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[Bartonella quintana endocarditis. Aortic localization and mitral valve abscess].

Bartonella Quintana is an exceptionally rare cause of endocarditis. The frequency of this condition is increasing and is probably underestimated because of the difficulty in diagnosing. The clinical context is that of socially deprived classes, the agent of transmission of the germ being body lice. The commonest valve affected is the aortic valve. This infection may also give rise to a mitral annulus abscess, as in this particular case. The diagnosis should be suspected in all cases of endocarditis with negative blood cultures in socially deprived patients as special diagnostic methods are required. Bartonellosis serology and drainage of effusions to perform a Gimenez stain to show intra-cellular bacteria and a polymerase chain reaction to sequence the nucleic acids, will give an accurate diagnosis. Similarly, the operative specimens should be sent to a specialised department for the culture of these bacteria (in France, the Marseille Ricketsioses Institute). The treatment of Bartonella endocarditis is very controversial. The usual recommendations are an association of betalactamines and an aminoside for one month and macrolides or tetracyclines. There is lack of consensus about follow-up. It would seem prudent to perform a clinical examination to search for a relapse of the infection and monthly serologies until they return to normal values.

Abscess↗

Infections with blood parasites in the small British rodents Apodemus sylvaticus, Clethrionomys glareolus and Microtus agrestis.

Three populations of small wild British rodents were studied by capture-recapture methods over a period of 3 years, a fourth group was studied for 1 year and a fifth was sampled annually for 4 years. Blood smears were taken from 3 species of rodents: the woodmouse Apodemus sylvaticus, the bank vole Clethrionomys glareolus (and an island sub-species C.g. skomerensis) and the short-tailed vole Microtus agrestis. The smears were examined microscopically. Four genera of haemoparasites Babesia, Hepatozoon, Trypanosoma and Grahamella were detected. Babesia was absent from C.g. skomerensis, Hepatozoon was rarely found in A. sylvaticus and M. agrestis and Trypanosoma was rare in A. sylvaticus. More males were infected than females but the difference was only statistically significant for the infection with Hepatozoon in adult C.g. skomerensis. Infections with Babesia and Hepatozoon were more prevalent in adult animals and infections with Trypanosoma were more prevalent in younger individuals. Only in C.g. skomerensis was there a significant difference between age classes in the prevalence of infection with Grahamella--there being more adults infected. Concurrent infections were detected, Hepatozoon being the parasite most commonly involved. The prevalence of infections was found to be approximately proportional to the number of animals known to be alive, regardless of the season.

Age Factors↗

Grahamella in small woodland mammals in the U.K.: isolation, prevalence and host specificity.

Bacteria isolated from the blood of small woodland mammals were identified as members of the genus Grahamella. The prevalence of Grahamella infection among the 37 small mammals examined, detected by cultivation of blood samples, was 62%. This figure is somewhat higher than previous reports. Further characterization of the isolates, based on restriction enzyme analysis of the 16S rRNA gene, serological reactivity and DNA hybridization studies, revealed three distinct Grahamella species. One of the species was found in five different species of small mammal (Apodemus sylvaticus, A. flavicollis, Clethrionomys glareolus, Microtus agrestis and Neomys fodiens). All three species were found in M. agrestis, although there was no evidence of concurrent infection of an animal by more than one species of Grahamella. These observations demonstrate that Grahamella spp. are not host-specific, as previously thought, and that it is therefore invalid to name Grahamella spp. solely on the basis of the host in which they are observed.

Animals↗

Ectoparasites of gray squirrels in two different habitats and screening of selected ectoparasites for bartonellae.

Gray squirrels, Sciurus carolinensis, were livetrapped in 2 different habitat types, woodland (67 squirrels) and parkland (53 squirrels), in southeastern Georgia. Ectoparasites were recovered from anesthetized squirrels and compared between hosts from the 2 habitats. Because of the absence of low vegetation in parkland habitats, it was hypothesized that the ectoparasite fauna, especially ticks and chiggers, would be more diverse on woodland squirrels. The results were generally in agreement with this hypothesis. Seventeen species of ectoparasites were recovered from woodland squirrels, compared with 6 species from parkland squirrels. Five species of ticks and 3 species of chiggers parasitized the woodland squirrels compared with no ticks or chiggers on the parkland squirrels. Significantly higher infestation prevalences were recorded on woodland compared with parkland squirrels for the flea Orchopeas howardi, the tick Amblyomma americanum, and the mesostigmatid mite Androlaelaps fahrenholzi. The mean intensity for O. howardi also was significantly higher on woodland than on parkland squirrels. Because a new strain of Bartonella sp. was isolated recently from S. carolinensis in Georgia, selected ectoparasites from this study were screened for bartonellae by polymerase chain reaction (PCR). Some of the fleas and lice, but none of the mites tested, were PCR positive, suggesting that fleas, or lice, or both, might be vectors of bartonellae between squirrels. Six distinct strains of Bartonella sp. were detected, 2 in fleas and 4 in lice.

Animals↗

Haemobartonella canis infection in research dogs.

During 1970-1972 haemobartonellosis occurred in research canines at 2 widely separated institutions. Clinical anemia occurred in a splenectomized dog at a Maryland facility, and subsequent screening disclosed an infection rate of 65% in a group of 20 splenectomized subjects. Treatment was successful, and the animals were used in research. A research institution in Texas encountered a number of dogs with fever (to 106 degrees F) and eosinophilia (to 42%) following minor surgery. Blood from affected animals was injected iv into splenectomized dogs, and 3 of 6 recipients developed haemobartonellosis. Further study was conducted, with some success, to establish a relationship between fever and eosinophilia and Haemobartonella canis infection in nonsplenectomized subjects. Our experiences suggest that haemobartonellosis is a widespread, latent disease of dogs and that significant potential exists for the infection to adversely affect research results.

Animals↗

The nature of age immunity to Plasmodium berghei in the rat.

The intensity of Plasmodium berghei infections decreases as the age of the rat host increases. The nature of this 'age immunity' was investigated. No experimental support was found for innate resistance involving either serum non-antibody factors or changes in the erythrocytes that inhibit parasites in older rats. A cross reacting immune response active against P. berghei was not found. Evidence is presented which shows that rats less than 7 weeks old lack at least part of the functional immunological apparatus by which older rats produce a protective immune response. It is suggested that the defect might involve T lymphocytes.

Age Factors↗

[Cat scratch (?) disease].

The case of a 24 year old female student who developed typical cat scratch disease following an insect sting invited to review the literature. Over the last two years, Rocalimaea henselae could be identified and is now considered to be responsible for the majority of infected cases. It is related to Rochalimaea quintana that provokes trench fever and to Bartonella bacilliformis, known as the inciting agent of the verruca peruana and of Oroya fever. Recently, it has been proposed to integrate Rochalimaea and Bartonella into the family of Bartonellaceae. The diverse and fascinating array of clinical syndromes caused by R. henselae as well as their treatment are described. Capability to affect organs other than skin and lymph nodes is primarily but not exclusively associated with immunodeficiencies. In countries like Switzerland little information on these clinical pictures is available. However, it is important to recognize the typical symptoms and signs in order to initiate the appropriate and necessary examinations.

Adult↗

Intraerythrocytic parasites in rodent populations of Connecticut: Babesia and Grahamella species.

A total of 612 Peromyscus leucopus, 11 Microtus pennsylvanicus, 21 Clethrionomys gapperi, and 4 Tamias striatus was collected in Connecticut and examined for Babesia and Grahamella during 1976 and 1977. Babesia antibodies were detected in sera of 9 P. leucopus collected from 4 sites. Babesia parasites were not detected in the blood smears of captured rodents. Subsequent splenectomy and subinoculation of blood from these rodents into susceptible animals failed to induce disease and no Babesia was isolated. Six of 10 P. leucopus inoculated with a Shelter Island, New York strain of B. microti remained infected for 3 1/2 months. Indirect fluorescent antibody titers of experimentally infected P. leucopus ranged from 1:8 to 1:256. Prevalence of Grahamella peromysci infection, as determined from examinations of blood smears of P. leucopus, was 13%. This infection rate is a conservative estimate because parasitemia is difficult to detect in intact animals. Twenty of 58 P. leucopus, taken at 2 sites and with negative blood smears for G. peromysci, developed parasitemia after splenectomy.

Animals↗