1
|
López-Rueda S, Valente-Acosta B, Murillo-Zolezzi A, Moreno-Sánchez F, Hoyo-Ulloa I, Baquera-Heredia JJ. A Man in His Forties with Recurrent Cat-Scratch Disease. Case Rep Infect Dis 2024; 2024:4411133. [PMID: 38444733 PMCID: PMC10914428 DOI: 10.1155/2024/4411133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 02/05/2024] [Accepted: 02/22/2024] [Indexed: 03/07/2024] Open
Abstract
Cat-scratch disease (CSD) is a self-limited zoonotic infection transmitted by felines caused by the Gram-negative bacillus Bartonella henselae. It usually presents with lymphadenopathy and constitutional symptoms that resolve within eight weeks, with, or without antibiotic treatment. The diagnosis is made by serology, molecular diagnosis in a biopsy, or a positive culture. The recurrence or reactivation of B. henselae has rarely been reported. We present the case of a 45-year-old man with a history of CSD two years before who presented to the clinic with groin lymphadenopathy. The patient had a history of close contact with felines though no known risk exposure was reported. The diagnosis was made with a positive serology suggestive of recent infection along with histopathological changes suggestive of CSD. Subsequently, azithromycin was administered with complete resolution of symptoms.
Collapse
Affiliation(s)
- Sara López-Rueda
- The American British Cowdray Medical Center, Sur 136 116, Alvaro Obregon, Mexico City 01120, Mexico
| | - Benjamin Valente-Acosta
- The American British Cowdray Medical Center, Sur 136 116, Alvaro Obregon, Mexico City 01120, Mexico
| | - Adrian Murillo-Zolezzi
- The American British Cowdray Medical Center, Sur 136 116, Alvaro Obregon, Mexico City 01120, Mexico
| | - Francisco Moreno-Sánchez
- The American British Cowdray Medical Center, Sur 136 116, Alvaro Obregon, Mexico City 01120, Mexico
| | - Irma Hoyo-Ulloa
- The American British Cowdray Medical Center, Sur 136 116, Alvaro Obregon, Mexico City 01120, Mexico
| | | |
Collapse
|
2
|
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.
Collapse
|
3
|
Steed D, Collins J, Farris AB, Guarner J, Yarar D, Friedman-Moraco R, Doane T, Pouch S, Marshall Lyon G, Woodworth MH. Haemophagocytic lymphohistiocytosis associated with bartonella peliosis hepatis following kidney transplantation in a patient with HIV. THE LANCET. INFECTIOUS DISEASES 2022; 22:e303-e309. [PMID: 35500593 PMCID: PMC9942922 DOI: 10.1016/s1473-3099(22)00276-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 10/28/2021] [Accepted: 04/22/2022] [Indexed: 02/04/2023]
Abstract
Bacillary peliosis hepatis is a well recognised manifestation of disseminated Bartonella henselae infection that can occur in immunocompromised individuals. Haemophagocytic lymphohistiocytosis is an immune-mediated condition with features that can overlap with a severe primary infection such as disseminated Bartonella spp infection. We report a case of bacillary peliosis hepatis and secondary haemophagocytic lymphohistiocytosis due to disseminated Bartonella spp infection in a kidney-transplant recipient with well controlled HIV. The patient reported 2 weeks of fever and abdominal pain and was found to have hepatomegaly. He recalled exposure to a sick dog but reported no cat exposures. Laboratory evaluation was notable for pancytopenia and cholestatic injury. The patient met more than five of eight clinical criteria for haemophagocytic lymphohistiocytosis. Pathology review of a bone marrow core biopsy identified haemophagocytosis. A transjugular liver biopsy was done, and histopathology review identified peliosis hepatis. Warthin-Starry staining of the bone marrow showed pleiomorphic coccobacillary organisms. The B henselae IgG titre was 1:512, and Bartonella-specific DNA targets were detected by peripheral blood PCR. Treatment with doxycycline, increased prednisone, and pausing the mycophenolate component of his transplant immunosuppression regimen resulted in an excellent clinical response. Secondary haemophagocytic lymphohistiocytosis can be difficult to distinguish from severe systemic infection. A high index of suspicion can support the diagnosis of systemic Bartonella spp infection in those who present with haemophagocytic lymphohistiocytosis, especially in patients with hepatomegaly, immunosuppression, and germane animal exposures.
Collapse
Affiliation(s)
- Danielle Steed
- Division of Hospital Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Jeffrey Collins
- Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA
| | - Alton B Farris
- Department of Medicine, and Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Jeannette Guarner
- Department of Medicine, and Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Dilek Yarar
- Kidney Specialists of Kentucky, Bowling Green, KY, USA
| | | | - Tristan Doane
- Department of Medicine, and Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Stephanie Pouch
- Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA
| | - G Marshall Lyon
- Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA
| | - Michael H Woodworth
- Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA.
| |
Collapse
|
4
|
Li M, Yan K, Jia P, Wei E, Wang H. Metagenomic next-generation sequencing may assist diagnosis of cat-scratch disease. Front Cell Infect Microbiol 2022; 12:946849. [PMID: 36189365 PMCID: PMC9524480 DOI: 10.3389/fcimb.2022.946849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 08/26/2022] [Indexed: 11/28/2022] Open
Abstract
Bartonella henselae, the pathogen that causes cat-scratch disease (CSD), is relatively rare in the clinic. CSD usually causes mild clinical manifestations, which self-heal in a matter of weeks. However, in immunocompromised patients, CSD may cause systemic disorders that can lead to critical illness. Due to the diversity of symptom signs and the lack of a golden standard for diagnosis, identifying atypical CSD in a timely manner presents a challenge. Metagenomic next-generation sequencing (mNGS), is a promising technology that has been widely used in the detection of pathogens in clinical infectious diseases in recent years. mNGS can detect multiple pathogens quickly and accurately from any given source. Here, we present a case of atypical CSD, which was diagnosed using mNGS. The patient manifested a fever of unknown infectious origin, and routine antibiotic treatment was ineffective. mNGS was employed to test the patient’s peripheral blood, which led to the detection of B. henselae. This was rarely seen in previous CSD reports. We surmised that the patient presented with atypical CSD and thus a targeted therapy was recommended. Crucially, the patient recovered rapidly. Based on this case study findings, we recommend that CSD should be included in the differential diagnosis for fever of unknown origin and that mNGS may be helpful in the diagnosis of CSD.
Collapse
|
5
|
Goaz S, Rasis M, Binsky Ehrenreich I, Shapira L, Halutz O, Graidy-Varon M, Leibovitch C, Maisler N, Glikman D, Ephros M, Giladi M. Molecular Diagnosis of Cat Scratch Disease: a 25-Year Retrospective Comparative Analysis of Various Clinical Specimens and Different PCR Assays. Microbiol Spectr 2022; 10:e0259621. [PMID: 35262411 PMCID: PMC9045166 DOI: 10.1128/spectrum.02596-21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 02/14/2022] [Indexed: 02/07/2023] Open
Abstract
Cat-scratch disease (CSD), caused primarily by Bartonella henselae, is a common etiology of infectious regional lymphadenopathy. Lymphadenopathy is preceded by a primary inoculation lesion and may progress to suppuration. Laboratory diagnosis of CSD is hampered by the limitations of available confirmatory tests. PCR, in general, is highly sensitive and specific; however, clinical sensitivity in CSD varies greatly between studies. We aimed to identify clinical specimens and PCR assays best suited for CSD diagnosis using a national CSD registry and a uniform case definition. Different clinical specimens and PCR assays, including conventional and real-time PCR, were evaluated. PCR was positive in 335/390 (86%) CSD patients and 425/482 (88%) PCR tests. The highest PCR sensitivity was achieved in lymph node pus aspirates (96%; n = 278 tests) followed by primary lesions (88%; n = 50), lymph node fine needle aspirations (85%; n = 46), lymph node biopsy specimens (73%; n = 91) and paraffin-embedded lymph nodes (59%; n = 17), (P < 0.001). Sensitivity was similar in all types of PCR assays studied. PCR negative predictive value of pus aspirate and lymph node biopsy specimen patient groups was 82% and 72%, respectively. Specificity was 100% based on 125 non-CSD patients with negative PCR. In conclusion, the specimen type rather than the PCR assay type has a major impact on CSD molecular diagnosis. We assume that the inadequate sensitivity of the biopsy specimens was due to sampling errors or the presence of inhibitory factors. Primary lesions should be sampled more frequently for CSD diagnosis. Physicians should be aware of the low PCR negative predictive value of lymph node biopsy specimens. IMPORTANCE Polymerase chain reaction (PCR) for the detection of Bartonella henselae is an important tool for the diagnosis of cat scratch disease (CSD); however, clinical sensitivity varies greatly between studies. The current study shows that the specimen type, with pus aspiration, fine needle aspiration, and primary inoculation lesion having significantly higher sensitivity than fresh or formalin-fixed paraffin-embedded lymph node biopsy specimen, rather than the type of the PCR assay, whether a conventional or a real-time assay, has a major impact on the performance of diagnostic PCR for CSD. The new data provide new tools for the clinical microbiologist when interpreting the results of the PCR assays. Primary inoculation lesions, although easily accessible, are often neglected and should be sampled more frequently for molecular diagnosis of CSD. Physicians should be aware that negative PCR, particularly if performed on fresh or paraffin-embedded lymph node biopsy specimens, does not exclude CSD.
Collapse
Affiliation(s)
- Sher Goaz
- The Bernard Pridan Laboratory for Molecular Biology of Infectious diseases, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- The Azrieli Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
| | - Michal Rasis
- The Bernard Pridan Laboratory for Molecular Biology of Infectious diseases, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | | | - Lev Shapira
- The Bernard Pridan Laboratory for Molecular Biology of Infectious diseases, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ora Halutz
- Microbiology Laboratory, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Merav Graidy-Varon
- Microbiology Laboratory, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Cecilia Leibovitch
- Microbiology Laboratory, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | | | - Daniel Glikman
- The Azrieli Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
- Infectious Disease Unit, Padeh Poriya Medical Center, Tiberias, Israel
| | - Moshe Ephros
- Pediatric Infectious Disease Unit, Carmel Medical Center and the Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Michael Giladi
- The Bernard Pridan Laboratory for Molecular Biology of Infectious diseases, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Infectious Disease Unit, Tel Aviv Sourasky Medical Center, and The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
6
|
Neupane P, Maggi RG, Basnet M, Lashnits E, Andrews GP, Breitschwerdt EB. Bartonella henselae Recombinant Pap31 for the Diagnosis of Canine and Human Bartonelloses. Pathogens 2022; 11:182. [PMID: 35215127 PMCID: PMC8877253 DOI: 10.3390/pathogens11020182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 02/04/2023] Open
Abstract
Bartonella spp. comprise a genus of Gram-negative alphaproteobacteria that are slow growing, fastidious, and facultative intracellular pathogens with zoonotic potential. Immunofluorescent antibody assays (IFAs), Western blot (WB), and enzyme-linked immunosorbent assays (ELISAs), the frequently used modalities for the serological diagnosis of canine and human Bartonelloses, generate numerous false negative results. Therefore, the development of a reliable serodiagnostic assay for Bartonelloses is of clinical and epidemiological importance. Pap31, a heme binding surface protein of B. henselae, is associated with bacterial adhesion and related to bacterial colonization. To our knowledge, B. henselae Pap31 and its fragments (N-terminal (NTD), middle (MD), and C-terminal (CTD) domains) have not been investigated for the serodiagnosis of canine and human Bartonelloses. In this study, we evaluate the diagnostic utility of B. henselae recombinant whole Pap31 (rPap31) and Pap31 fragments by ELISA using sera from 70 dogs (36 Bartonella spp. IFA-positive (naturally infected), and 34 Bartonella spp. IFA- and PCR-negative (control dogs)) and 36 humans (18 Bartonella spp. IFA-positive (naturally infected) and 18 controls)). In the dogs, the area under the curve (AUC) score of recombinant whole Pap31 was 0.714 with a sensitivity of 42% and specificity of 94% at an OD cutoff value of 0.8955. Among the evaluated recombinant Pap31 proteins for the diagnosis of canine Bartonelloses, rPap31-NTD yielded the highest AUC score of 0.792 (95% CI 0.688-0.895) with a sensitivity of 44% and specificity of 100% at a cutoff value of 1.198. In concordance with this finding, rPap31-NTD also had the highest AUC score of 0.747 (95% CI 0.581-0.913) among the Pap31 recombinant proteins for the diagnosis of human Bartonelloses, with 39% sensitivity and 94% specificity at a cutoff value of 1.366. Recombinant whole Pap31 (rPap31) resulted in 72% sensitivity and 61% specificity at a cutoff value of 0.215 for human Bartonelloses. Due to either low sensitivity or questionable specificity, our findings indicate that recombinant Pap31 and the selected fragments may not be appropriate diagnostic targets in detecting anti-Bartonella antibodies in Bartonella-infected dogs and humans. The findings from this study can be used to further assess the antigenicity and immunogenicity of B. henselae Pap31 as a diagnostic target.
Collapse
Affiliation(s)
- Pradeep Neupane
- Department of Clinical Sciences, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Dr., Raleigh, NC 27607, USA; (P.N.); (R.G.M.)
| | - Ricardo G. Maggi
- Department of Clinical Sciences, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Dr., Raleigh, NC 27607, USA; (P.N.); (R.G.M.)
| | - Manoj Basnet
- Department of Electrical and Computer Engineering, University of Memphis, Memphis, TN 38111, USA;
| | - Erin Lashnits
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53713, USA;
| | - Gerard P. Andrews
- Department of Veterinary Sciences, College of Agriculture and Natural Resources, University of Wyoming, Laramie, WY 82070, USA;
| | - Edward B. Breitschwerdt
- Department of Clinical Sciences, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Dr., Raleigh, NC 27607, USA; (P.N.); (R.G.M.)
| |
Collapse
|
7
|
Lashnits E, Neupane P, Bradley JM, Richardson T, Maggi RG, Breitschwerdt EB. Comparison of Serological and Molecular Assays for Bartonella Species in Dogs with Hemangiosarcoma. Pathogens 2021; 10:pathogens10070794. [PMID: 34201572 PMCID: PMC8308881 DOI: 10.3390/pathogens10070794] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/18/2021] [Accepted: 06/18/2021] [Indexed: 11/23/2022] Open
Abstract
Currently, a gold standard diagnostic test for Bartonella infection in dogs is lacking. This represents a critical limitation for the development and evaluation of new diagnostic tests, as well as for the diagnosis of, and research on, bartonellosis in dogs. This retrospective observational study aims to compare the results of commonly performed and newly-reported Bartonella spp. diagnostic tests in banked clinical specimens from 90 dogs with hemangiosarcoma (HSA) using composite reference standard (CRS) and random effects latent class analysis (RE-LCA) techniques. Samples from each dog were tested using six serological or molecular diagnostic assays, including indirect fluorescent antibody (IFA) and Western blot (WB) for the detection of antibodies in serum, and qPCR and droplet digital PCR (ddPCR) in blood and fresh frozen tissue biopsy samples (mainly splenic HSA tumors and histopathologically normal spleen or skin/adipose tissue). Bartonella infection prevalence was estimated to be 78% based on the CRS (parallel testing with all six assays), and 64% based on the RE-LCA model. The assay with the highest diagnostic accuracy was qPCR performed on fresh frozen tissue biopsy samples (sensitivity: 94% by RE-LCA and 80% by CRS; specificity: 100%). When comparing newly-reported to traditional Bartonella diagnostic assays, ddPCR was more sensitive for the detection of Bartonella DNA than qPCR when testing blood samples (36% vs. 0%, p < 0.0001). Dogs that were positive on serological assays alone with negative molecular assays were highly unlikely (<3%) to be classified as infected by the RE-LCA model. These data indicate that Bartonella spp. DNA can be PCR amplified from fresh frozen tissues from a majority of dogs with HSA using both qPCR and ddPCR, supporting the use of these methods for future controlled studies comparing the prevalence of Bartonella spp. DNA in the tissue of dogs with HSA to that of unaffected controls.
Collapse
Affiliation(s)
- Erin Lashnits
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53713, USA;
- Intracellular Pathogens Research Laboratory, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA; (P.N.); (J.M.B.); (T.R.); (R.G.M.)
| | - Pradeep Neupane
- Intracellular Pathogens Research Laboratory, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA; (P.N.); (J.M.B.); (T.R.); (R.G.M.)
| | - Julie M. Bradley
- Intracellular Pathogens Research Laboratory, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA; (P.N.); (J.M.B.); (T.R.); (R.G.M.)
| | - Toni Richardson
- Intracellular Pathogens Research Laboratory, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA; (P.N.); (J.M.B.); (T.R.); (R.G.M.)
| | - Ricardo G. Maggi
- Intracellular Pathogens Research Laboratory, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA; (P.N.); (J.M.B.); (T.R.); (R.G.M.)
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA
| | - Edward B. Breitschwerdt
- Intracellular Pathogens Research Laboratory, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA; (P.N.); (J.M.B.); (T.R.); (R.G.M.)
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA
- Correspondence:
| |
Collapse
|
8
|
Lashnits E, Maggi R, Jarskog F, Bradley J, Breitschwerdt E, Frohlich F. Schizophrenia and Bartonella spp. Infection: A Pilot Case-Control Study. Vector Borne Zoonotic Dis 2021; 21:413-421. [PMID: 33728987 PMCID: PMC8170724 DOI: 10.1089/vbz.2020.2729] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Recently, infections with emerging zoonotic bacteria of the genus Bartonella have been reported in association with a range of central nervous system (CNS) symptoms. Currently, it remains unknown if Bartonella spp. infection is associated with symptoms of schizophrenia/schizoaffective disorder (SCZ/SAD). The objective of this study was to determine if there is an association between Bartonella species infection and SCZ/SAD. A secondary objective was to determine if SCZ/SAD symptoms were more severe among participants with documented Bartonella spp. infection. Using a case-control study design, 17 cases and 13 controls were evaluated with a series of clinical and cognitive assessments. Blood samples were collected and tested for Bartonella spp. infection using serological, microbiological, and molecular techniques. People with SCZ/SAD were more likely than healthy volunteers to have Bartonella spp. DNA in their bloodstream, with 11 of 17 cases (65%) positive by Bartonella spp. droplet digital PCR (ddPCR). In comparison, only one healthy volunteer was Bartonella spp. ddPCR positive (8%, p = 0.0024). Based on serology, Bartonella spp. exposure was common among people with SCZ/SAD (12 of 17) as well as among healthy volunteers (12 of 13), with no significant difference between the groups (p = 0.196). Within the case group of people with SCZ/SAD, there was no significant difference in SCZ/SAD severity scores between people with and without ddPCR evidence of Bartonella spp. infection. This pilot study provides preliminary evidence in support of future investigations that should examine a potential contribution of Bartonella spp. infection to SCZ/SAD.
Collapse
Affiliation(s)
- Erin Lashnits
- Comparative Medicine Institute, Department of Clinical Sciences, Intracellular Pathogens Research Laboratory, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Ricardo Maggi
- Comparative Medicine Institute, Department of Clinical Sciences, Intracellular Pathogens Research Laboratory, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Fredrik Jarskog
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Julie Bradley
- Comparative Medicine Institute, Department of Clinical Sciences, Intracellular Pathogens Research Laboratory, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Edward Breitschwerdt
- Comparative Medicine Institute, Department of Clinical Sciences, Intracellular Pathogens Research Laboratory, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Flavio Frohlich
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Center for Neurostimulation and Neuroscience Center, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Neurology and University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| |
Collapse
|
9
|
Clinical challenge - scratching the surface of the sheath. Surv Ophthalmol 2021; 67:875-878. [PMID: 33610587 DOI: 10.1016/j.survophthal.2021.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 02/10/2021] [Accepted: 02/15/2021] [Indexed: 11/23/2022]
Abstract
A 63-year-old white man with hypertension, hyperlipidemia, adrenal insufficiency, and history of metastatic spindle cell melanoma previously treated with ipilimumab, presented with unilateral papillitis in the left eye. The disc edema evolved to neuroretinitis with additional MRI findings of perineuritis. Broad laboratory evaluation confirmed active B. henselae infection, and he confirmed exposure to a newly adopted kitten. His vision improved following a course of antibiotics and oral steroids with resolution of clinical findings. To the best of our knowledge, this is the first reported case of cat-scratch neuroretinitis with MRI findings of optic nerve and optic nerve sheath enhancement.
Collapse
|
10
|
Logan JMJ, Hall JL, Chalker VJ, O'Connell B, Birtles RJ. Bartonella clarridgeiae infection in a patient with aortic root abscess and endocarditis. Access Microbiol 2019; 1:e000064. [PMID: 32974498 PMCID: PMC7491929 DOI: 10.1099/acmi.0.000064] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 09/18/2019] [Indexed: 11/24/2022] Open
Abstract
Introduction. Bartonella species are increasingly recognized as agents of culture-negative endocarditis. However, to date, almost all human cases have been associated with two members of the genus, Bartonella henselae and Bartonella quintana. B. henselae infections are zoonotic, with domestic cats serving as reservoir hosts for the pathogen. Bartonella clarridgeiae also exploits cats as reservoir hosts, but its zoonotic potential is far less established. Case presentation. A 34-year-old male presented with palpitations after a history of aortic incompetence. During surgery for an aortic valve replacement, two vegetations were found on the aortic valve. PCR analysis of the vegetation demonstrated the presence of Bartonella species and so the patient was treated post-operatively with ceftriaxone and doxycycline, making a good recovery. Further PCR-based analysis of the patient’s aortic vegetation confirmed the presence of B. clarridgeiae. Conclusion. This report expands the number of Bartonella species associated with endocarditis and provides clear evidence that B. clarridgeiae should be considered a zoonotic pathogen.
Collapse
Affiliation(s)
- Julie M J Logan
- Bacterial Reference Department, Public Health England, London NW9 5EQ, UK
| | - Jessica L Hall
- School of Science, Engineering and Environment, University of Salford, Manchester M5 4WT, UK
| | - Vicki J Chalker
- Bacterial Reference Department, Public Health England, London NW9 5EQ, UK
| | - Brian O'Connell
- Microbiology Department, St James's Hospital, Dublin 8, Ireland
| | - Richard J Birtles
- School of Science, Engineering and Environment, University of Salford, Manchester M5 4WT, UK
| |
Collapse
|
11
|
Del Pozo AA, Angulo-Cruzado M, Amenero-Vega R, Álvarez-Lulichac A, Fernández-Cosavalente H, Barboza-Meca J, Rodriguez-Morales AJ. Hepatosplenic abscesses in an immunocompetent child with cat-scratch disease from Peru. Ann Clin Microbiol Antimicrob 2019; 18:23. [PMID: 31307480 PMCID: PMC6628487 DOI: 10.1186/s12941-019-0322-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 07/06/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cat-scratch disease (CSD) is a zoonotic infection caused by Bartonella henselae and B. clarridgeiae. The typical manifestations of CSD include regional lymphadenitis and fever. However, CSD can have a wide variety of clinical manifestations that can lead to incorrect diagnoses and prolonged hospital stays. CASE PRESENTATION We present a case of a 3-year-old boy admitted to the pediatric service due to prolonged fever and abdominal pain. He received empirical antimicrobial treatment due to suspicion of infection. Abdominal ultrasound showed hepatosplenic abscesses. An IFA detected the presence of IgG antibodies against B. henselae (1:256). Patient was successfully treated with azithromycin and discharged after 7 weeks. CONCLUSIONS Hepatosplenic abscesses in CSD are rarely reported, particularly in immunocompetent children, with this, only 36 cases in PubMed, Web of Sciences and Scopus bibliographical databases. High rate of suspicion and serological tests availability are of utmost importance in order to detect it and treat it successfully and promptly.
Collapse
Affiliation(s)
| | | | - Ricardo Amenero-Vega
- Faculty of Human Medicine, Universidad Nacional de Trujillo, Trujillo, Peru.,Sociedad Cientifica de Estudiantes de Medicina, Universidad Nacional de Trujillo, Trujillo, Peru
| | | | - Hugo Fernández-Cosavalente
- Department of Pediatrics, Faculty of Human Medicine, Universidad Nacional de Trujillo, Trujillo, Peru.,Department of Pediatrics, Hospital Belen de Trujillo, Trujillo, Peru
| | | | - Alfonso J Rodriguez-Morales
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnologica de Pereira, Pereira, Risaralda, Colombia. .,Universidad Privada Franz Tamayo/UniFranz, Cochabamba, Bolivia.
| |
Collapse
|
12
|
Allizond V, Costa C, Sidoti F, Scutera S, Bianco G, Sparti R, Banche G, Dalmasso P, Cuffini AM, Cavallo R, Musso T. Serological and molecular detection of Bartonella henselae in specimens from patients with suspected cat scratch disease in Italy: A comparative study. PLoS One 2019; 14:e0211945. [PMID: 30735549 PMCID: PMC6368319 DOI: 10.1371/journal.pone.0211945] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 01/24/2019] [Indexed: 02/02/2023] Open
Abstract
Cat scratch disease (CSD) is an infectious disease caused by Bartonella henselae, usually characterized by self-limiting regional lymphadenopathy and fever. Given the low clinical diagnostic sensitivity and specificity of conventional anti-B. henselae indirect immunofluorescence assays (IFAs), real-time polymerase chain reaction (PCR)-based detection of B. henselae is now being proposed as a more sensitive tool to diagnose CSD. Thus, here we have assessed the efficacy of real-time PCR in detecting B. henselae in different specimens from patients with suspected CSD and compared it to that of IFA. From March 2011 to May 2016, at the Microbiology and Virology Unit, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin, Italy, 115 clinical specimens (56 aspirated pus, 39 fresh lymph node biopsies, and 20 whole blood samples) and 99 sera from 115 patients with suspected CSD (62 females and 53 males between the ages of 3 months and 68 years) were analyzed by both real-time PCR, used in a qualitative way, and IFA (IgM and IgG) for the presence of B. henselae. For 16 patients, serological results were not available due to a clinical decision not to request the test. B. henselae DNA positivity was detected by real-time PCR in 37.39% of patients, while 62.61% of them were negative. Thus, patients were divided into two groups: real-time PCR+ (n = 43) and real-time PCR- (n = 72). Real-time PCR screening of whole blood, biopsies, and aspirated pus revealed B. henselae positivity in 40%, 38.46%, and 35.71% of patients, respectively. When we analyzed samples by IFA, we found the presence of B. henselae in 28 out of 99 (28.28%) patients, of which 11 (11.11%) belonged to the real-time PCR+ group and 17 (17.17%) to the real-time PCR- group. Among the 71 seronegative subjects, 16 (16.16%) were found positive for B. henselae by real-time PCR. Thus, by combining the results of both assays, we were able to increase the percentage of B. henselae positive specimens from 27.27% (real-time PCR) or 28.28% (IFA) to 44.44% (real-time PCR+IFA). Altogether, these findings indicate that the early detection of B. henselae in patients with suspicious CSD through combined real-time PCR and serological analyses can lead to a more accurate diagnosis of CSD, thereby allowing prompt and appropriate disease management.
Collapse
Affiliation(s)
- Valeria Allizond
- Microbiology section, Department of Public Health and Pediatrics, University of Torino, Turin, Italy
| | - Cristina Costa
- Microbiology and Virology Unit, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Francesca Sidoti
- Microbiology and Virology Unit, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Sara Scutera
- Microbiology section, Department of Public Health and Pediatrics, University of Torino, Turin, Italy
| | - Gabriele Bianco
- Microbiology and Virology Unit, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Rosaria Sparti
- Microbiology section, Department of Public Health and Pediatrics, University of Torino, Turin, Italy
| | - Giuliana Banche
- Microbiology section, Department of Public Health and Pediatrics, University of Torino, Turin, Italy
- * E-mail:
| | - Paola Dalmasso
- Statistics section, Department of Public Health and Pediatrics, University of Torino, Turin, Italy
| | - Anna Maria Cuffini
- Microbiology section, Department of Public Health and Pediatrics, University of Torino, Turin, Italy
| | - Rossana Cavallo
- Microbiology and Virology Unit, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Tiziana Musso
- Microbiology section, Department of Public Health and Pediatrics, University of Torino, Turin, Italy
| |
Collapse
|