, and 1 with B. koehlerae, were studied. Diagnosis was confirmed by conventional PCR and DNA sequencing of surgical cardiac specimens. Similar to the case with IFA, anti-Bartonella IgG titers of ≥1:800 were found in 94% of patients by EIA; cross-reactivity between B. henselae and B. quintana precluded species-specific serodiagnosis, and frequent (41%) but low-titer cross-reactivity between Coxiella burnetii antibodies and B. henselae antigen was found in patients with Q fever endocarditis. Low-titer (1:100) cross-reactivity was uncommonly found also in patients with brucellosis and culture-positive endocarditis, particularly Enterococcus faecalis endocarditis. Real-time PCR performed on explanted heart valves/vegetations was in complete agreement with results of sequence-based diagnosis with characteristic melting curves. The genus-specific probe identified five additional endocarditis-associated Bartonella spp. at the genus level. In conclusion, EIA coupled with a novel real-time PCR assay can play an important role in Bartonella endocarditis diagnosis and expand the diagnostic arsenal at the disposal of the clinical microbiologist. Since serology remains a major diagnostic tool, recognizing its pitfalls is essential to avoid incorrect diagnosis.
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Yehudina Y, Trypilka S. Case Reports of Cat Scratch Disease in Patient With Unjustified Surgical Intervention. Cureus 2021; 13:e14632. [PMID: 34055506 PMCID: PMC8144071 DOI: 10.7759/cureus.14632] [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: 11/05/2022] Open
Abstract
Cat scratch disease (CSD) is often a rare and unrecognized illness, but it is important for practitioners to consider. CSD is commonly diagnosed in children, but adults may also get this disease. The manifestations of CSD can include the damage of internal organs, joints, eyes, heart, and kidneys. CSD should be included in the differential diagnoses of fever of unknown origin and any lymphadenopathy syndrome. For rheumatologists, this pathology is of interest due to the systemic involvement, as well as the disease debut from the musculoskeletal symptoms. We present a CSD clinical case of a patient whose disease began with an acute abdomen clinic, and after two months transformed into arthritis of the hand joints.
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Affiliation(s)
| | - Svitlana Trypilka
- Rheumatologist Policlinic Department, Communal Non-Commercial Enterprise of Kharkov Regional Council "Regional Clinical Hospital", Kharkiv, UKR
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Ericson ME, Breitschwerdt EB, Reicherter P, Maxwell C, Maggi RG, Melvin RG, Maluki AH, Bradley JM, Miller JC, Simmons GE, Dencklau J, Joppru K, Peterson J, Bae W, Scanlon J, Bemis LT. Bartonella henselae Detected in Malignant Melanoma, a Preliminary Study. Pathogens 2021; 10:326. [PMID: 33802018 PMCID: PMC7998106 DOI: 10.3390/pathogens10030326] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/04/2021] [Accepted: 03/08/2021] [Indexed: 02/06/2023] Open
Abstract
Bartonella bacilliformis (B. bacilliformis), Bartonella henselae (B. henselae), and Bartonella quintana (B. quintana) are bacteria known to cause verruga peruana or bacillary angiomatosis, vascular endothelial growth factor (VEGF)-dependent cutaneous lesions in humans. Given the bacteria's association with the dermal niche and clinical suspicion of occult infection by a dermatologist, we determined if patients with melanoma had evidence of Bartonella spp. infection. Within a one-month period, eight patients previously diagnosed with melanoma volunteered to be tested for evidence of Bartonella spp. exposure/infection. Subsequently, confocal immunohistochemistry and PCR for Bartonella spp. were used to study melanoma tissues from two patients. Blood from seven of the eight patients was either seroreactive, PCR positive, or positive by both modalities for Bartonella spp. exposure. Subsequently, Bartonella organisms that co-localized with VEGFC immunoreactivity were visualized using multi-immunostaining confocal microscopy of thick skin sections from two patients. Using a co-culture model, B. henselae was observed to enter melanoma cell cytoplasm and resulted in increased vascular endothelial growth factor C (VEGFC) and interleukin 8 (IL-8) production. Findings from this small number of patients support the need for future investigations to determine the extent to which Bartonella spp. are a component of the melanoma pathobiome.
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Affiliation(s)
- Marna E. Ericson
- T Lab Inc., 910 Clopper Road, Suite 220S, Gaithersburg, MD 20878, USA;
| | - Edward B. Breitschwerdt
- Intracellular Pathogens Research Laboratory, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607, USA; (E.B.B.); (R.G.M.); (J.M.B.)
| | - Paul Reicherter
- Dermatology Clinic, Truman Medical Center, University of Missouri, Kansas City, MO 64108, USA;
| | - Cole Maxwell
- Department of Dermatology, University of Minnesota, Minneapolis, MN 55455, USA; (C.M.); (A.H.M.); (J.D.); (J.P.); (W.B.); (J.S.)
| | - Ricardo G. Maggi
- Intracellular Pathogens Research Laboratory, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607, USA; (E.B.B.); (R.G.M.); (J.M.B.)
| | - Richard G. Melvin
- Department of Biomedical Sciences, Duluth Campus, Medical School, University of Minnesota, Duluth, MN 55812, USA; (R.G.M.); (G.E.S.J.); (K.J.)
| | - Azar H. Maluki
- Department of Dermatology, University of Minnesota, Minneapolis, MN 55455, USA; (C.M.); (A.H.M.); (J.D.); (J.P.); (W.B.); (J.S.)
- Department of Dermatology, College of Medicine, University of Kufa, Kufa 54003, Iraq
| | - Julie M. Bradley
- Intracellular Pathogens Research Laboratory, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607, USA; (E.B.B.); (R.G.M.); (J.M.B.)
| | | | - Glenn E. Simmons
- Department of Biomedical Sciences, Duluth Campus, Medical School, University of Minnesota, Duluth, MN 55812, USA; (R.G.M.); (G.E.S.J.); (K.J.)
| | - Jamie Dencklau
- Department of Dermatology, University of Minnesota, Minneapolis, MN 55455, USA; (C.M.); (A.H.M.); (J.D.); (J.P.); (W.B.); (J.S.)
| | - Keaton Joppru
- Department of Biomedical Sciences, Duluth Campus, Medical School, University of Minnesota, Duluth, MN 55812, USA; (R.G.M.); (G.E.S.J.); (K.J.)
| | - Jack Peterson
- Department of Dermatology, University of Minnesota, Minneapolis, MN 55455, USA; (C.M.); (A.H.M.); (J.D.); (J.P.); (W.B.); (J.S.)
| | - Will Bae
- Department of Dermatology, University of Minnesota, Minneapolis, MN 55455, USA; (C.M.); (A.H.M.); (J.D.); (J.P.); (W.B.); (J.S.)
| | - Janet Scanlon
- Department of Dermatology, University of Minnesota, Minneapolis, MN 55455, USA; (C.M.); (A.H.M.); (J.D.); (J.P.); (W.B.); (J.S.)
| | - Lynne T. Bemis
- Department of Biomedical Sciences, Duluth Campus, Medical School, University of Minnesota, Duluth, MN 55812, USA; (R.G.M.); (G.E.S.J.); (K.J.)
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Abstract
Diagnosis of systemic cat scratch disease may be challenging. Here, we describe a case of an immunocompetent girl exhibiting fever and multifocal hepatosplenic abscesses. Diagnostic tests for Bartonella henselae infection (enzyme immunoassay and polymerase chain reaction) were found steadily negative and the diagnosis, suspected on the basis of the Margilet's criteria, was finally confirmed by indirect immunofluorescent antibodies.
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Bayart JL, Gusbin C, Lardinois B, Scohy A, Kabamba-Mukadi B. Analytical and clinical evaluation of new automated chemiluminescent immunoassays for the detection of IgG and IgM anti-Bartonella henselae antibodies. Diagn Microbiol Infect Dis 2020; 98:115203. [PMID: 33032158 DOI: 10.1016/j.diagmicrobio.2020.115203] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 08/26/2020] [Accepted: 08/26/2020] [Indexed: 12/23/2022]
Abstract
Serological diagnosis of Bartonella henselae infection mainly rely on microscopic immunofluorescence assays (IFA), which are however time-consuming and poorly standardized. The aim of the study was to assess the use of the new fully automated VirClia® chemiluminescent immunoassays for the detection of IgG and IgM anti-B. henselae antibodies. Eighty-one patients with a well-defined B. henselae infection as well as 80 patients with an alternative disease were included. The VirClia® IgG antibody assay showed a sensitivity of 79.0% and a specificity of 93.8% for the diagnosis of B. henselae infection. For the VirClia® IgM assay, results were more conflicting with a sensitivity of 42.0% and a specificity of 98.2% to predict IFA IgM results. In 11 additional patients with uninterpretable IFA due to autoimmune antibodies, VirClia® assays were able to deliver valuable quantitative results. The VirClia® IgG assay shows good analytical and clinical performances and could be easily integrated in the diagnostic workflow of B. henselae infection.
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Affiliation(s)
- Jean-Louis Bayart
- Département des Laboratoires Cliniques, Cliniques Universitaires St-Luc - Université Catholique de Louvain, Brussels, Belgium.
| | - Catherine Gusbin
- Département des Laboratoires Cliniques, Cliniques Universitaires St-Luc - Université Catholique de Louvain, Brussels, Belgium
| | - Benjamin Lardinois
- Département des Laboratoires Cliniques, Cliniques Universitaires St-Luc - Université Catholique de Louvain, Brussels, Belgium
| | - Anaïs Scohy
- Département des Laboratoires Cliniques, Cliniques Universitaires St-Luc - Université Catholique de Louvain, Brussels, Belgium
| | - Benoît Kabamba-Mukadi
- Département des Laboratoires Cliniques, Cliniques Universitaires St-Luc - Université Catholique de Louvain, Brussels, Belgium; Pôle de Recherche en Microbiologie Médicale, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium; Centre National de Référence Bartonella, Cliniques Universitaires St-Luc - Université Catholique de Louvain, Brussels, Belgium
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Johnson A. Ocular complications of cat scratch disease. Br J Ophthalmol 2020; 104:1640-1646. [PMID: 32122915 DOI: 10.1136/bjophthalmol-2019-315239] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 01/22/2020] [Accepted: 02/13/2020] [Indexed: 11/03/2022]
Abstract
Cat scratch disease (CSD) in humans is caused by infection with Bartonella henselae or other Bartonella spp. The name of the disease reflects the fact that patients frequently have a history of contact (often involving bites or scratches) with infected cats. Patients with CSD typically develop lesions at the site where the skin is broken together with regional lymphadenopathy but may go on to exhibit systemic symptoms and with deep-seated infections at a range of sites including the eye. Patients with CSD may present with a range of inflammatory eye conditions, including Parinaud's oculoglandular syndrome, neuroretinitis, multifocal retinitis, uveitis and retinal artery occlusion. Bartonella spp. are fastidious bacteria that are difficult to culture from clinical specimens so microbiological diagnosis is frequently made on the basis of positive serology for anti-Bartonella antibodies or detection of bacterial DNA by PCR. Due to the lack of clinical trials, the evidence base for optimal management of patients with CSD-associated eye infections (including the role of antibiotics) is weak, being derived from single reports or small, uncontrolled case series.
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Affiliation(s)
- Alan Johnson
- NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London W12 0NN, UK
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