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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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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: 4] [Impact Index Per Article: 4.0] [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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Gonçalves-Oliveira J, Damasco PV, Assis MRDS, Freitas DE, Pessoa Junior AA, de Sousa LS, Rodrigues NG, Damasco PH, Ribeiro PF, Barbosa GF, Moreira NS, Guedes JF, Coutinho HMDR, Madi K, de Lemos ERS. Infectious endocarditis caused by Bartonella henselae associated with infected pets: two case reports. J Med Case Rep 2023; 17:143. [PMID: 37072873 PMCID: PMC10112992 DOI: 10.1186/s13256-023-03839-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 02/24/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Blood culture-negative infective endocarditis is a potentially severe disease that can be associated with infectious agents such as Bartonella spp., Coxiella burnetti, Tropheryma whipplei, and some fungi. CASE PRESENTATION Reported here are two cases of blood culture-negative infective endocarditis in patients with severe aortic and mitral regurgitation in Brazil; the first case is a 47-year-old white man and the second is a 62-year-old white woman. Bartonella henselae deoxyribonucleic acid was detectable in the blood samples and cardiac valve with vegetation paraffin-fixed tissue samples. Additionally, an investigation was carried out on patients' pets, within the context of One Health, and serum samples collected from cats and dogs were reactive by indirect immunofluorescence assay. CONCLUSIONS Even though the frequency of bartonellosis in Brazil is unknown, physicians should be aware of the possibility of blood culture-negative infective endocarditis caused by Bartonella, particularly in patients with weight loss, kidney changes, and epidemiological history for domestic animals.
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Affiliation(s)
- Jonathan Gonçalves-Oliveira
- Laboratório de Hantaviroses E Rickettsioses, Instituto Oswaldo Cruz (IOC/FIOCRUZ), Manguinhos, Rio de Janeiro, RJ, Brazil.
| | - Paulo Vieira Damasco
- Faculdade de Ciências Médicas, Time de Endocardite Do Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro (HUPE/UERJ), Rio de Janeiro, RJ, Brazil
- Escola de Medicina e Cirurgia, Departamento de Doenças Infecciosas e Parasitárias, Universidade do Federal do Estado do Rio de Janeiro (DIP/UNIRIO), Rio de Janeiro, RJ, Brazil
| | - Matheus Ribeiro da S Assis
- Laboratório de Hantaviroses E Rickettsioses, Instituto Oswaldo Cruz (IOC/FIOCRUZ), Manguinhos, Rio de Janeiro, RJ, Brazil
| | - Dominique E Freitas
- Laboratório de Hantaviroses E Rickettsioses, Instituto Oswaldo Cruz (IOC/FIOCRUZ), Manguinhos, Rio de Janeiro, RJ, Brazil
| | - Adonai Alvino Pessoa Junior
- Laboratório de Hantaviroses E Rickettsioses, Instituto Oswaldo Cruz (IOC/FIOCRUZ), Manguinhos, Rio de Janeiro, RJ, Brazil
| | - Luiza S de Sousa
- Escola de Medicina e Cirurgia, Departamento de Doenças Infecciosas e Parasitárias, Universidade do Federal do Estado do Rio de Janeiro (DIP/UNIRIO), Rio de Janeiro, RJ, Brazil
| | - Nicollas G Rodrigues
- Faculdade de Ciências Médicas, Time de Endocardite Do Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro (HUPE/UERJ), Rio de Janeiro, RJ, Brazil
| | - Paula H Damasco
- Faculdade de Ciências Médicas, Time de Endocardite Do Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro (HUPE/UERJ), Rio de Janeiro, RJ, Brazil
| | - Pedro F Ribeiro
- Faculdade de Ciências Médicas, Time de Endocardite Do Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro (HUPE/UERJ), Rio de Janeiro, RJ, Brazil
| | - Giovanna F Barbosa
- Faculdade de Ciências Médicas, Time de Endocardite Do Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro (HUPE/UERJ), Rio de Janeiro, RJ, Brazil
| | | | - Jeferson F Guedes
- Serviço de Cardiologia e Ecocardiografia, Hospital Municipal Miguel Couto (HMMC-RJ), Leblon, Rio de Janeiro, RJ, Brazil
| | - Henrique M da Rocha Coutinho
- Faculdade de Ciências Médicas, Time de Endocardite Do Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro (HUPE/UERJ), Rio de Janeiro, RJ, Brazil
| | - Kalil Madi
- Diretoria Técnica do Círculo Brasileiro de Patologia, Vila Isabel, Rio de Janeiro, RJ, Brazil
| | - Elba R Sampaio de Lemos
- Laboratório de Hantaviroses E Rickettsioses, Instituto Oswaldo Cruz (IOC/FIOCRUZ), Manguinhos, Rio de Janeiro, RJ, Brazil
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De Salvo MN, Hercolini C, Arístegui E, Bruno A, Brambati DF, Cicuttin GL. Bartonella spp. associated with rodents in an urban protected area, Buenos Aires (Argentina). Comp Immunol Microbiol Infect Dis 2020; 72:101515. [PMID: 32659525 DOI: 10.1016/j.cimid.2020.101515] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 06/21/2020] [Accepted: 06/27/2020] [Indexed: 11/18/2022]
Abstract
At least 15 of the 30 Bartonella species are involved in human pathologies, and several of them are associated with rodents and their fleas. The aims of this study were detect and molecularly characterize the Bartonella infections in rodents from an urban protected area of Buenos Aires City (Argentina). A total of 186 rodents were captured and identified. For PCR of the 16S rRNA fragment, 23.7 % of the samples tested positive, and two groups (GrA and GrB) were identified. Likewise, the comparison between the sequences obtained for the gltA gene determined the presence of three genotypes, closely related to Bartonella spp. detected in sigmodontine rodents and their fleas in the Americas, which form a well-separated clade. The high prevalence of Bartonella in rodents from an urban protected area of Buenos Aires city is relevant from a public health perspective.
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Affiliation(s)
- María Nazarena De Salvo
- Sección Serología y Pruebas Diagnósticas, Instituto de Zoonosis Luis Pasteur, Ciudad Autónoma de Buenos Aires, Argentina.
| | - Carina Hercolini
- División de Acciones Comunitarias para la Salud, Instituto de Zoonosis Luis Pasteur, Ciudad Autónoma de Buenos Aires, Argentina
| | - Evangelina Arístegui
- División de Acciones Comunitarias para la Salud, Instituto de Zoonosis Luis Pasteur, Ciudad Autónoma de Buenos Aires, Argentina
| | - Antonella Bruno
- División de Acciones Comunitarias para la Salud, Instituto de Zoonosis Luis Pasteur, Ciudad Autónoma de Buenos Aires, Argentina
| | - Diego Fernando Brambati
- División de Acciones Comunitarias para la Salud, Instituto de Zoonosis Luis Pasteur, Ciudad Autónoma de Buenos Aires, Argentina
| | - Gabriel Leonardo Cicuttin
- Sección Serología y Pruebas Diagnósticas, Instituto de Zoonosis Luis Pasteur, Ciudad Autónoma de Buenos Aires, Argentina
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Lins KDA, Drummond MR, Velho PENF. Cutaneous manifestations of bartonellosis. An Bras Dermatol 2019; 94:594-602. [PMID: 31780437 PMCID: PMC6857551 DOI: 10.1016/j.abd.2019.09.024] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 02/27/2019] [Indexed: 12/20/2022] Open
Abstract
Bartonellosis are diseases caused by any kind of Bartonella species. The infection manifests as asymptomatic bacteremia to potentially fatal disorders. Many species are pathogenic to humans, but three are responsible for most clinical symptoms: Bartonella bacilliformis, Bartonella quintana, and Bartonella henselae. Peruvian wart, caused by B. bacilliformis, may be indistinguishable from bacillary angiomatosis caused by the other two species. Other cutaneous manifestations include maculo-papular rash in trench fever, papules or nodules in cat scratch disease, and vasculitis (often associated with endocarditis). In addition, febrile morbilliform rash, purpura, urticaria, erythema nodosum, erythema multiforme, erythema marginatus, granuloma annularis, leukocytoclastic vasculitis, granulomatous reactions, and angioproliferative reactions may occur. Considering the broad spectrum of infection and the potential complications associated with Bartonella spp., the infection should be considered by physicians more frequently among the differential diagnoses of idiopathic conditions. Health professionals and researchers often neglected this diseases.
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Affiliation(s)
- Karina de Almeida Lins
- Department of Clinical Medicine, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil; Laboratory of Applied Research in Dermatology and Bartonella Infection, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Marina Rovani Drummond
- Department of Clinical Medicine, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil; Laboratory of Applied Research in Dermatology and Bartonella Infection, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Paulo Eduardo Neves Ferreira Velho
- Laboratory of Applied Research in Dermatology and Bartonella Infection, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil; Discipline of Dermatology, Department of Clinical Medicine, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil.
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Risk Factors for Bartonella species Infection in Blood Donors from Southeast Brazil. PLoS Negl Trop Dis 2016; 10:e0004509. [PMID: 26999057 PMCID: PMC4801220 DOI: 10.1371/journal.pntd.0004509] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 02/12/2016] [Indexed: 01/24/2023] Open
Abstract
Bacteria from the genus Bartonella are emerging blood-borne bacteria, capable of causing long-lasting infection in marine and terrestrial mammals, including humans. Bartonella are generally well adapted to their main host, causing persistent infection without clinical manifestation. However, these organisms may cause severe disease in natural or accidental hosts. In humans, Bartonella species have been detected from sick patients presented with diverse disease manifestations, including cat scratch disease, trench fever, bacillary angiomatosis, endocarditis, polyarthritis, or granulomatous inflammatory disease. However, with the advances in diagnostic methods, subclinical bloodstream infection in humans has been reported, with the potential for transmission through blood transfusion been recently investigated by our group. The objective of this study was to determine the risk factors associated with Bartonella species infection in asymptomatic blood donors presented at a major blood bank in Southeastern Brazil. Five hundred blood donors were randomly enrolled and tested for Bartonella species infection by specialized blood cultured coupled with high-sensitive PCR assays. Epidemiological questionnaires were designed to cover major potential risk factors, such as age, gender, ethnicity, contact with companion animals, livestock, or wild animals, bites from insects or animal, economical status, among other factors. Based on multivariate logistic regression, bloodstream infection with B. henselae or B. clarridgeiae was associated with cat contact (adjusted OR: 3.4, 95% CI: 1.1–9.6) or history of tick bite (adjusted OR: 3.7, 95% CI: 1.3–13.4). These risk factors should be considered during donor screening, as bacteremia by these Bartonella species may not be detected by traditional laboratory screening methods, and it may be transmitted by blood transfusion. Bacteria from the genus Bartonella are capable of causing long-lasting infection. Despite the fact that these bacteria may cause several diseases such as cat scratch disease, trench fever, and infection of cardiac valves, which can be fatal, they may also cause asymptomatic infection in humans. Several blood-sucking arthropods have been suggested or confirmed as responsible for transmitting these bacteria, including sandflies, body lice, fleas, ticks, and keds. In this study, 500 asymptomatic human blood donors from Brazil were screened for infection with species of Bartonella by blood culture coupled with molecular detection and genetic sequencing, and risk factors associated with such infection were identified. In this population, contact with cats and history of tick bite were significantly associated with human infection by Bartonella species. Since laboratory screening of donated blood for the presence of Bartonella species is not generally performed by blood banks, these risk factors should be should be considered during donor screening in order to avoid transmission of Bartonella species by blood transfusion.
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Siciliano RF, Castelli JB, Mansur AJ, Pereira dos Santos F, Colombo S, do Nascimento EM, Paddock CD, Brasil RA, Velho PENF, Drummond MR, Grinberg M, Strabelli TMV. Bartonella spp. and Coxiella burnetii Associated with Community-Acquired, Culture-Negative Endocarditis, Brazil. Emerg Infect Dis 2016. [PMID: 26197233 PMCID: PMC4517744 DOI: 10.3201/eid2108.140343] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We evaluated culture-negative, community-acquired endocarditis by using indirect immunofluorescent assays and molecular analyses for Bartonella spp. and Coxiella burnetii and found a prevalence of 19.6% and 7.8%, respectively. Our findings reinforce the need to study these organisms in patients with culture-negative, community-acquired endocarditis, especially B. henselae in cat owners.
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Mangini S, Higuchi MDL, Kawakami JT, Reis MM, Ikegami RN, Palomino SAP, Pomerantzeff PMA, Fiorelli AI, Marcondes-Braga FG, Bacal F, Ferreira SMA, Issa VS, Souza GEC, Chizzola PR, Bocchi EA. Infectious agents and inflammation in donated hearts and dilated cardiomyopathies related to cardiovascular diseases, Chagas' heart disease, primary and secondary dilated cardiomyopathies. Int J Cardiol 2014; 178:55-62. [PMID: 25442238 DOI: 10.1016/j.ijcard.2014.10.133] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 10/21/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND Clinical and experimental conflicting data have questioned the relationship between infectious agents, inflammation and dilated cardiomyopathy (DCM). OBJECTIVES The aim of this study was to determine the frequency of infectious agents and inflammation in endomyocardial biopsy (EMB) specimens from patients with idiopathic DCM, explanted hearts from different etiologies, including Chagas' disease, compared to donated hearts. METHODS From 2008 to 2011, myocardial samples from 29 heart donors and 55 patients with DCMs from different etiologies were studied (32 idiopathic, 9 chagasic, 6 ischemic and 8 other specific etiologies). Inflammation was investigated by immunohistochemistry and infectious agents by immunohistochemistry, molecular biology, in situ hybridization and electron microscopy. RESULTS There were no differences regarding the presence of macrophages, expression of HLA class II and ICAM-I in donors and DCM. Inflammation in Chagas' disease was predominant. By immunohistochemistry, in donors, there was a higher expression of antigens of enterovirus and Borrelia, hepatitis B and C in DCMs. By molecular biology, in all groups, the positivity was elevated to microorganisms, including co-infections, with a higher positivity to adenovirus and HHV6 in donors towards DCMs. This study was the first to demonstrate the presence of virus in the heart tissue of chagasic DCM. CONCLUSIONS The presence of inflammation and infectious agents is frequent in donated hearts, in the myocardium of patients with idiopathic DCM, myocardial dysfunction related to cardiovascular diseases, and primary and secondary cardiomyopathies, including Chagas' disease. The role of co-infection in Chagas' heart disease physiopathology deserves to be investigated in future studies.
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Affiliation(s)
- Sandrigo Mangini
- Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil.
| | - Maria de Lourdes Higuchi
- Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - Joyce Tiyeko Kawakami
- Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - Marcia Martins Reis
- Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - Renata Nishiyama Ikegami
- Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil
| | | | | | - Alfredo Inácio Fiorelli
- Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil
| | | | - Fernando Bacal
- Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil
| | | | - Victor Sarli Issa
- Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil
| | | | - Paulo Roberto Chizzola
- Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - Edimar Alcides Bocchi
- Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil
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Bartonella spp. in cats from Buenos Aires, Argentina. Vet Microbiol 2014; 168:225-8. [DOI: 10.1016/j.vetmic.2013.10.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Revised: 10/03/2013] [Accepted: 10/13/2013] [Indexed: 11/23/2022]
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Bartonella henselae infection in a family experiencing neurological and neurocognitive abnormalities after woodlouse hunter spider bites. Parasit Vectors 2013; 6:98. [PMID: 23587343 PMCID: PMC3639822 DOI: 10.1186/1756-3305-6-98] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 02/20/2013] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Bartonella species comprise a group of zoonotic pathogens that are usually acquired by vector transmission or by animal bites or scratches. METHODS PCR targeting the Bartonella 16S-23S intergenic spacer (ITS) region was used in conjunction with BAPGM (Bartonella alpha Proteobacteria growth medium) enrichment blood culture to determine the infection status of the family members and to amplify DNA from spiders and woodlice. Antibody titers to B. vinsonii subsp. berkhoffii (Bvb) genotypes I-III, B. henselae (Bh) and B. koehlerae (Bk) were determined using an IFA test. Management of the medical problems reported by these patients was provided by their respective physicians. RESULTS In this investigation, immediately prior to the onset of symptoms two children in a family experienced puncture-like skin lesions after exposure to and presumptive bites from woodlouse hunter spiders. Shortly thereafter, the mother and both children developed hive-like lesions. Over the ensuing months, the youngest son was diagnosed with Guillain-Barre (GBS) syndrome followed by Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP). The older son developed intermittent disorientation and irritability, and the mother experienced fatigue, headaches, joint pain and memory loss. When tested approximately three years after the woodlouse hunter spider infestation, all three family members were Bartonella henselae seroreactive and B. henselae DNA was amplified and sequenced from blood, serum or Bartonella alpha-proteobacteria (BAPGM) enrichment blood cultures from the mother and oldest son. Also, B. henselae DNA was PCR amplified and sequenced from a woodlouse and from woodlouse hunter spiders collected adjacent to the family's home. CONCLUSIONS Although it was not possible to determine whether the family's B. henselae infections were acquired by spider bites or whether the spiders and woodlice were merely accidental hosts, physicians should consider the possibility that B. henselae represents an antecedent infection for GBS, CIDP, and non-specific neurocognitive abnormalities.
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