| A 50-year-old alcoholic man with a 1-year history of pyrexia of unknown origin was admitted with symptoms of endocarditis. Large vegetations on his mitral and aortic valve were found on echocardiography. Using the Bactec 9240 system. bartonella quintana could be grown from two culture sets of blood collected before the start of antimicrobial therapy. This is the first case report of culture-proven bartonella infection in the UK. and is noteworthy because bartonella quintana was detected in conventional blood culture systems after prolonged incubation. ( info) |
2/47. Disseminated Bartonella infection with granulomatous hepatitis in a liver transplant recipient. Disseminated infection with Bartonella spp with granulomatous hepatitis was diagnosed in a liver transplant recipient presenting with fever of unknown origin. Pathological findings on liver biopsy were atypical, with scant granulomas seen only after a second biopsy. The patient responded promptly to antibiotic therapy. Infections caused by Bartonella spp should be considered in transplant recipients with fever of unknown origin. ( info) |
| BACKGROUND: Systemic manifestations of bartonella henselae infection are rare in the immunocompetent host. The infection generally has initial symptoms of prolonged fever and multiple granulomatous lesions in liver and spleen. methods: Retrospective analysis of the records of all patients with hypoechogenic lesions in the liver and/or spleen diagnosed from 1990 through 1996 in three pediatric clinics in northern italy. RESULTS: Among the 13 patients reviewed, 9 had evidence of B. henselae infection and hepatosplenic involvement: five had prolonged and unexplained fever lasting from 3 to 16 weeks, and four had typical cat-scratch disease and peripheral lymphadenitis. All patients had increased sedimentation rate and normal aminotransferase serum activity. Five children had a liver biopsy, by laparotomy in three and by needle in two. In all, the predominant liver lesion was a necrotizing granuloma. All patients were treated with broad-spectrum antibiotics. Fever lasted from 3 to 16 weeks, and hepatic and splenic lesions resolved in all with residual splenic calcification in one. CONCLUSIONS: Systemic B. henselae infection represents an important cause of inflammatory hypoechogenic hepatosplenic lesions in children. serology provides rapid diagnosis, avoiding multiple and invasive investigations. Hepatosplenic involvement can be found even in children with typical cat-scratch disease without apparent systemic manifestations. The frequency of liver and/or splenic involvement in cat-scratch disease is probably underestimated. ( info) |
4/47. Isolation of a new subspecies, Bartonella vinsonii subsp. arupensis, from a cattle rancher: identity with isolates found in conjunction with borrelia burgdorferi and babesia microti among naturally infected mice. bacteremia with fever due to a novel subspecies of Bartonella vinsonii was found in a cattle rancher. The subspecies shared major characteristics of the genus Bartonella in terms of most biochemical features and cellular fatty acid profile, but it was distinguishable from other subspecies of B. vinsonii by good growth on heart infusion agar supplemented with X factor and by its pattern of enzymatic hydrolysis of peptide substrates. dna relatedness studies verified that the isolate belonged to the genus Bartonella and that it was genotypically related to B. vinsonii. The highest level of relatedness was observed with recently characterized strains from naturally infected mice that were coinfected with borrelia burgdorferi and babesia microti. We propose the name Bartonella vinsonii subsp. arupensis subsp. nov. as the new subspecies to accommodate these human and murine isolates. ( info) |
5/47. Seroepidemiology of Bartonella vinsonii subsp. berkhoffii infection in california coyotes, 1994-1998. The prevalence of antibodies to Bartonella vinsonii subsp. berkhoffii in coyotes (Canis latrans) in california ranged from 51% in central to 34% in southern and 7% in northern california. Seropositive coyotes were more likely to be from coastal than inland counties (p clustered distribution of Bartonella seropositivity in coyotes suggests that B. vinsonii subsp. berkhoffii infection is vectorborne. Further investigation is warranted to evaluate which arthropods are vectors and what the mode of transmission is from wildlife to domestic dogs and possibly humans. ( info) |
6/47. Demonstration of Bartonella grahamii dna in ocular fluids of a patient with neuroretinitis. We describe the clinical and laboratory features of a 55-year-old human immunodeficiency virus-negative female patient who presented with bilateral intraocular inflammatory disease (neuroretinitis type) and behavioral changes caused by a Bartonella grahamii infection. diagnosis was based on the PCR analysis of dna extracted from the intraocular fluids. dna analysis of the PCR product revealed a 100% identity with the 16S rRNA gene sequence of B. grahamii. The patient was successfully treated with doxycycline (200 mg/day) and rifampin (600 mg/day) for 4 weeks. This is the first report that demonstrates the presence of a Bartonella species in the intraocular fluids of a nonimmunocompromised patient and that indicates that B. grahamii is pathogenic for humans. ( info) |
7/47. Bartonella vinsonii subsp. berkhoffii as an agent of afebrile blood culture-negative endocarditis in a human. We report a case of endocarditis in a human infected with Bartonella vinsonii subsp. berkhoffii, which causes bacteremia and endocarditis in dogs. Bacterial identification was established by PCR amplification and sequencing of an intergenic spacer region (ITS1), 16S ribosomal dna, and a gene encoding citrate synthase (gltA). Bartonella antibodies were detected by immunofluorescence. ( info) |
| A case of bartonella henselae bacteraemia is reported in an immunocompetent 8-year-old boy with cat-scratch disease. serology to B. henselae, diagnosed by polymerase chain reaction, was positive. dna was extracted from peripheral whole blood and amplified with specific primers targeting the htrA gene of B. henselae. A non-isotopic hybridization assay with a species-specific oligonucleotide probe was used to detect the amplified product. CONCLUSION: The polymerase chain reaction can be used for the rapid laboratory diagnosis of bacteraemia in cat-scratch disease. ( info) |
| 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. ( info) |
10/47. Bartonella infection associated with systemic juvenile rheumatoid arthritis. A 4-year-old girl with systemic juvenile rheumatoid arthritis had Bartonella infection diagnosed serologically. This case suggested that Bartonella (most probably bartonella henselae) infection may in part be responsible for the development of systemic juvenile rheumatoid arthritis. ( info) |