James L. Schaller, M.D.  •  239-263-0133


Recent Bartonella Articles: 2009 Update

Some of the articles below have pearls for the clinician treating emerging infections and people with many Bartonella problems who do not get well. Bartonella hits every organ at least 20 ways, and is more than a passing cold with many patients.

See also: Bartonella Diagnosis and Treatment

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1. Otolaryngol Pol. 2009 May-Jun;63(3):271-3.

[Cat scratch disease--an underestimated diagnosis]

[Article in Polish]

Szaleniec J, Oles K, Sk�adzien J, Strek P.

Katedra Klinika Otolaryngologii UJCM w Krakowie. asiat@uci.agh.edu.pl

INTRODUCTION: Cat scratch disease is a rare and frequently underestimated cause of lymphadenopathy, which may occur also in the head and neck. The infection is most commonly caused by intracellular bacilli Bartonella, transmitted by domestic animals. AIM: We present a case report of a patient treated in the Department of Otolaryngology UJCM in Krakow. The patient presented with a neck tumor. Due to unclear clinical manifestation he underwent surgical treatment. The postoperative histopathological examination suggested cat scratch disease. In detailed anamnesis the patient admitted contact with cats and dogs in his household. No posoperative complications were observed. CONCLUSIONS: In every case of neck tumor it is advisable to consider cat scratch disease, remembering that exclusion of a neoplastic process remains a priority.

PMID: 19886535 [PubMed - in process]

2. Vector Borne Zoonotic Dis. 2009 Oct 29. [Epub ahead of print]

Cervical Lymphadenitis in a Patient Coinfected with Toxoplasma gondii and Bartonella henselae.

Yoon HJ, Lee WC, Choi YS, Cho S, Song YG, Choi JY, Kim CO, Kim EJ, Kim JM.

1 Department of Internal Medicine, Eulji University School of Medicine , Daejeon, Korea.

Abstract Cat scratch disease, caused by Bartonella henselae, is a worldwide zoonosis that is most frequently associated with the bite or scratch of a kitten under 6 months of age, as well as from a fleabite. Toxoplsma gondii is also another important zoonotic agent in cats and humans, which is mainly acquired by ingestion of food or water that is contaminated with oocytes shed by cats or by eating undercooked or raw meat containing tissue cysts. Here, we report a first case of young patient with cervical lymphadenitis, which shows serological and histological evidence of B. henselae and T. gondii coinfection in Korea with literature review.

PMID: 19874186 [PubMed - as supplied by publisher]

3. Am J Trop Med Hyg. 2009 Nov;81(5):811-6.

Prevalence and genetic heterogeneity of Bartonella strains cultured from rodents from 17 provinces in Thailand.

Bai Y, Kosoy MY, Lerdthusnee K, Peruski LF, Richardson JH.

Centers for Disease Control and Prevention, Fort Collins, Colorado, USA. bby5@cdc.gov

To study the distribution and diversity of Bartonella in rodents from Thailand, 330 rodents belonging to 13 species were tested. The majority (80.6%) of rodents examined belonged to the genus Rattus. Bartonellae were cultured from 41.5% of the rodents with a wide range of prevalence by host species and regions. Sequencing of gltA revealed diverse Bartonella strains. Bartonellae from Rattus spp. belonged to 23 variants and clustered with Bartonella coopersplainensis, Bartonella elizabethae, Bartonella phoceensis, Bartonella rattimassiliensis, Bartonella tribocorum, and an unknown geno-group. Bartonellae from Bandicota spp. belonged to six variants and clustered with B. coopersplainensis, B. rattimassilliensis, and B. tribocorum. Three variants from Mus spp. clustered with B. coopersplainensis or B. rattimassilliensis. The only isolate from a Berylmys berdmorei fell into the B. tribocorum group. The observations highlight the need to study these agents for their role in human febrile illnesses of unknown etiology in Thailand and elsewhere in Asia.

PMID: 19861616 [PubMed - in process]

4. Jpn J Ophthalmol. 2009 Sep;53(5):490-3. Epub 2009 Oct 22.

Seroprevalence of Bartonella henselae in patients with uveitis and healthy individuals in Tokyo.

Kamoi K, Yoshida T, Takase H, Yokota M, Kawaguchi T, Mochizuki M.

Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan. koju.oph@tmd.ac.jp

PURPOSE: To compare the seroprevalence of Bartonella henselae, a pathogen of cat scratch disease, in patients with uveitis and in healthy individuals. METHODS: Serum samples were collected from 197 consecutive patients with various entities of uveitis at Tokyo Medical and Dental University Hospital, and from 83 healthy age- and sex-matched volunteers. Anti-Bartonella IgG and IgM antibodies were examined by indirect immunofluorescent antibody. RESULTS: Serum antibodies to B. henselae were positive in 39 of 197 (19.8%) patients with uveitis, and in 21 of 83 (25.3%) of the healthy volunteers. There was no statistical difference in the seroprevalence between the two groups. The overall seroprevalence of B. henselae was 60 of 280 (21.4%). CONCLUSIONS: The seroprevalence of B. henselae was similar in both patients with uveitis and in healthy volunteers in Tokyo, Japan. These data indicate that a significant number of healthy individuals are asymptomatic carriers of B. henselae, which should be kept in mind when a diagnosis of cat scratch disease is made.

PMID: 19847604 [PubMed - in process]

5. Vet Parasitol. 2009 Sep 26. [Epub ahead of print]

Babesia canis and other tick-borne infections in dogs in Central Poland.

Welc-Faleciak R, Rodo A, Sinski E, Bajer A.

Department of Parasitology, Institute of Zoology, Faculty of Biology, University of Warsaw, 1 Miecznikowa Street, 02-096 Warsaw, Poland.

Vector-borne infections constitute increasing health problem in dogs worldwide, including sled dogs, dramatically decreasing the fitness of working dogs and even leading to death. In the period 2006-2008 eighty-two blood samples were collected from eight sled dog kennels in Central Poland. The prevalence of four vector-borne infections (Babesia canis, Bartonella sp., Anaplasma/Ehrlichia and Borrelia burgdorferi) was estimated in 82 sled dogs using PCR and nested PCR for diagnosis and the same methods were used to identify the vector-borne pathogens in 26 dogs presenting at veterinary clinics with symptoms of vector-borne diseases. None of four studied vector-borne pathogens was detected in samples originating from veterinary clinics. Among the remaining 82 dogs B. canis infections were confirmed in three dogs undergoing treatment for babesiosis. The DNA of tick-borne pathogens was also found among 22 (27.8%) of the 79 apparently healthy dogs, including 20 cases of B. canis infection (25.3%), one case of B. burgdorferi s.l. infection and one case of Anaplasma phagocytophilum infection. No evidence of Bartonella spp. and Ehrlichia canis infections were found in this set of samples. Sequencing of a Babesia fragment of 18S rDNA amplified from acute (n=5) and asymptomatic (n=5) cases revealed that all isolates were identical to the Babesia canis canis sequence, originally isolated from Dermacentor reticulatus ticks in Poland. A range of factors was shown to affect the distribution of babesiosis in sled dogs. The data are also discussed in respect to the health risk factors generated by asymptomatic B. canis infections and the efficiency of chemoprophylaxis measures taken by sled dog owners.

PMID: 19837515 [PubMed - as supplied by publisher]

6. J Med Case Reports. 2009 Jul 17;3:7325.

Fatal myocarditis-associated Bartonella quintana endocarditis: a case report.

Montcriol A, Benard F, Fenollar F, Ribeiri A, Bonnet M, Collart F, Guidon C.

INTRODUCTION: Bartonella spp. infection is not rare and must be considered with great care in patients with suspected infective endocarditis, particularly if regular blood cultures remain sterile. Management of these infections requires knowledge of the identification and treatment of these bacteria. CASE PRESENTATION: A 50-year-old Senegalese man was admitted to our Department of Cardiac Surgery with a culture-negative endocarditis. Despite valvular surgery and adequate antibiotic treatment, recurrence of the endocarditis was observed on the prosthetic mitral valve. Heart failure required circulatory support. Weaning off the circulatory support could not be attempted owing to the absence of heart recovery. Bacteriological diagnosis of Bartonella quintana endocarditis was performed by molecular methods retrospectively after the death of the patient. CONCLUSIONS: This case report underlines the severity and difficulty of the diagnosis of Bartonella quintana endocarditis. The clinical picture suggested possible Bartonella quintana associated myocarditis, a feature that should be considered in new cases.

PMCID: 2737767 PMID: 19830188 [PubMed - in process]

7. Hong Kong Med J. 2009 Oct;15(5):391-3.

A serologically proven case of cat-scratch disease presenting with neuroretinitis.

Chu BC, Tam VT.

Caritas Medical Centre, Shamshuipo, Kowloon, Hong Kong. dr_cychu@yahoo.com.hk

Cat-scratch disease is a clinical syndrome that usually presents as a self-limiting illness featuring regional lymphadenopathy, fever, and small skin lesions in association with a cat scratch or bite. It is caused by the Gram-negative bacillus Bartonella henselae, which commonly affects children and young adults. Ocular bartonellosis is the most common atypical manifestation of cat-scratch disease. It can present with a wide spectrum of ocular diseases including neuroretinitis, Parinaud's oculoglandular syndrome, and other forms of intra-ocular inflammation. This case report describes cat-scratch disease neuroretinitis in a 10-year-old girl who presented with typical signs, including optic disc swelling and a macular star, preceded by pyrexia of unknown origin and cervical lymphadenopathy.

PMID: 19801700 [PubMed - in process]

8. Med Mal Infect. 2009 Sep 30. [Epub ahead of print]

[PCR rDNA 16S used for the etiological diagnosis of blood culture negative endocarditis.]

[Article in French]

Baty G, Lanotte P, Hocqueloux L, Prazuck T, Bret L, Romano M, Mereghetti L.

Service de bacteriologie-virologie, hopital Bretonneau, CHRU de Tours, Tours, France.

We report the case of a 55 year-old man presenting with a double aortic and mitral endocarditis for which resected valve culture was repeatedly negative. Specific PCR made on valves because of highly positive blood tests for Bartonella henselae remained negative. A molecular approach was made with 16S rDNA PCR, followed by sequencing. Bartonella quintana was identified as the etiology of endocarditis. B. quintana, "fastidious" bacteria, even if hard to identify in a laboratory, is often reported as a blood culture negative endocarditis (BCNE) agent. Molecular biology methods have strongly improved the diagnosis of BCNE. We propose a review of the literature focusing on the interest of broad-spectrum PCR on valve for the etiological diagnosis of BCNE.

PMID: 19796889 [PubMed - as supplied by publisher]

9. Mikrobiyol Bul. 2009 Jul;43(3):391-401.

[Investigation of Bartonella henselae seroprevalence and related risk factors in blood donors admitted to Pamukkale University Blood Center]

[Article in Turkish]

Yilmaz C, Ergin C, Kaleli I.

Pamukkale Universitesi Tip Fakultesi, Mikrobiyoloji Anabilim Dali, Denizli. cansev@gmail.com

Bartonella henselae is an emerging infectious agent that mainly causes cat scratch disease, basillary angiomatosis and peliosis hepatitis. Although many basillary angiomatosis cases have been reported especially from the Mediterranean region of Turkey, adequate data about the seroprevalence of B. henselae in Turkey does not exist. The aim of this study was to investigate the seroprevalence of B. henselae in volunteer blood donors and the related risk factors. In this study, sera samples were randomly collected from 800 (771 man, 29 women; age range: 18-60 years) voluntary healthy blood donors admitted to Pamukkale University Research and Training Hospital. B. henselae (Houston-1 strain) total antibodies were investigated by an in-house indirect immunofluorescent antibody assay. Seropositivity was detected in 6% (48/800) of the donors. B. henselae (Houston-1) antibody titer was 1/64 in 40 of the donors, 1/128 in 4, 1/256 in 2, 1/512 in 1 and 1/1024 in 1 of the donors. Statistical analysis of epidemiological and demographical data revealed that high seroprevalence rates have been found in rabbit stockfarmers (p = 0.004), students staying at hostels (p = 0.04) and people with history of tick-bite (p = 0.03). No significant statistical differences were found in each related groups in terms of age, sex, chronic disorders, sport activities, outside behaviors, being injured by any wild or domestic animals, working outdoors, geographical properties of the area of inhabitance, hunting and travelling (p > 0.05). One of the high titer (1/512) antibody positive subjects was a cat owner and had a history of phlebotomus bite, pediculosis and sporting in open area while 1/1024 titer positive case was a farmer and a dog owner. Our healthy blood donors' seroprevalence results are similar to those of other Mediterranean countries. The analysis of epidemiological data revealed that tick bite history and rabbit stockfarming were the risk factors for B. henselae infection. Variability and regional intensity of vectors may provide important clues to spreading disease. Consequently, these data showed that bartonellosis is an emerging disease in our country and detailed questionnaire for blood donors may be helpful to prevent transmission. Further larger scale research is necessary to determine the seroprevalence of B. henselae and analyse the related risk factors in Mediterranean-type climate regions.

PMID: 19795614 [PubMed - in process]

10. Clin Microbiol Infect. 2009 Sep 28. [Epub ahead of print]

Molecular detection of Bartonella quintana in human body lice from Mexico City.

Alcantara V, Rolain JM, Eduardo AG, Raul MJ, Raoult D.

Health Ministry in Mexico City, Direccion General de Servicios Medicos y Urgencias SSA-GDF. Mexico City, Mexico.

PMID: 19793127 [PubMed - as supplied by publisher]

11. Clin Microbiol Infect. 2009 Sep 28. [Epub ahead of print]

Comparison of the performances of MLVA vs. the main other typing techniques for Bartonella henselae.

Bouchouicha R, Boulouis HJ, Berrich M, Monteil M, Chomel B, Haddad N.

UMR BIPAR, ENVA/AFSSA/INRA, Maisons-Alfort, France.

PMID: 19793125 [PubMed - as supplied by publisher]

12. Clin Microbiol Infect. 2009 Sep 28. [Epub ahead of print]

Prevalence of Coxiella burnetii and Bartonella species as cases of infective endocarditis in Marseilles (1994-2007).

Casalta JP, Gouriet F, Richet H, Thuny F, Habib G, Raoult D.

Unite des Rickettsies, Faculte de Medecine, Universite de la Mediterranee, Boulevard Jean Moulin, Marseille, cedex, France.

PMID: 19793124 [PubMed - as supplied by publisher]

13. Clin Microbiol Infect. 2009 Sep 28. [Epub ahead of print]

Detection of Bartonella henselae - DNA in macronodular hepatic lesions of an immunocompetent woman.

Mastrandrea S, Simonetta Taras M, Capitta P, Tola S, Marras V, Strusi G, Masala G.

Istituto Zooprofilattico Sperimentale of Sardinia, Sassari, Italy.

PMID: 19793123 [PubMed - as supplied by publisher]

14. Klin Padiatr. 2009 Sep 29. [Epub ahead of print]

Cat Scratch Disease - Heterogeneous in Clinical Presentation: Five Unusual Cases of an Infection Caused by Bartonella henselae.

Weinspach S, Tenenbaum T, Sch�nberger S, Schaper J, Engers R, Rueggeberg J, Mackenzie CR, Wolf A, Mayatepek E, Schroten H.

Department of General Pediatrics, University Children's Hospital, Heinrich Heine University Dusseldorf, Germany.

HINTERGRUND: Die Katzenkratzkrankheit (CSD) ist im Kindesalter verbreitet. Das weite Spektrum in der klinischen Pr�sentation erschwert jedoch die Diagnose. Atypische Verl�ufe der CSD pr�sentieren sich klinisch h�ufig �hnlich schweren Krankheitsbildern wie Tuberkulose, anderen Mykobakterien, Epstein-Barr-Virus-Infektion (EBV) oder maligne Erkrankungen. In seltenen F�llen ist das gleichzeitige Auftreten dieser schweren Erkrankungen und CSD beschrieben. CSD fruhzeitig in die m�glichen Differenzialdiagnosen einzubeziehen und fruhzeitige Diagnostik einzuleiten, ist daher sinnvoll. Diese Diagnostik umfasst die Serologie und, wenn m�glich, histologische und molekulare Diagnostik aus Gewebeproben. PATIENTEN UND METHODE: Es wurde eine Fallserie mit 5 F�llen von atypischer CSD aus unserer Klinik erstellt. Wir untersuchten die F�lle serologisch gesicherter CSD auf spezifische anamnestische Hinweise und klinische Zeichen. ERGEBNISSE: Das klinische Spektrum umfasst nicht nur die typischen Symptome entsprechend der Beschreibung von 1950, sondern umfasst ein weites Spektrum von klinischen Verl�ufen. Dies beinhaltet das Fehlen von Kratzspuren durch Katzen, Fieber, einer Prim�rl�sion oder peripherer Lymphadenopathie. Echoarme Herde in Leber, Milz und Lymphknoten sind typische Befunde der Sonografie, im CT oder MRT. Die CSD als m�gliche Diffferenzialdiagnose bei Verdacht auf Tuberkulose oder Malignomen zu ignorieren, kann zu unn�tiger Hospitalisation und Verz�gerungen der ad�quaten Therapie fuhren. SCHLUSSFOLGERUNG: CSD sollte differenzialdiagnostisch bei allen Patienten mit intraabdomineller Lymphadenopathie, abdominellen Schmerzen und unklarem Fieber berucksichtigt werden. Eine Infektion ist auch bei fehlendem Kontakt zu Katzen nicht ausgeschlossen Eine sorgf�ltige Anamnese ist wichtig, deshalb ist die Kenntnis wegweisender klinischer Symptome und die Durchfuhrung gezielter Diagnostik bei atypischen Verl�ufen notwendig. Nach unseren Erfahrungen kann eine fruhzeitige serologische Untersuchung auf BARTONELLA HENSELAE eine invasive Diagnostik vermeiden. � Georg Thieme Verlag KG Stuttgart � New York.

PMID: 19790029 [PubMed - as supplied by publisher]

15. J Dermatol. 2009 Oct;36(10):548-50.

Rapid detection of Bartonella henselae heat shock protein DNA by nested polymerase chain reaction from swollen lymph nodes of a patient with cat-scratch disease.

Umekoji A, Fukai K, Yanagihara S, Ono E, Sowa J, Ishii M.

PMID: 19785710 [PubMed - in process]

16. Vet Ther. 2009 Spring-Summer;10(1-2):9-16.

Comparative in vivo adulticidal activity of a topical dinotefuran versus an imidacloprid-based formulation against cat fleas (Ctenocephalides felis) on cats.

Murphy M, Ball CA, Gross S.

Charles River Laboratories Preclinical Services Ireland, Carrentrila, Ballina, Co. Mayo, Ireland.

Fleas cause significant discomfort to pet cats and distress to their owners and are also vectors of disease severe infestations can cause anemia or flea allergy dermatitis and can lead to infections with Dipylidium caninum and Bartonella henselae. Rapid flea kill is an important feature of flea preventives. The efficacy of dinotefuran (Vectra for Cats and Kittens, Summit VetPharm) was compared with that of imidacloprid (Advantage, Bayer Animal Health) against Ctenocephalides felis when applied topically once on day 0. Cats were infested with 100 (+-3) C. felis on study days -1, 8, 15, 22, and 29. Live fleas were counted on study days 0 (2, 6, and 12 hours after treatment), 9, 16, 23, 29 (2, 6, and 12 hours after infestation), and 30. Cats treated with dinotefuran had significantly (P less than .05) fewer fleas than the control cats at all posttreatment examinations except day 29 at 2 hours after infestation and significantly (P less than .05) fewel fleas than cats treated with imidacloprid on days 0 (2 hours after treatment), 9, 16, 23, 29 (6 and 12 hours after infestation), and 30.

PMID: 19742443 [PubMed - indexed for MEDLINE]

17. Pediatr Infect Dis J. 2009 Sep 4. [Epub ahead of print]

CULTURE NEGATIVE ENDOCARDITIS CAUSED BY BARTONELLA HENSELAE IN A CHILD WITH CONGENITAL HEART DISEASE.

Das BB, Wasser E, Bryant KA, Woods CR, Yang SG, Zahn M.

From the *Division of Cardiology, Department of Pediatrics, University of Louisville School of Medicine, Louisville, KY; daggerUniversity of Louisville School of Medicine, Louisville, KY; double daggerDivision of Infectious Diseases, Department of Pediatrics, University of Louisville School of Medicine, Louisville, KY; and section signLouisville Metro Department of Public Health and Wellness, Louisville, KY.

A 9-year-old white male with congenital aortic and subaortic stenosis palliated by the Ross-Konno procedure presented with culture-negative endocarditis. Serologic studies and polymerase chain reaction testing of resected homograft valvular tissue provided evidence of Bartonella henselae as the etiology. B. henselae can cause endocarditis in children, particularly those with underlying valvular disease. Serologic testing for B. henselae should be considered in children with culture-negative endocarditis.

PMID: 19738506 [PubMed - as supplied by publisher]

18. MMWR Recomm Rep. 2009 Sep 4;58(RR-11):1-166.

Guidelines for the Prevention and Treatment of Opportunistic Infections among HIV-exposed and HIV-infected children: recommendations from CDC, the National Institutes of Health, the HIV Medicine Association of the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the American Academy of Pediatrics.

Mofenson LM, Brady MT, Danner SP, Dominguez KL, Hazra R, Handelsman E, Havens P, Nesheim S, Read JS, Serchuck L, Van Dyke R; Centers for Disease Control and Prevention; National Institutes of Health; HIV Medicine Association of the Infectious Diseases Society of America; Pediatric Infectious Diseases Society; American Academy of Pediatrics.

Collaborators: Brady M, Dominguez KL, Havens P, Handelsman E, Mofenson LM, Nesheim S, Read JS, van Dyke R, Benjamin DK Jr, Bialek SR, Boulware D, Christenson J, Gaur A, Gershon A, Hazra R, Hughes W, Kimberlin D, Ikeda T, Kleiman M, McAuley J, Moscicki AB, Nelson L, Oleske J, Rutstein R, Sanchez PJ, Schuval S, Seward JF, Stauffer W, Ch'ng TW, Yogev R.

National Institutes of Health, Bethesda, Maryland, USA.

This report updates and combines into one document earlier versions of guidelines for preventing and treating opportunistic infections (OIs) among HIV-exposed and HIV-infected children, last published in 2002 and 2004, respectively. These guidelines are intended for use by clinicians and other health-care workers providing medical care for HIV-exposed and HIV-infected children in the United States. The guidelines discuss opportunistic pathogens that occur in the United States and one that might be acquired during international travel (i.e., malaria). Topic areas covered for each OI include a brief description of the epidemiology, clinical presentation, and diagnosis of the OI in children; prevention of exposure; prevention of disease by chemoprophylaxis and/or vaccination; discontinuation of primary prophylaxis after immune reconstitution; treatment of disease; monitoring for adverse effects during treatment; management of treatment failure; prevention of disease recurrence; and discontinuation of secondary prophylaxis after immune reconstitution. A separate document about preventing and treating of OIs among HIV-infected adults and postpubertal adolescents (Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents) was prepared by a working group of adult HIV and infectious disease specialists. The guidelines were developed by a panel of specialists in pediatric HIV infection and infectious diseases (the Pediatric Opportunistic Infections Working Group) from the U.S. government and academic institutions. For each OI, a pediatric specialist with content-matter expertise reviewed the literature for new information since the last guidelines were published; they then proposed revised recommendations at a meeting at the National Institutes of Health (NIH) in June 2007. After these presentations and discussions, the guidelines underwent further revision, with review and approval by the Working Group, and final endorsement by NIH, CDC, the HIV Medicine Association (HIVMA) of the Infectious Diseases Society of America (IDSA), the Pediatric Infectious Disease Society (PIDS), and the American Academy of Pediatrics (AAP). The recommendations are rated by a letter that indicates the strength of the recommendation and a Roman numeral that indicates the quality of the evidence supporting the recommendation so readers can ascertain how best to apply the recommendations in their practice environments. An important mode of acquisition of OIs, as well as HIV infection among children, is from their infected mother; HIV-infected women coinfected with opportunistic pathogens might be more likely than women without HIV infection to transmit these infections to their infants. In addition, HIV-infected women or HIV-infected family members coinfected with certain opportunistic pathogens might be more likely to transmit these infections horizontally to their children, resulting in increased likelihood of primary acquisition of such infections in the young child. Therefore, infections with opportunistic pathogens might affect not just HIV-infected infants but also HIV-exposed but uninfected infants who become infected by the pathogen because of transmission from HIV-infected mothers or family members with coinfections. These guidelines for treating OIs in children therefore consider treatment of infections among all children, both HIV-infected and uninfected, born to HIV-infected women. Additionally, HIV infection is increasingly seen among adolescents with perinatal infection now surviving into their teens and among youth with behaviorally acquired HIV infection. Although guidelines for postpubertal adolescents can be found in the adult OI guidelines, drug pharmacokinetics and response to treatment may differ for younger prepubertal or pubertal adolescents. Therefore, these guidelines also apply to treatment of HIV-infected youth who have not yet completed pubertal development. Major changes in the guidelines include 1) greater emphasis on the importance of antiretroviral therapy for preventing and treating OIs, especially those OIs for which no specific therapy exists; 2) information about the diagnosis and management of immune reconstitution inflammatory syndromes; 3) information about managing antiretroviral therapy in children with OIs, including potential drug--drug interactions; 4) new guidance on diagnosing of HIV infection and presumptively excluding HIV infection in infants that affect the need for initiation of prophylaxis to prevent Pneumocystis jirovecii pneumonia (PCP) in neonates; 5) updated immunization recommendations for HIV-exposed and HIV-infected children, including hepatitis A, human papillomavirus, meningococcal, and rotavirus vaccines; 6) addition of sections on aspergillosis; bartonella; human herpes virus-6, -7, and -8; malaria; and progressive multifocal leukodystrophy (PML); and 7) new recommendations on discontinuation of OI prophylaxis after immune reconstitution in children. The report includes six tables pertinent to preventing and treating OIs in children and two figures describing immunization recommendations for children aged 0--6 years and 7--18 years. Because treatment of OIs is an evolving science, and availability of new agents or clinical data on existing agents might change therapeutic options and preferences, these recommendations will be periodically updated and will be available at http://AIDSInfo.nih.gov.

PMID: 19730409 [PubMed - indexed for MEDLINE]

19. Arch Soc Esp Oftalmol. 2009 Aug;84(8):389-94.

[Neuroretinitis. Clinical cases]

[Article in Spanish]

Valverde-Gubianas M, Ramos-L�pez JF, L�pez-Torres JA, Toribio-Garc�a M, Milla-Pe�alver C, G�lvez Torres-Puchol J, Medialdea-Marcos S.

Servicio de Oftalmolog�a, Hospital Universitario Virgen de las Nieves, Granada, Espa�a. marga_valverde@hotmail.com

OBJECTIVE: Evaluate the etiology and the most frequent funduscopic alterations of the neuroretinitis. METHODS: We present the case of a woman 24 years old with a bilateral decrease of visual sharpness (AV), painless and progressive, the funduscopic examination of which reveals a bilateral optical disc edema, with no hemorrhages or exudates, retina edema of the posterior pole and phlebitic areas. The systematic study was normal except for the hemogram (18,000/mm(3) leucocytes with 79% neutrophils) and the positive serology next to a Chlamydia. We also present the case of a 64 years old woman with a decrease of AV at the right eye of one week duration. At the back of the eye a macular star can be seen, and papilla edema. A systematic study gave normal results and positive serology at Bartonella henselae. RESULTS: The illness produced by a cat scratch is the most common cause of neuroretinitis. The customary findings are a loss of AV, discromatopsia, afferent papillary defects and abnormality on the visual field. Other frequent findings at the back of the eye are hemorrhagic nerve fibers, cotton-like exudates, papilla edema, macular star and glassy inflammation. The roll of antibiotic therapy is questionable. Oral ciprofloxacine seems to give good results.

PMID: 19728239 [PubMed - in process]

20. Ultrastruct Pathol. 2009 Jul-Aug;33(4):151-4.

Bartonellosis as cause of death after red blood cell unit transfusion.

Magalh�es RF, Urso Pitassi LH, Lania BG, Barjas-Castro ML, Neves Ferreira Velho PE.

Dermatology Division, Department of Internal Medicine, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil. renatafmagalhaes@uol.com.br

The authors present the case of a young man with aplastic anemia who went into shock and died after several red blood cell unit transfusions. Immunohematological studies did not show any abnormality and blood cultures from patients and blood bags were negative. The ultrastructural findings, allied with current scientific knowledge, permitted the diagnosis of Bartonella sp. infection. In face of this diagnosis, two possibilities should be considered: the first one is that the patient was already infected by the bacteria before the last RBC unit transfusion. The pathogen could be involved in aplastic anemia etiology and in the failure to recover hemoglobin levels, in spite of the transfusions. The second possibility is that the RBC unit was contaminated with a Bartonella sp., which would have led to a state of shock, causing the death of the patient.

PMID: 19728230 [PubMed - in process]

21. Microb Ecol. 2009 Sep 2. [Epub ahead of print]

Evolutional and Geographical Relationships of Bartonella grahamii Isolates from Wild Rodents by Multi-locus Sequencing Analysis.

Inoue K, Kabeya H, Kosoy MY, Bai Y, Smirnov G, McColl D, Artsob H, Maruyama S.

Laboratory of Veterinary Public Health, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, 1866 Kameino, Fujisawa, Kanagawa, 252-8510, Japan.

PMID: 19727928 [PubMed - as supplied by publisher]

22. Vet Microbiol. 2009 Aug 8. [Epub ahead of print]

Molecular detection of Bartonella henselae and Bartonella koehlerae from aortic valves of Boxer dogs with infective endocarditis.

Ohad DG, Morick D, Avidor B, Harrus S.

Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Israel.

Cardiac aortic valves from five dogs that died from acquired infective endocarditis were retrospectively molecularly screened for Bartonella infection. Identification was carried out using PCR targeting four gene fragments (rpoB, ribC, 16S rRNA and gltA), and the 16S-23S intergenic spacer (ITS). Bartonella henselae DNA was detected in aortic valve tissue from one Boxer dog with moderate subaortic stenosis (SAS). Bartonella koehlerae DNA was detected from the aortic valve of another Boxer dog with severe SAS. The latter dog was both a littermate and a housemate of the dog with the B. henselae infection. Other animals residing at the same household were also screened for Bartonella infection. B. henselae was molecularly detected in a spleen aspirate from the dogs' mother, and isolated and molecularly characterized from another housemate cat. This is the first molecular identification of B. henselae and B. koehlerae, two zoonotic Bartonella species, from valves of dogs with canine infective endocarditis, suggesting their role in the pathogenesis of this disease. Moreover, this is the first report describing the detection of B. koehlerae from dogs.

PMID: 19716241 [PubMed - as supplied by publisher]

23. J Vet Intern Med. 2009 Aug 26. [Epub ahead of print]

Recurrent Osteomyelitis in a Cat due to Infection with Bartonella vinsonii subsp. berkhoffii Genotype II.

Varanat M, Travis A, Lee W, Maggi RG, Bissett SA, Linder KE, Breitschwerdt EB.

Intracellular Pathogens Research Laboratory, Center for Comparative Medicine and Translational Research, College of Veterinary Medicine, North Carolina State University (NCSU), Raleigh, NC.

PMID: 19709358 [PubMed - as supplied by publisher]

24. Genome Dyn. 2009;6:158-169. Epub 2009 Aug 19.

Genomics of Host-Restricted Pathogens of the Genus Bartonella.

Engel P, Dehio C.

Biozentrum, University of Basel, Basel, Switzerland.

The alpha-proteobacterial genus Bartonella comprises numerous arthropod-borne pathogens that share a common host-restricted life-style, which is characterized by long-lasting intraerythrocytic infections in their specific mammalian reservoirs and transmission by blood-sucking arthropods. Infection of an incidental host (e.g. humans by a zoonotic species) may cause disease in the absence of intra-erythrocytic infection. The genome sequences of four Bartonella species are known, i.e. those of the human-specific pathogens Bartonella bacilliformis and Bartonella quintana, the feline-specific Bartonella henselae also causing incidental human infections, and the rat-specific species Bartonella tribocorum. The circular chromosomes of these bartonellae range in size from 1.44 Mb (encoding1,283 genes) to 2.62 Mb (encoding 2,136 genes). They share a mostly synthenic core genome of 959 genes that features characteristics of a host-integrated metabolism. The diverse accessory genomes highlight dynamic genome evolution at the species level, ranging from significant genome expansion in B. tribocorum due to gene duplication and lateral acquisition of prophages and genomic islands (such as type IV secretion systems that adopted prominent roles in host adaptation and specificity) to massive secondary genome reduction in B. quintana. Moreover, analysis of natural populations of B. henselae revealed genomic rearrangements, deletions and amplifications, evidencing marked genome dynamics at the strain level. Copyright � 2009 S. Karger AG, Basel.

PMID: 19696500 [PubMed - as supplied by publisher]

25. Eur J Clin Microbiol Infect Dis. 2009 Nov;28(11):1363-8. Epub 2009 Aug 14.

Real-time PCR strategy and detection of bacterial agents of lymphadenitis.

Angelakis E, Roux V, Raoult D, Rolain JM.

URMITE CNRS-IRD UMR 6236, Faculte de Medecine et de Pharmacie, Universite de la Mediterranee, 27 Bd Jean Moulin, 13385, Marseille Cedex 05, France.

The aim of this study was to compare 16 S rRNA gene amplification and sequencing with a systematic real-time PCR assay screening strategy that includes all common known pathogens recovered from lymph node biopsy specimens. Lymph node biopsy samples sent to our laboratory from January 2007 to December 2008 were tested in the study. Lymph nodes were screened for the presence of any bacteria by PCR amplification and sequencing targeting the 16 S rRNA gene and also by a specific real-time PCR strategy that includes Bartonella henselae, mycobacteria, Francisella tularensis, and Tropheryma whipplei. By testing 491 lymph nodes, we found that the sensitivity of our specific real-time PCR assay strategy was significantly higher than 16 S rRNA PCR amplification and sequencing for the detection of Bartonella henselae (142 vs 98; p < 10(-4)), Francisella tularensis (16 vs 10, p < 10(-4)), and mycobacteria (8 versus 3, p < 10(-4)). None of the samples was positive for Tropheryma whipplei. Our study demonstrates the usefulness and specificity of a systematic real-time PCR strategy for molecular analysis of lymph node biopsy specimens and the higher sensitivity compared with standard 16 S rRNA gene amplification and sequencing.

PMID: 19685089 [PubMed - in process]

26. Otolaryngol Pol. 2009 Mar-Apr;63(2):154-7.

[Cat scratch disease--a diagnostic problem, case report]

[Article in Polish]

Dabrowska-Bien J, Pietniczka-Za�eska M, Rowicki T.

Oddzia� Otolaryngologii Miedzyleskiego Szpitala Specjalistycznego w Warszawie. justinebien@gmail.com

AIM OF THE STUDY: Cat scratch disease as a possible cause of neck limphadenopathy. MATERIAL AND METHODS: We present a case of 40-years old men operated in our department on regional unilateral lymphadenopathy. The diagnosis of cat scratch disease was confirmed by the histopathologic examination. CONCLUSIONS: Regional lymphadenopathy with history of contact with cats or other animals suggests the diagnosis of cat scratch disease. If we considered this disease in differential diagnosis it would mean less traumatic treatment for the patient. Cat scratch disease is diagnosed in Poland very rarely; we need to spread the knowledge about this infectious disease.

PMID: 19681487 [PubMed - indexed for MEDLINE]

27. Med Hypotheses. 2009 Aug 7. [Epub ahead of print]

The pathophysiology of the acute phase of human bartonellosis resembles AIDS.

Ticona E, Huaroto L, Garcia Y, Vargas L, Madariaga MG.

Servicio de Enfermedades Infecciosas, Hospital Nacional Dos de Mayo, Parque Historia de la Medicina Peruana s/n, Lima 01, Peru; Facultad de Medicina Humana, Universidad Nacional Mayor de San Marcos, Lima, Peru; Facultad de Medicina Humana, Universidad de San Martin de Porres, Lima, Peru.

Human bartonellosis is a South American anthroponosis caused by Bartonella bacilliformis. The disease has an acute phase characterized by invasion of red blood cells by parasites, and consequent severe anemia; and a chronic phase presenting with benign vascular tumors. During the acute phase, affected individuals are prone to developing opportunistic infections with a variety of organisms similar to the ones seen in AIDS. After antibiotic treatment is instituted, a subgroup of patients may develop atypical symptoms which potentially represent clinical manifestations of the restoration of macrophage function. We speculate that the pathophysiology of the acute phase of human bartonellosis resembles AIDS, with a period of immunosuppression following the infection and later, clinical manifestations of immune reconstitution subsequent to treatment.

PMID: 19665314 [PubMed - as supplied by publisher]

28. Future Microbiol. 2009 Aug;4:743-58.

Pestilence, persistence and pathogenicity: infection strategies of Bartonella.

Minnick MF, Battisti JM.

The University of Montana, Division of Biological Sciences, Missoula, MT 59812, USA. mike.minnick@mso.umt.edu

It has been nearly two decades since the discovery of Bartonella as an agent of bacillary angiomatosis in AIDS patients and persistent bacteremia and 'nonculturable' endocarditis in homeless people. Since that time, the number of Bartonella species identified has increased from one to 24, and 10 of these bacteria are associated with human disease. Although Bartonella is the only genus that infects human erythrocytes and triggers pathological angiogenesis in the vascular bed, the group remains understudied compared with most other bacterial pathogens. Numerous questions regarding Bartonella's molecular pathogenesis and epidemiology remain unanswered. Virtually every mammal harbors one or more Bartonella species and their transmission typically involves a hematophagous arthropod vector. However, many details regarding epidemiology and the public health threat imposed by these animal reservoirs is unclear. A handful of studies have shown that bartonellae are highly-adapted pathogens whose parasitic strategy has evolved to cause persistent infections of the host. To this end, virulence attributes of Bartonella include the subversion of host cells with effector molecules delivered via a type IV secretion system, induction of pathological angiogenesis through various means, including inhibition of apoptosis and activation of hypoxia-inducing factor 1, use of afimbrial adhesins that are orthologs of Yersinia adhesin A, incorporation of lipopolysaccharides with low endotoxic potency in the outer membrane, and several other virulence factors that help Bartonella infect and persist in erythrocytes and endothelial cells of the host circulatory system.

PMCID: 2754412 PMID: 19659429 [PubMed - indexed for MEDLINE]

29. Pediatr Hematol Oncol. 2009 Sep;26(6):454-60.

Cervical lymphadenopathy in childhood epidemiology and management.

Papadopouli E, Michailidi E, Papadopoulou E, Paspalaki P, Vlahakis I, Kalmanti M.

Department of Pediatrics, University Hospital of Heraklion, Heraklion, Greece. evap@galinos.med.uoc.gr

Cervical lymphadenopathy (CL) is common in childhood. The aim of this study is to evaluate the etiology, follow-up, and treatment of persistent CL. The authors studied retrospectively 50 children with CL, hospitalized at the Department of Pediatrics and Pediatrics Surgery. Patients underwent ultrasonography. Thirty-six percent presented abnormal ultrasonographic image and underwent excisional biopsy. Biopsies revealed 4 thyroglossal cysts, 3 branchial cysts, 1 hemangioma, 2 sebaceous cysts, 1 dermoid cyst, 5 occurrences of tuberculosis lymphadenitis, 1 occurrence of Bartonella henselae lymphadenopathy, and 1 case of non-Hodgkin lymphoma. In conclusion, CL is usually a benign finding; bacterial and viral infections are the most common causes. Ultrasonography help in etiology and follow-up of CL.

PMID: 19657996 [PubMed - indexed for MEDLINE]

30. Int J Syst Evol Microbiol. 2009 Aug 5. [Epub ahead of print]

Bartonella japonica sp. nov. and Bartonella silvatica sp. nov., isolated from Apodemus mice in Japan.

Inoue K, Kabeya H, Shiratori H, Ueda K, Kosoy MY, Chomel BB, Boulouis HJ, Maruyama S.

Laboratory of Veterinary Public Health, Department of Veterinary Medicine, Nihon University;

Two bacterial strains, Fuji 18-1T and Fuji 23-1T, were isolated from the blood of the small Japanese field mouse (Apodemus argenteus) and the large Japanese field mouse (A. speciosus), respectively, captured in the forest of Mt. Fuji, Japan. Phenotypic characterization (growth condition, incubation period, biochemical properties, and cell morphology), DNA G+C content (40.1% for Fuji 18-1T and 40.4% for Fuji 23-1T), and sequence analysis of 16S rRNA gene indicated that both strains were members of the genus Bartonella. Using rpoB and gltA sequencing analysis, the highest sequence similarities between Fuji 18-1T, Fuji 23-1T and other known Bartonella species showed values considerably lower than 91.4% and 89.9% in rpoB, 89.1%, and 90.4% in gltA, respectively. It is known that the similarities 95.4% in rpoB and 96.0% in gltA can be applied for cut-off values for designating a new Bartonella species. In the phylogenetic tree based on the merged set of concatenated sequence of 7 loci of 16S rRNA, ftsZ, gltA, groEL, ribC, rpoB, and ITS, Fuji 18-1T and Fuji 23-1T formed a distinct clade from other known Bartonella species, respectively. These data support classification of strains Fuji 18-1T and Fuji 23-1T as novel species of the genus Bartonella. The names Bartonella japonica sp. nov. and Bartonella silvatica sp. nov. are proposed for these new species of the genus Bartonella. The type strains of B. japonica and B. silvatica are Fuji 18-1T (= JCM 15567T = CIP 109861T) and Fuji 23-1T (= JCM 15566T = CIP 109862T), respectively.

PMID: 19656930 [PubMed - as supplied by publisher]

31. Acta Radiol. 2009 Jul 27:1-4. [Epub ahead of print]

Diffusion-Weighted Magnetic Resonance Imaging in Cervical Lymphadenopathy: Report of Three Cases of Patients with Bartonella henselae Infection Mimicking Malignant Disease.

Muenzel D, Duetsch S, Fauser C, Slotta-Huspenina J, Gaa J, Rummeny EJ, Holzapfel K.

Department of Radiology.

Diffusion-weighted MR imaging is a potential technique for differentiation between benign and malignant lymph nodes. However, lympadenopathy caused by Bartonella henselae infection shows low ADC values in diffusion weighted MRI as typically seen in malignant disease.

PMID: 19636985 [PubMed - as supplied by publisher]

32. Int J Syst Evol Microbiol. 2009 Jul 23. [Epub ahead of print]

Bartonella rattaustraliani sp. nov., Bartonella queenslandensis sp. nov. and Bartonella coopersplainsensis sp. nov., from Australian rats.

Gundi VA, Taylor C, Raoult D, La Scola B.

Faculte de Medecine de Marseille, Universite de la Mediterranee;

A total of 11 Bartonella isolates were recovered from the blood of Melomys, Uromys and Rattus species in Australia and were characterised using phenotypic and genotypic methods. Comparison of 16S rDNA, ftsZ, gltA and 16S-23S intergenic spacer region fragments from the isolates indicated they formed three sequence similarity groups that were distinct from one another and from the currently recognised Bartonella species. Phylogenetic analysis based on alignment of concatenated sequences inferred distinct evolutionary lineages for each of the three groups within the Bartonella genus. On the basis of these data, we propose the isolates be accommodated in three novel Bartonella species, namely Bartonella rattaustraliani sp. nov. (type strain AUST/NH4T =CIP 109051T =CCUG 52161T =CSUR B609T), Bartonella queenslandensis sp. nov. (type strain AUST/NH12T =CIP 109057T =CCUG 52167T =CSUR B617T) and Bartonella coopersplainsensis sp. nov. (type strain AUST/NH20T =CIP 109064T =CCUG 52174T =CSUR B619T).

PMID: 19628592 [PubMed - as supplied by publisher]

33. Int J STD AIDS. 2009 Aug;20(8):585-6.

Cat scratch disease: a diagnostic conundrum.

Scott C, Azwa A, Cohen C, McIntyre M, Desmond N.

Department of Sexual Health & HIV Medicine, St Stephens Centre, Chelsea & Westminster Hospital, 369 Fulham Road, London, UK. christopher.scott@chelwest.nhs.uk

We report the case of a patient who presented to a clinic for evaluation of inguinal lymphadenopathy. Histology of the lymph nodes revealed micoabscess formation suggesting infection with Lymphogranuloma venereum (LGV) or Bartonella henselae--the causative agent in cat scratch disease (CSD). The patient recalled no preceding animal exposure. Clinical and serological findings initially suggested early LGV but convalescent serology supported CSD. This serves as an important reminder that B. henselae infection should be considered a cause of regional lymphadenopathy in individuals suspected of having LGV.

PMID: 19625597 [PubMed - indexed for MEDLINE]

34. Emerg Infect Dis. 2009 Jul;15(7):1150-2.

Bartonella rochalimae and other Bartonella spp. in fleas, Chile.

Perez-Mart�nez L, Venzal JM, Gonz�lez-Acu�a D, Portillo A, Blanco JR, Oteo JA.

PMCID: 2744255 PMID: 19624952 [PubMed - indexed for MEDLINE]

35. Wei Sheng Wu Xue Bao. 2009 Apr 4;49(4):429-37.

[Biological and molecular characteristics of a cat-borne Bartonella clarridgeiae]

[Article in Chinese]

Li D, Liu Q, Song X, Zhang J, Xu C, Yang X.

National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China. lidongmei@icdc.cn

OBJECTIVE: To characterize a Bartonella strain M9HN-SHQ from a blood culture of cat from Henan Province,China. METHODS: The organisms were subcultured in 5% CO2 at 37 degrees C on trypticase soy agar containing 5% sheep blood for 6 to 7 days. We analyzed the isolate using whole-cell fatty acid analysis,Etest for susceptibility testing, random amplified polymorphic DNA (RAPD), pulsed-field gel electrophoresis(PFGE) and sequence analysis of 16S rRNA, gltA, groEL, ftsZ, rpoB, ribC and 16S-23S rRNA intergenic spacer region. RESULTS: Isolate M9HN-SHQ stained faintly as a gram-negative rod but was easier to visualize when stained by the Gimenez technique. Most of the biochemical and cellular fatty acid properties of strain M9HN-SHQ were typical for bacteria of the Bartonella genus. The strain was susceptible to Cefotaxime sodium, Rifampin, Ciprofloxacin and other four antibiotics. Genotypic characterization of strain M9HN-SHQ, including RAPD, PFGE was distinguishable from the reference strains of B. henselae, B. elizabethae, B. vinsonii subsp. berkhoffii and B. grahamii. Sequence analysis of the genes from the seven chromosomal regions identified the strain M9HN-SHQ as B. clarridgeiae. CONCLUSION: To our knowledge,this is the first report that documents Bartonella clarridgeiae infections of domestic cats in China.

PMID: 19621628 [PubMed - indexed for MEDLINE]

36. Med Mal Infect. 2009 Jul 16. [Epub ahead of print]

[Hepatic localization of cat scratch disease in an immunocompetent patient.]

[Article in French]

Renou F, Raffray L, Gerber A, Moiton MP, Ferrandiz D, Yvin JL.

Service de medecine interne, maladies infectieuses et dermatologie, centre hospitalier departemental Felix-Guyon, allee des Topazes, 97400 Saint-Denis, France.

INTRODUCTION: The cat-scratch disease is a benign inoculation disease and a well-known cause of localized lymphadenopathy. Visceral localizations are rare and occur mostly in immunocompetent patients. CASE: We report the case of a 57-year-old-man with lymphadenopathy of the right arm with hepatic nodules related to a Bartonella henselae infection. CONCLUSION: The cat-scratch disease must be screened for in case of hepatic and/or splenic nodules. A cause of immunodeficiency should be investigated.

PMID: 19616394 [PubMed - as supplied by publisher]

37. Oral Maxillofac Surg Clin North Am. 2009 Aug;21(3):269-74.

The bacteriology of salivary gland infections.

Brook I.

Georgetown University School of Medicine, 4431 Albemarle Street NW, Washington, DC 20016, USA. ib6@georgetown.edu

The parotid gland is the salivary gland most commonly affected by inflammation. However, infection of the salivary glands can occur in any of the glands. The most common pathogens associated with acute bacterial infection are Staphylococcus aureus and anaerobic bacteria. The predominant anaerobes include: anaerobic Gram negative bacilli (eg, pigmented Prevotella and Porphyromonas); Fusobacterium spp; and Peptostreptococcus spp. In addition, Streptococcus spp (including Streptococcus pneumoniae) and aerobic and facultative Gram-negative bacilli (including Escherichia coli) have been reported. Aerobic and facultative Gram-negative bacilli are often seen in hospitalized patients. Organisms less frequently found are Haemophilus influenzae, Treponema pallidum, Bartonella henselae, and Eikenella corrodens. Mycobacterium tuberculosis and atypical mycobacteria are rare causes of infection. The choice of antibiotics should be guided by identification of the etiologic agent.

PMID: 19608044 [PubMed - indexed for MEDLINE]

38. Cardiology. 2009;114(3):208-11. Epub 2009 Jul 15.

Infective endocarditis by bartonellaquintana masquerading as antineutrophil cytoplasmic antibody-associated small vessel vasculitis.

Sugiyama H, Sahara M, Imai Y, Ono M, Okamoto K, Kikuchi K, Nagai R.

Department of Cardiovascular Medicine, University of Tokyo Hospital, Tokyo, Japan. hsugiyama-tky@umin.ac.jp

The Bartonella species have been recently recognized as important causative agents of culture-negative bacterial endocarditis. Antineutrophil cytoplasmic antibodies (ANCAs) have been associated with the spectrum of idiopathic small vessel vasculitis. However, a variety of infections can result in a false-positive ANCA test, and especially subacute bacterial endocarditis (SBE) with the presence of ANCAs occasionally mimics the clinical manifestations of an ANCA-associated vasculitis such as skin purpura and glomerulonephritis. In contrast, noninfectious endocardial involvement is known to be part of the spectrum of the manifestations of the ANCA-associated vasculitis. Therefore, it is crucial to distinguish an ANCA-positive SBE from an ANCA-associated vasculitis with endocardial compromise, because the misdiagnosis of an SBE as an ANCA-associated vasculitis can lead to an inappropriate immunosuppressive therapy with catastrophic consequences. The differential diagnosis is sometimes difficult, especially in the case of culture-negative infective endocarditis with a positive ANCA test. We describe here a case of a culture-negative SBE caused by Bartonellaquintana, accompanied with a positive cytoplasmic ANCA test and clinical findings masquerading as ANCA-associated vasculitis. Both a serological test for Bartonella and polymerase chain reaction restriction fragment length polymorphism analysis were helpful for a correct diagnosis and appropriate treatment. Copyright 2009 S. Karger AG, Basel.

PMID: 19602882 [PubMed - in process]

39. Vet Microbiol. 2009 Nov 18;139(3-4):293-7. Epub 2009 Jun 21.

Detection of Bartonella spp. in wild rodents in Israel using HRM real-time PCR.

Morick D, Baneth G, Avidor B, Kosoy MY, Mumcuoglu KY, Mintz D, Eyal O, Goethe R, Mietze A, Shpigel N, Harrus S.

Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot 76100, Israel.

The prevalence of Bartonella spp. in wild rodents was studied in 19 geographical locations in Israel. One hundred and twelve rodents belonging to five species (Mus musculus, Rattus rattus, Microtus socialis, Acomys cahirinus and Apodemus sylvaticus) were included in the survey. In addition, 156 ectoparasites were collected from the rodents. Spleen sample from each rodent and the ectoparasites were examined for the presence of Bartonella DNA using high resolution melt (HRM) real-time PCR. The method was designed for the simultaneous detection and differentiation of eight Bartonella spp. according to the nucleotide variation in each of two gene fragments (rpoB and gltA) and the 16S-23S intergenic spacer (ITS) locus, using the same PCR protocol which allowed the simultaneous amplification of the three different loci. Bartonella DNA was detected in spleen samples of 19 out of 79 (24%) black rats (R. rattus) and in 1 of 4 (25%) Cairo spiny mice (A. cahirinus). In addition, 15 of 34 (44%) flea pools harbored Bartonella DNA. Only rat flea (Xenopsyla cheopis) pools collected from black rats (R. rattus) were positive for Bartonella DNA. The Bartonella sp. detected in spleen samples from black rats (R. rattus) was closely related to both B. tribocorum and B. elizabethae. The species detected in the Cairo spiny mouse (A. cahirinus) spleen sample was closely related to the zoonotic pathogen, B. elizabethae. These results indicate that Bartonella species are highly prevalent in suburban rodent populations and their ectoparasites in Israel. Further investigation of the prevalence and zoonotic potential of the Bartonella species detected in the black rats and the Cairo spiny mouse is warranted.

PMID: 19595521 [PubMed - in process]

40. PLoS Genet. 2009 Jul;5(7):e1000546. Epub 2009 Jul 3.

Run-off replication of host-adaptability genes is associated with gene transfer agents in the genome of mouse-infecting Bartonella grahamii.

Berglund EC, Frank AC, Calteau A, Vinnere Pettersson O, Granberg F, Eriksson AS, N�slund K, Holmberg M, Lindroos H, Andersson SG.

Department of Molecular Evolution, Evolutionary Biology Centre, Uppsala University, Uppsala, Sweden.

The genus Bartonella comprises facultative intracellular bacteria adapted to mammals, including previously recognized and emerging human pathogens. We report the 2,341,328 bp genome sequence of Bartonella grahamii, one of the most prevalent Bartonella species in wild rodents. Comparative genomics revealed that rodent-associated Bartonella species have higher copy numbers of genes for putative host-adaptability factors than the related human-specific pathogens. Many of these gene clusters are located in a highly dynamic region of 461 kb. Using hybridization to a microarray designed for the B. grahamii genome, we observed a massive, putatively phage-derived run-off replication of this region. We also identified a novel gene transfer agent, which packages the bacterial genome, with an over-representation of the amplified DNA, in 14 kb pieces. This is the first observation associating the products of run-off replication with a gene transfer agent. Because of the high concentration of gene clusters for host-adaptation proteins in the amplified region, and since the genes encoding the gene transfer agent and the phage origin are well conserved in Bartonella, we hypothesize that these systems are driven by selection. We propose that the coupling of run-off replication with gene transfer agents promotes diversification and rapid spread of host-adaptability factors, facilitating host shifts in Bartonella.

PMCID: 2697382 PMID: 19578403 [PubMed - indexed for MEDLINE]

41. Vet Microbiol. 2009 Oct 20;139(1-2):197-201. Epub 2009 Jun 6.

"Candidatus Bartonella thailandensis": a new genotype of Bartonella identified from rodents.

Saisongkorh W, Wootta W, Sawanpanyalert P, Raoult D, Rolain JM.

Universite de la Mediterranee, Unite des Rickettsies, URMITE CNRS-IRD, UMR 6236, Faculte de Medecine et de Pharmacie, Marseille 13385, France.

Bartonella species, intracellular parasite of erythrocytes and endothelial cells, are zoonotic pathogens of wild and domestic animals including rodents. Many species of rodents are commensally infected with a few Bartonella species in Asia. However, there are only few reports on detection of Bartonella in Thailand. Our objective was to detect the presence of Bartonella species in rodents from Thailand. Among 247 rodents captured in five provinces from Thailand we identified Bartonella species using molecular methods targeting three genes i.e. citrate synthase (gltA), beta-subunit of the RNA polymerase (rpoB) and cell division protein gene (ftsZ) and the 16S-23S rRNA intergenic spacer (ITS). Overall, we found 21 rodents being infected with a Bartonella species including seven B. coopersplainsensis, four B. phoceensis, six B. queenslandensis, one B. rochalimae, one Bartonella sp. RN24BJ and two genotypes of a new Bartonella that we propose to give the provisional status "Candidatus Bartonella thailandensis". To the best of our knowledge, these Bartonella species have been detected for the first time in Thailand.

PMID: 19574002 [PubMed - in process]

42. Tidsskr Nor Laegeforen. 2009 Jun 25;129(13):1326-8.

[Risk of infections among orienteers]

[Article in Norwegian]

Hagen K.

Nasjonalt kompetansesenter for hodepine, Avdeling for nevrologi og klinisk nevrofysiologi, St. Olavs hospital, 7006 Trondheim. knut.hagen@ntnu.no

BACKGROUND: Research on orienteers is useful for assessing the risk of infections associated with physical activity in the forest. In this paper four types of infections are reviewed, and the efficacy of preventive initiatives is discussed. MATERIAL AND METHODS: The paper is based on literature retrieved from a non-systemic search in PubMed. RESULTS: Hepatitis B infection was more prevalent among orienteers before they were obliged to use protective clothing. In the 1980s, there was an increase of sudden unexpected death among young Swedish orienteers. Bartonella infection was later suggested as an underlying cause. No unexpected deaths have occurred among young orienteers after 1992 when specific advice was given regarding training and competitions. Orienteers do not seem to be affected by lyme borreliosis or tick-borne encephalitis (TBE) more often than others, but only two old studies have been performed. INTERPRETATION: Orienteers may be at risk of acquiring infection from lyme borreliosis and TBE in Norway in the future, as the incidence of these contagions is increasing. Norwegian medical personnel should consider TBE vaccination of orienteers and others who wander in areas with a high prevalence of infected ticks.

PMID: 19561657 [PubMed - indexed for MEDLINE]

43. J Heart Lung Transplant. 2009 Jul;28(7):736-9.

Disseminated infection with Bartonella henselae in a lung transplant recipient.

Lienhardt B, Irani S, Gaspert A, Weishaupt D, Boehler A.

Clinic of Pulmonary Medicine, University Hospital, Zurich, Switzerland.

We present the case of a lung transplant recipient with disseminated infection with Bartonella henselae. In non-immunosuppressed humans, the organism typically causes a local infection that manifests itself as regional lymphadenopathy. The role of the host immune response to B henselae is critical in preventing progression to systemic disease. Only rare cases of bartonellosis in transplant recipients have been reported. We discuss aspects and difficulties of diagnosis and treatment of bartonellosis in a lung transplant recipient who suffered from a severe multisystem involvement of this disease. In our case, the initial response to therapy was unsatisfying and necessitated an extended anti-infective combination therapy, which eventually was successful.

PMID: 19560704 [PubMed - indexed for MEDLINE]

44. J Feline Med Surg. 2009 Aug;11(8):663-7. Epub 2009 Jun 26.

Serum feline pancreatic lipase immunoreactivity concentration and seroprevalences of antibodies against Toxoplasma gondii and Bartonella species in client-owned cats.

Bayliss DB, Steiner JM, Sucholdolski JS, Radecki SV, Brewer MM, Morris AK, Lappin MR.

Department of Clinical Sciences, Colorado State University, Fort Collins, CO, United States. dbayliss@medvetmemphis.com

Feline pancreatitis is a commonly suspected illness and it has been proposed that some cases of feline pancreatitis may be caused by infection with Toxoplasma gondii or Bartonella species. Feline pancreatic lipase immunoreactivity (fPLI) is a test performed on serum that is commonly combined with other clinical findings as an indirect aid in the diagnosis of pancreatitis. The purpose of this study was to determine if there are associations between fPLI concentration and the presence of serum antibodies against T gondii or Bartonella species. Serum samples from 458 cats, for which serum fPLI concentrations had already been determined, were assayed by enzyme-linked immunosorbent assay for the presence of T gondii immunoglobulin (Ig) G (IgG) and IgM antibodies, and Bartonella species IgG antibodies. The association between fPLI concentration and T gondii or Bartonella species antibodies was determined. No statistically significant association was found between fPLI concentration and T gondii or Bartonella species antibodies, suggesting that serological tests for the organisms are not useful in cases with increased fPLI concentration.

PMID: 19560385 [PubMed - in process]

45. Vet Microbiol. 2009 Sep 18;138(3-4):368-72. Epub 2009 Feb 4.

Co-isolation of Bartonella henselae and Bartonella vinsonii subsp. berkhoffii from blood, joint and subcutaneous seroma fluids from two naturally infected dogs.

Diniz PP, Wood M, Maggi RG, Sontakke S, Stepnik M, Breitschwerdt EB.

Center for Comparative Medicine and Translational Research, North Carolina State University, Raleigh, 27606, USA.

This report describes the clinical presentation, isolation and treatment of two dogs naturally infected with Bartonella henselae and Bartonella vinsonii subsp. berkhoffii. Chronic and progressive polyarthritis was the primary complaint for dog #1, from which B. henselae and B. vinsonii subsp. berkhoffii were cultured on three independent occasions from blood and joint fluid samples, despite administration of nearly 4 months of non-consecutive antibiotic therapy. A clinically atypical and progressively severe trauma-associated seroma was the primary complaint for dog #2, from which B. henselae and B. vinsonii subsp. berkhoffii were isolated from serum, blood and seroma fluid. Dogs can be co-infected with two Bartonella spp. and infection with these organisms should not be ruled out if specific antibodies are not detected. Specialized culture techniques should be used for isolation and to assess antibiotic efficacy.

PMID: 19560291 [PubMed - in process]

46. Clin Imaging. 2009 Jul-Aug;33(4):318-21.

Computed tomography and magnetic resonance imaging of cat-scratch disease: a report of two cases.

Wang CW, Chang WC, Chao TK, Liu CC, Huang GS.

Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.

Cat-scratch disease (CSD) is a bacterial infection that typically causes swelling of the lymph nodes. The patients usually have a history of being scratched, bitten, or licked by cats and often by kittens. Understanding the characteristic radiological and clinical features may lead to a noninvasive diagnosis and prevent unnecessary invasive procedures. We report two cases of CSD with computed tomography and magnetic resonance imaging showing nodules or masses of lymphadenopathy with subcutaneous edema and fat infiltration in the lymphatic drainage area. The imaging features and clinical manifestations are described, and the differential diagnosis of CSD is discussed.

PMID: 19559357 [PubMed - indexed for MEDLINE]

47. Am J Trop Med Hyg. 2009 Jul;81(1):67-74.

Tick-borne zoonotic bacteria in ticks collected from central Spain.

Toledo A, Olmeda AS, Escudero R, Jado I, Valc�rcel F, Casado-Nistal MA, Rodr�guez-Vargas M, Gil H, Anda P.

Laboratorio de Espiroquetas y Pat�genos Especiales, Servicio de Bacteriolog�a, Centro Nacional de Microbiolog�a, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.

The prevalence of tick-borne and related bacteria infecting adult ticks in central Spain was assessed by molecular methods. Six areas were sampled monthly during a 2-year longitudinal study. A total of 1,038 questing and 442 feeding ticks, belonging to eight different species, were tested. The most abundant species were Hyalomma lusitanicum (54% of captures), followed by Dermacentor marginatus (23%) and Rhipicephalus sanguineus (10%). Four human pathogens, including seven Rickettsia species, Anaplasma phagocytophilum, Borrelia burgdorferi, and Francisella tularensis, were detected at percentages of 19.0, 2.2, 1.7, and 0.5, respectively, whereas Bartonella spp. was never detected. In terms of infection and tick abundance, H. lusitanicum seems to be the most significant tick species in the area, carrying three of the five agents tested, and the anthropophilic tick, D. marginatum, infected with Rickettsia spp. and F. tularensis, is the most relevant in terms of public health. The significance of these data is discussed.

PMID: 19556569 [PubMed - indexed for MEDLINE]

48. Am J Trop Med Hyg. 2009 Jul;81(1):55-8.

Isolation and genetic characterization of a Bartonella strain closely related to Bartonella tribocorum and Bartonella elizabethae in Israeli commensal rats.

Harrus S, Bar-Gal GK, Golan A, Elazari-Volcani R, Kosoy MY, Morick D, Avidor B, Baneth G.

Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel. harrus@agri.huji.ac.il

Ten Bartonella isolates were cultured from blood drawn from black rats (Rattus rattus) captured in the Tel Aviv area. Genetic characterization included amplification and sequencing of five gene fragments including the ribC, rpoB, 16S, groEL, and gltA and the 16S-23S intergenic spacer region. Sequence comparisons showed that all 10 isolates were identical in all genes studied comprising a total of 3,873 bp analyzed. The sequences of each of the partial genes analyzed indicated a high sequence similarity (97-99.8%) to B. tribocorum or B. elizabethae. The gltA sequence was 100% homologous to a genotype identified in R. rattus in Dhaka, Bangladesh, suggesting the existence of a widespread Asian Bartonella strain infecting the black rats (R. rattus). The detection of a Bartonella genotype closely related to B. elizabethae in the biggest metropolitan center in Israel warrants further study of its zoonotic potential and pathogenic characteristics.

PMID: 19556567 [PubMed - indexed for MEDLINE]

49. J Clin Microbiol. 2009 Aug;47(8):2647-50. Epub 2009 Jun 24.

Duplex PCR assay simultaneously detecting and differentiating Bartonella quintana, B. henselae, and Coxiella burnetii in surgical heart valve specimens.

Tang YW.

Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee, USA. yiwei.tang@vanderbilt.edu

A duplex PCR (dPCR) assay was developed to simultaneously detect and differentiate Bartonella quintana, Bartonella henselae, and Coxiella burnetii from surgical heart valve tissue specimens with an analytic sensitivity of 10 copies/reaction. Among 17 specimens collected from patients with a clinical diagnosis of culture-negative endocarditis, 2, 4, and 2 were positive for B. quintana, B. henselae, and C. burnetii, respectively, by the dPCR assay, which matched the results obtained by universal bacterial 16S rRNA gene amplification and sequencing.

PMCID: 2725655 PMID: 19553582 [PubMed - indexed for MEDLINE]

50. Clin Microbiol Infect. 2009 Jun 22. [Epub ahead of print]

Uveitis: an emerging clinical form of Bartonella infection.

Terrada C, Bodaghi B, Conrath J, Raoult D, Drancourt M.

Department of Ophthalmology, Pitie-Salpetri�re Hospital, Assistance Publique-H�pitaux de Paris, Paris.

PMID: 19548998 [PubMed - as supplied by publisher]

LYME DISEASE BABESIA BARTONELLA BEST DOCTORS 26 BOOKS/27 PAPERS  TREATMENT ILADS IGENEX MOLD ILLNESS BIOTOXINS JAMES SCHALLER