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PubMed2001

Association of Bartonella species and Coxiella burnetii infection with coronary artery disease.

Coronary artery disease is an inflammatory condition associated with several infections. We prospectively evaluated 155 consecutive patients undergoing coronary angiography for evidence of Bartonella species and Coxiella burnetii infection. All Bartonella cultures were found to be negative. Multivariable logistic regression analysis that controlled for potential confounding factors revealed no association between coronary artery disease and seropositivity to Bartonella henselae (odds ratio [OR], 0.852; 95% confidence interval [CI], 0.293-2.476), Bartonella quintana (OR, 0.425; 95% CI, 0.127-1.479), C. burnetii phase 1 (OR, undefined), and C. burnetii phase 2 (OR, 0.731; 95% CI, 0.199-2.680). The geometric mean titer (GMT) for C. burnetii phase 1 assay was slightly higher in persons with coronary artery disease than in those without such disease (P<.02). B. henselae, B. quintana, and C. burnetii seropositivity was not strongly associated with coronary artery disease. On the basis of GMTs, C. burnetii infection may have a modest association with coronary artery disease.

Bartonella↗
PubMed1995

[Cat scratch disease caused by Bartonella henselae].

Bartonella henselae is an etiologic agent of cat-scratch disease and, in immunocompromised patients, of bacillary angiomatosis and other severe syndromes. Cat-scratch disease usually presents as lymphadenopathy, which resolves spontaneously within 2-4 months. The utility of antibiotic therapy remains controversial. In Tyrol four cases of human cat-scratch disease were diagnosed in children in 1994, yielding a prevalence of 0.7/100,000 per year. A 3-year-old boy had lymphadenitis coli since one year despite antituberculosis therapy which was initiated because of the histopathological picture and a positive tuberculin reaction (despite negative mycobacteria-cultures and -PCR). Two girls, age 9 and 13 years, had lymphadenitis at upper or lower extremities after cat-scratches from kittens. A 13-year-old boy presented with febrile illness and right hip pain, computer tomography revealed an osteolytic lesion; symptoms subsided within 3 weeks. Diagnosis of cat-scratch disease is based on cat contact, negative studies for other similar diseases, characteristic histopathologic features (if available), and results of an indirect immunofluorescence test (antigen: Houston-1 isolate, ATCC 49882). We believe that the availability of this serological test will increase the number of diagnosed cases of human Bartonella henselae infections.

Adolescent↗
PubMed2000

Bartonella henselae associated uveitis and HLA-B27.

AIM: To investigate the frequency of HLA-B27 in patients with presumed Bartonella henselae associated uveitis and to describe the clinical characteristics of HLA-B27 positive patients with uveitis and presumed ocular bartonellosis (POB). METHODS: The diagnosis of POB was considered in 19 patients with unexplained uveitis (except for the HLA-B27 association) and high positive IgG (titre >/=1:900) and/or IgM (titre >/=1:250) antibodies against B henselae. In addition to B henselae serology and HLA-B27 typing, all patients underwent an extensive standard diagnostic screening procedure for uveitis and in all cases the results were within the normal limits. The control group consisted of 25 consecutive patients with panuveitis and negative B henselae serology. RESULTS: HLA-B27 was positive in six of the 19 patients (32%) with POB in contrast to the 4% frequency of HLA-B27 in the control group (p=0.03) and 8% prevalence of HLA-B27 in the Dutch population (p=0.003). At the time of positive Bartonella serological testing five of six HLA-B27 positive patients with POB had severe posterior segment involvement with papillitis, macular oedema, and vitreitis. The duration of intraocular inflammatory activity was more than 6 months in five HLA-B27 positive patients. Although four of the six HLA-B27 positive patients had previous recurrent attacks of acute anterior uveitis, the clinical presentation at the time of positive Bartonella serology differed, as illustrated by the involvement of the posterior segment and chronic course of the ocular disease. CONCLUSIONS: The frequency of HLA-B27 in patients with uveitis and serological characteristics of acute infection with B henselae is higher than in the general Dutch population. The findings of this study also suggest a relation between infection with Bartonella species and HLA-B27.

Adolescent↗
PubMed2003

Detection of Bartonella henselae and Bartonella clarridgeiae DNA in hepatic specimens from two dogs with hepatic disease.

A 4-year-old Basset Hound and a 6-year-old Doberman Pinscher were referred for diagnostic evaluation following documentation of persistently increased hepatic enzyme activities and hepatic dysfunction. Histologic evaluation of hepatic biopsy specimens from the 2 dogs revealed granulomatous hepatitis in the Basset Hound and lymphocytic hepatitis with fibrosis and copper accumulation in the Doberman Pinscher. No etiologic agents were identified histologically. Bartonella henselae DNA was subsequently amplified from hepatic tissue from the Basset Hound and Bartonella clarridgeiae was amplified from hepatic tissue from the Doberman Pinscher. Amplification was performed with a polymerase chain reaction assay incorporating primers that target a portion of the 16S-23S rRNA intergenic spacer region. Both dogs were treated with azithromycin, in combination with a variety of other medications and herbal treatments, and improved clinically. Identification of Bartonella DNA in these dogs indicates the need for future prospective studies to determine the clinical relevance of Bartonella spp infection in dogs with hepatic disease.

Animals↗
PubMed1996

Intermediate uveitis and retinal vasculitis as manifestations of cat scratch disease.

PURPOSE: To study the ocular manifestations of systemic Rochalimaea infection. METHODS: We examined a healthy 21-year old woman who had floaters in both eyes. A bilateral mild vitreitis and multiple foci of retinal vasculitis were found; during the ensuing two weeks, exudates appeared over the inferior pars plana. The patient owned five kittens but had no history of cat bites or scratches. Serum levels of antibodies to Rochalimaea were elevated. RESULT: The retinal vasculitis and vitreitis resolved after three weeks of therapy with ciprofloxacin hydrochloride without concomitant anti-inflammatory therapy. CONCLUSION: Rochalimaea infection should be considered in the differential diagnosis of intermediate uveitis and retinal vasculitis.

Adult↗
PubMed1995

Prevalence of Bartonella henselae antibodies in pet cats throughout regions of North America.

Cat exposure has been directly associated with the development of human Bartonella henselae infections, resulting in cat-scratch disease, bacillary angiomatosis, or bacteremia. The prevalence of serum antibody titers to B. henselae was determined for selected pet cats from 33 geographic locations throughout the United States and several areas in western Canada. Seroprevalences paralleled increasing climatic warmth (P < .02) and annual precipitation (P < .03). These warm, humid areas with the highest seroprevalence would also have the highest number of potential arthropod vectors. The southeastern United States, Hawaii, coastal California, the Pacific Northwest, and the south central plains had the highest average prevalences (54.6%, 47.4%, 40.0%, 34.3%, and 36.7%, respectively). Alaska, the Rocky Mountain-Great Plains region, and the Midwest had low average prevalences (5.0%, 3.7%, and 6.7%, respectively). Overall, 27.9% (175/628) of the cats tested were seropositive. The seroprevalence of B. henselae in cats varies throughout the United States and appears to be influenced by climate.

Animals↗
PubMed1998

Bartonella henselae antibody prevalence in free-ranging and captive wild felids from California.

In order to determine the importance of wild felids in the epidemiology of Bartonella spp. infection, 136 Nobuto strips or serum samples from free-ranging mountain lions (Felis concolor) and bobcats (Felis rufus) captured in California (USA) between 1985 and 1996 were tested for B. henselae antibodies (titer > or = 1:64) using an immunofluorescence test. Similarly, 124 serum samples from 114 captive wild cats representing 26 species or subspecies collected between 1991 and 1995 were retrieved from the serum banks of four California zoological parks. Fifty-three percent (33/62) of the bobcats, 35% (26/74) of the mountain lions, and 30% (34/114) of the captive wild felids (genera Acinonyx, Panthera and Felis) had B. henselae antibodies. In captive wild felids, prevalence varied widely among the species, but seropositivity was more likely to occur in the genus Felis than in the genus Acinonyx or Panthera. Prevalence was evenly distributed between sexes, except for free-ranging mountain lions. Antibody prevalence ranged from 25% in 0- to 2-yr-old captive felids to 35% in cats > or = 9-yr-old, but the highest antibody titers were observed in cats < 5-yr-old.

Age Factors↗
PubMed2006

[Endocarditis due to Bartonella spp. Three new clinical cases and Spanish literature review].

INTRODUCTION: Infections by Bartonella spp. include a wide spectrum of emerging and re-emerging infectious diseases, such as culture-negative endocarditis. METHODS: Description of 3 cases of endocarditis due to Bartonella spp. and review of those previously reported in Spain. RESULTS: Including these 3 new cases of endocarditis due to Bartonella spp., a total of 6 cases have been reported in Spain. The median age of the patients was 51.6 years and 83.3% were men. There was history of contact with cats in 66.7%, and 50% were alcoholic. Only one patient had prior valvular disease. There were no clinical manifestations typical to any of the Bartonella species. The aortic valve was the one most commonly affected. In all cases, B. henselae was the agent implicated. The diagnosis was made by serology in 5 cases (83.3%). The outcome was favorable in all patients, although 4 of them (66.7%) required valve replacement. CONCLUSION: Endocarditis due to Bartonella spp. is present in Spain and is likely to be underestimated. We should suspect this pathogen in patients with negative blood cultures and a history of chronic alcoholism, homeless patients, and those who have had contact with cats or who have been bitten by fleas or lice, as well as patients with endocarditis and positive serology against Chlamydia spp.

Actinobacillus Infections↗
PubMed1997

Redefining AIDS: towards a modification of the current AIDS case definition.

AIDS is defined by the occurrence of an opportunistic infection or tumor considered indicative of advanced infection with human immunodeficiency virus (HIV). Even though recent modifications have improved the widely used AIDS case definition issued by the World Health Organization and the Centers for Disease Control and Prevention, the modified version has fallen short of generating a globally functional instrument for the surveillance of HIV-related infections. The clinical AIDS case definition should be as comprehensive as possible. In many countries, only the diagnosis of an AIDS-defining illness will grant the affected patient social benefits or access to medical care. An expanded AIDS case definition is also likely to improve surveillance of HIV-associated morbidity and mortality; increase the awareness of emerging infections; increase the number of clinical endpoints in clinical trials; and facilitate the introduction of diagnostic tests, screening programs, and preventive measures. Examples of opportunistic infections and tumors that could be considered in future modifications of the AIDS case definition are discussed in detail.

AIDS-Related Opportunistic Infections↗
PubMed2004

Carrion's disease (Bartonellosis bacilliformis) confirmed by histopathology in the High Forest of Peru.

Bartonellosis or Carrion's disease is endemic in some regions of Peru, classically found in the inter-Andean valleys located between 500 and 3200 meters above sea level. We report the case of a 43 year-old male patient, farmer, who was born in the Pichanaki district (Chanchamayo, Junin), located in the High Forest of Peru. He presented with disseminated, raised, erythematous cutaneous lesions, some of which bled. The distribution of these lesions included the nasal mucosa and penile region. Additionally subcutaneous nodules were distributed over the trunk and extremities. Hematologic exams showed a moderate anemia. Serologic studies for HIV and Treponema pallidum were negative. The histopathologic results of two biopsies were compatible with Peruvian wart. Oral treatment with ciprofloxacin (500 mg BID) was begun. Over 10 days, the patient showed clinical improvement. This is the first report of a confirmed case of bartonellosis in the eruptive phase originating from the Peruvian High Forest, showing the geographical expansion of the Carrion's disease.

Adult↗
PubMed1955

[Carrión].

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Bartonella Infections↗