BARTONELLA, KISSANRAAPIMATAUTI

Punkin/vertaimevien hyönteisten välityksellä voi saada useita erilaisia taudinaiheuttajia elimistöönsä.

Valvojat: Bb, Tiina, viltsu, Sailairina

BARTONELLA, KISSANRAAPIMATAUTI

ViestiKirjoittaja soijuv » To Syys 10, 2009 12:26

BARTONELLA

Bartonellat ovat gram-negatiivisia bakteereja jotka kykenevät tunkeutumaan solujen sisälle esim. makrofagi, puna- ja endoteelisolu. Ne aiheuttavat usein kroonisen infektion. Bakteeria levittävät esim. täit, kärpäset (löydetty esim. hirvikärpäsistä Suomessa) ja kirput.

http://www.ncbi.nlm.nih.gov/pubmed/1838 ... rom=pubmed


Bartonellabakteerin voi saada myös esim. punkinpiston, kissanraapaisun jne. välityksellä.

http://www.cdc.gov/eid/content/14/7/pdfs/1074.pdf

Bartonellabakteeri aiheuttaa erityisesti silmä- ja sydänsairauksia, mutta myös lukuisia muita sairauksia.

http://www.cdc.gov/eid/content/14/7/pdfs/1074.pdf

Transmission of Bartonella henselae by Ixodes ricinus.

Bartonellabakteeri aiheuttaa erilaisia silmäsairauksia: näköhermon turvotus, verkkokalvon irtoaminen, vasoproliferatiivisia verkkokalvovaurioita, lasiaisen irtoaminen, lasiaisen tulehdus, verisuonten tukkeutuminen verkkokalvolla, näköhermonystyn tulehdus, valkeita pisteitä verkkokalvolla jne.

Beyond Cat Scratch Disease: Widening Spectrum of Bartonella henselae Infection.

http://pediatrics.aappublications.org/c ... 21/5/e1413

Ocular Manifestations
Parinaud oculoglandular syndrome, consisting of fever, regional lymphadenopathy, and follicular conjunctivitis, was first described in 1889 and is the most common ocular presentation of B henselae infection, affecting 5% of patients with CSD.10 Only within the last decade was B henselae identified as the causative agent of this syndrome.50 Route of infection is thought to be direct conjunctival inoculation. Typical symptoms include foreign body sensation, unilateral eye redness, serous discharge, and increased tear production. On examination, patients present with a necrotic granuloma with ulceration of the conjunctival epithelium and regional lymphadenopathy that affects the preauricular, submandibular, or cervical lymph nodes.51 The granuloma typically disappears after several weeks without scarring.10

Neuroretinitis, a form of optic neuropathy with optic disk swelling and macular stellate exudate, is the most common posterior segment ocular complication of Bartonella infection.51 B henselae is the most common identified etiology of neuroretinitis, with approximately two thirds of patients with neuroretinitis demonstrating serologic evidence of previous B henselae infection.52 Symptoms include painless visual loss with abrupt onset that is typically unilateral.53 On MRI, unilateral enhancement at the optic nerve-globe junction is highly specific for B henselae infection as cause for optic neuropathy.54 Macular exudates may take months to resolve and, even after resolution, patients may experience abnormal color vision and evoked potentials, subnormal contrast sensitivity, residual disk pallor, afferent pupillary defects, retinal pigment changes, and mildly decreased visual acuity.55

There are reports of ocular Bartonella disease with optic disk edema and retinal detachment without the classic macular stellate exudate seen with neuroretinitis.56 Other posterior segment presentations of B henselae infection include panuveitis with diffuse choroidal thickening, retinal vasoproliferative lesions, macular hole, vitreal detachment, vitritis, branch retinal artery and venous occlusions, retinal white spots, and papillitis.57?60 In HIV-positive patients, ocular B henselae infection presents as a subretinal mass associated with abnormal vascular network, which is best diagnosed by fluorescein angiography.61

Bartonellabakteeri voi aiheuttaa samantyyppisiä neurologisia ja esim. MS-tyyppisiä oireita kuin borreliabakteeri, esim. enkefalopatia, aivotulehdus, levottomuus, ärtyneisyys, jatkuva päänsärky, dementia, lihasten heikkous, puutuneisuus, tuntohäiriöt, tasapainohäiriöt, epilepsiatyyppiset kohtaukset, rakon/suoliston toimintahäiriöt jne. Bartonellainfektion mahdollisuus tulee huomioida myös sellaisissa tapauksissa joissa potilaan oireet jatkuvat borrelioosihoitojen jälkeen.

Bartonella henselae and Borrelia burgdorferi infections of the central nervous system.

http://lymepoland.com/pliki/Bart+Borelioza_CNS.pdf

Bartonella encephalitis in Infections of the Central Nervous System:
http://jcm.asm.org/cgi/content/full/46/9/2856

Bartonella spp. Bacteremia in Patients with Neurological and Neurocognitive Dysfunction

http://jcm.asm.org/cgi/content/full/46/9/2856

Bartonella Species in Blood of Immunocompetent Persons with Animal and Arthropod Contact

http://www.cdc.gov/eid/content/13/6/938.htm

Bartonella (Rochalimaea) antibodies, dementia, and cat ownership among men infected with human immunodeficiency virus.

http://www.ncbi.nlm.nih.gov/pubmed/8645 ... t=Abstract

Possible association between the organism Bartonella quintana and pediatric HIV encephalopathy

http://pediatrics.aappublications.org/c ... 21/5/e1413

Bartonella aiheuttaa myös esim. aivosairautta (enkefalopatia) ja agressiviista käyttäytymistä, mutta infektiosta huolimatta selkäydinestenäytteet ovat yleensä normaalit. Bakteeri voi infektoida myös maksan, munuaiset, pernan, keuhkokuumeen jne.

Beyond Cat Scratch Disease: Widening Spectrum of Bartonella henselae Infection

http://pediatrics.aappublications.org/c ... 21/5/e1413

Bartonellatestit antavat vääriä negatiivisia tuloksia esim. bakteerikantojen antigeeneissä esiintyvien erojen vuoksi. Allaolevassa tutkimuksessa 14 henkilöä (30 ? 53 v.) oli ollut vuosien ajan päivittäisessä kontaktissa yli 10 v. ajan eläinten, esim. kissan kanssa. Kaikki olivat myös saaneet useita erilaisten vertaimevien hyönteisten kuten punkkien, kirppujen, kärpästen jne. pistoja. Kaikilla esiintyi kroonisia tai jaksoittaisia oireita, kuten lihas- ja nivelkipuja, muistihäiriöitä, ihon tuntohäiriöitä, fatiikkia, päänsärkyä jne. Oireet olivat pääasiassa lieviä tai keskivaikeita. Hyvät ja huonot kaudet vuorottelivat. Useat olivat käyneet oireidensa vuoksi eri erikoisalojen lääkärien, esim. kardiologin, neurologin, sisätautilääkärin, infektiolääkärin jne. vastaanotoilla.

Bartonella Species in Blood of Immunocompetent Persons with Animal and Arthropod Contact. Relapsing illness due to Rochalimaea henselae in immunocompetent hosts: implication for therapy and new epidemiological associations.

http://www.cdc.gov/eid/content/13/6/938.htm

BARTONELLAINFEKTION HOITO ANTIBIOOTEILLA: Aminoglykosidit, Doksisykliini, Atsitromysiini, Rifampisiini, Levofloksasiini.

Suom.huom. Aminoglykosideihin kuuluvat muun muassa seuraavat lääkeaineet:
amikasiini
gentamisiini
kanamysiini
neomysiini
netilmisiini
streptomysiini
tobramysiini


Bartonella spp. Bacteremia in Patients with Neurological and Neurocognitive Dysfunction

http://jcm.asm.org/cgi/content/full/46/9/2856

Potilaiden hoidot olivat yksilöllisiä. Potilaat saivat tapauksesta riippuen plasmafereesin, antibiootteja, kortikosteroideja, suonensisäistä immunoglobuliinia, kouristuksia ehkäisevää lääkitystä jne.

Potilas 1. Doksisykliini 6 vko. Oireeton 3 v:n seurannassa.

Potilas 5. Doksisykliini 5 vko, atsitromysiini 6 vko, levofloksasiini 9 vko. Potilaan tilanne parani vähitellen ja hän pystyi palaamaan töihin. Viimeisen vuoden aikana hän sai toistamiseen doksisykliiniä ja rifampinia. Oireiden uusiutumista ei sen jälkeen enää tapahtunut.

Potilas 6. Atsitromysiini 6 vko.

Potilaat 2 ja 3. Doksisykliiniä ilman mainittavaa vaikutusta tilanteeseen.

Potilas 4. Jatkuva doksisykliinihoito 2 vuoden ajan. Tänä aikana päänsärky, selkä- ja nivelkivut ovat helpottaneet vaikkakin niveloireet pahenevat aika ajoin.

Antibiooteista telitromysiini oli tehokkainta, mutta myös makrolidit, erityisesti klaritromysiini, doksisykliini ja rifampisiini olivat tehokkaita. Etesti saattaa olla luotettava bartonellatesti.


In vitro susceptibility of Bartonella species to 17 antimicrobial compounds: comparison of Etest and agar dilution

http://jac.oxfordjournals.org/cgi/reprint/58/4/784.pdf

Bakteeria ei välttämättä saada helpolla hoidettua antibiooteilla. ?Bartonella ja brucella ovat samankaltaisia bakteereja. Kummatkin voivat aiheuttaa vaikeahoitoisen kroonisen infektion ihmisessä. Aminoglykosidi-ryhmän antibiootit saattavat olla tehokkaita kroonisen bartonellainfektion hoidossa. Kyseiset antibiootit olivat bakterisidisiä (bakteereja tappavaa).?

(Suom.huom. Aminoglykosideihin kuuluvat muun muassa seuraavat lääkeaineet: amikasiini, gentamisiini, kanamysiini, neomysiini, netilmisiini, streptomysiini, tobramysiini).

Bactericidal effect of antibiotics on Bartonella and Brucella spp.: clinical implications http://jac.oxfordjournals.org/cgi/content/full/46/5/811

Kaikilla antibiooteilla (in vitro), aminoglykosidejä lukuunottamatta oli ainoastaan bakteerien kasvua estävä vaikutus (bakteriostaattinen). Siitä sekä antibioottien huonosta soluläpäisevyydestä johtuen epäillään, että antibiootit eivät pysty tuhoamaan solujen sisällä olevia bartonellabakteereita. Tieto bartonellan aiheuttamista oireista lisääntyy koko ajan, mutta hoitoa koskeva tietoa on saatavissa lähinnä tapausselostuksista. Neuroretiniitin hoidossa käytetään yleisimmin doksisykliiniä sen hyvän läpäisevyyden vuoksi (silmät, keskushermosto). Yhdessä Rifampinin kanssa se lyhentää taudin kestoa, vähentää silmähermon turvotusta ja parantaa näkökykyä. Hoitoa jatketaan jopa 4 kk. Sydäntulehduksia hoidetaan aminoglykosidien ja doksisykliinin/keftriaksonin yhdistelmällä.


Beyond Cat Scratch Disease: Widening Spectrum of Bartonella henselae Infection

http://pediatrics.aappublications.org/c ... 21/5/e1413

?Ainoastaan sellaiset antibiootit jotka kykenevät tunkeutumaan solujen sisälle ja ovat bakteereja tappavia, kuten aminoglykosidit, voivat tuottaa tulosta kroonisen bartonellainfektion hoidossa.?

In Vitro Susceptibilities of Four Bartonella bacilliformis Strains to 30 Antibiotic Compounds.

http://aac.asm.org/cgi/content/full/43/ ... e6206c02ed

-----------------------------------------------------------------------------

Kirja bartonellasta: Epätyypillisen bartonellan diagnostiikka, hoito ja ennaltaehkäisy; lisäinfektio on yleinen syy borrelioosin hoidon epäonnistumiseen.

James Schaller, MD. The Diagnosis, Treatment and Prevention of Atypical Bartonella: A Common Cause of Lyme Disease Treatment Failure

-----------------------------------------------------------------------------

"Kissanraapimatauti on tunnettu jo 60 vuotta, mutta sen aiheuttaja on selvinnyt vasta viime vuosina. Diagnoosi on perustunut useisiin seikkoihin, jotka ovat kontakti kissaan ja usein pieni papula raapimakohdalla, paikallisten imusolmukkeiden suurentuminen, lämpöily, muiden samankaltaisten tautien pois sulkeminen sekä histologisesti imusolmukkeessa todettava hyperplasia sekä pienet absessit. Warthin-Starryn hopeavärjäyksellä imusolmukkeessa voidaan lisäksi todeta monimuotoisia mikrobeja (Margileth ja Hayden 1993). Viisi vuotta sitten kissanraapimatautipotilaiden imusolmukkeista onnistuttiin eristämään bakteeri, jolle annettiin nimeksi Afipia felis. Myöhemmin potilaiden imusolmukkeista kasvoi myös toinen bakteeri, riketsioihin kuuluva Rochalimaea henselae (Tompkins ja Steigbigel 1993). Vasta-aine- ja DNA-tutkimusten perusteella näyttää siltä, että R. henselae olisi kissanraapimataudin todellinen aiheuttaja.

Kissanraapimatauti on nykyään selvästi yleisin zoonoosi Yhdysvalloissa. Yleensä potilaat ovat lapsia, mutta myös aikuiset voivat sairastua. Tauti paranee yleensä itsestään 2 - 4 kuukaudessa. Siihen liittyvä kuumeilu, suurentuneet imusolmukkeet sekä joillakin potilailla todettavat keskushermosto-oireet, maksan granulomatoottiset muutokset sekä lyyttiset muutokset luustossa saattavat kuitenkin aiheuttaa erotusdiagnostisia ongelmia (Cohen- Abbo ym. 1992).

Kissanraapimatautia tavataan jonkin verran myös Suomessa. Sen todellisesta esiintymisestä maassamme ei kuitenkaan ole tietoa, koska vasta-aineiden mittaamiseen perustuvaa selvitystä ei ole vielä tehty. Taudin diagnoosi on tähän saakka ollut kliininen. R. henselae -vasta-aineita voidaan mitata joko entsyymi- immunologisilla tai immunofluoresenssimenetelmillä. Vasta-ainetestiä ei tiettävästi vielä tehdä Suomessa missään laboratoriossa. Bakteerin viljely esimerkiksi imusolmukenäytteestä tai verestä on mahdollinen, mutta bakteerin kasvuaika on useita viikkoja

Mikrobilääkkeiden tehosta kissanraapimataudin hoidossa ei ole varmaa näyttöä. Hoidossa on kokeiltu mm. sulfa-trimetopriimia, rifampisiinia, siprofloksasiinia sekä gentamysiiniä (Tompkins ja Steigbigel 1993). Kissanraapimatautia tutkitaan edelleen, ja ainakin mikrobilääkehoito vaatii vielä lisäselvityksiä, samoin kissoissa esiintyvien kirppujen ja punkkien osuus taudin levittäjinä (Margileth ja Hayden 1993). Immuunipuutteisilla potilailla on todettu niin ikään kissoihin liittyvä R. henselae ja R. quintana -bakteereiden aiheuttama tauti, basillaarinen angiomatoosi. Tätä tautia on todettu joitakin tapauksia myös aiemmin terveillä henkilöillä (Tompkins ja Steigbigel 1993). Potilaiden iholla havaitaan punertavia kyhmyjä, joissa voi olla haavaumia. Sisäelimissä saatetaan todeta useita veren täyttämiä onteloita. Basillaarinen angiomatoosi ei parane itsestään. Tautia voidaan hoitaa tehokkaasti tetrasykliineillä tai erytromysiinillä (Tompkins ja Steigbigel 1993). "

http://www.duodecimlehti.fi/web/guest/e ... ku_p_auth=

-----------------------------------------------------------------------------


Huonosti tunnettu hirvikärpänen saattaa levittää ihmiselle haitallisia tauteja.

Kotimaa 22.09.2006 23.12


- Hirvikärpänen on vaarallisempi otus kuin tiedetäänkään, kertoo metsäeläintieteen professori Kari Heliövaara Helsingin yliopistosta.

Helsingin yliopiston soveltavan biologian laitos teki yhdessä Metsäkeskuksen kanssa verkkokyselyn, jossa tiedusteltiin kokemuksia hirvikärpästen puremista. Kolmasosa vastaajista kertoi kärsineensä pitkäaikaisesta, jopa kuukausien mittaisesta tulehduksesta. Toinen kolmasosa oli kärsinyt kutinasta ja paukamista.

Toistaiseksi puremista ei ole koitunut vakavia seurauksia, mutta Keski-Euroopassa hirvikärpästen on todettu kantavan ihmiselle riskin muodostavia bakteereja.

Hirvikärpästen kantamien bartonellasuvun bakteerien tiedetään aiheuttaneen sydänlihastuleduksia ja Trypanosoma-suvun alkueläimet aiheuttavat unitautia - samaa tautia, jota tsetsekärpäset levittävät. Kärpäslajit muistuttavat muutenkin toisiaan.

- Hirvikärpäsen elämänkierto on hyvin poikkeuksellinen. Laji ei muni lainkaan, vaan toukka syntyy naaraasta. Jos naaras kantaa jotain bakteeria, se leviää toukkaan ja samaan tapaan ihmiseen. Hirvikärpäsen elämänkierto on samanlainen kuin tsetsekärpäsellä, eikä muita samanlaisia tunneta, Heliövaara valaisee.

Kärpästä on liki mahdoton torjua

Kärpänen puree ihmistä luullessaan tätä hirveksi. Ihmisen veri ei kuitenkaan sovi hirvikärpäsen ravinnoksi, joten se ei jää loisimaan pitkäksi aikaa toisin kuin hirviin ja metsäpeuroihin.

- Viime vuonna ammuttiin yksi hirvi tutkittavaksi. Löysimme siitä 10 000 hirvikärpästä, Heliövaara kertoo.

Metsässä liikkuville sienestäjille ja marjastajille hirvikärpänen on ikävä riesa, mutta metsätöitä tekevät kärsivät ötökästä eniten.

Hirvikärpänen on ihmiselle vaivalloinen sikäli, että sen torjuminen on lähes mahdotonta, eikä sen puremiin ole lääkkeitä. Sitkeä eläin kestää hyönteismyrkyt ja saattaa viihtyä ihmisen hiuksissa parikin päivää: se ei hätkähdä edes saunomista.

Kansanterveyslaitoksen infektologian erikoistutkijan Henrikki Brummer-Korvenkontion ja Tampereen yliopiston ihotautien professorin Timo Reunalan mukaan ainoa keino välttää hirvikärpäsiä on pukeutua vaaleaan, hyvin peittävään vaatetukseen, johon kuuluu tiivis huppu tai harsohattu.

Metsäalan ammattilaiset ovat tosin tästä eripuraisia. Ainoa täysin varma keino välttää purema näyttää olevan se, ettei liiku hirvikärpäsalueilla.

Hirvikärpäset viihtyvät tiheissä metsiköissä. Avoimilla alueilla niitä ei juuri ole, sillä hirvikärpänen ei kykene lentämään pitkiä matkoja.

Rauhoittava ihovoide voi helpottaa

Jos purema alkaa vaivata, Reunala ja Brummer-Korvenkontio neuvovat, että antibakteerista ainetta sisältävä hydrokortisonivoide ja antihistamiinitabletit saattavat lievittää kutinaa hieman.

Voimakkaimmissa reaktioissa ja näppylöiden märkiessä tarvitaan käynti lääkärissä. Tällöin käytössä ovat voimakkaammat kortisonivoiteet ja mahdollisesti myös sisäinen antibioottilääkitys.

Helsingin yliopiston ja Metsäkeskuksen kyselyn mukaan hirvikärpästen yleistyminen vaikuttaa jo metsässä liikkujien käyttäytymiseen. Kyselyyn vastanneista varsinkin naiset kertoivat suojautuvansa usein.

Osa vastaajista kertoi välttävänsä hirvikärpäsalueita ja osa jopa vähentäneensä metsässä liikkumista.

Lajista tiedetään hyvin vähän

Hirvikärpäsistä ei ole kovin paljon tietoa, sillä niitä ei ole tutkittu juuri lainkaan. Suomessa hirvikärpänen on melko tuore tuttavuus - ensimmäinen havainto tehtiin 1960-luvulla Kaakkois-Suomessa. 2000-luvulla hirvikärpästen lukumäärä on kasvanut, ja ne ovat levinneet Pohjois-Suomen poroihin. Hirvikärpästen määrää ei tosin tiedä kukaan, sillä sitä ei mitata.

Hirvikärpäsiä on myös Ruotsissa. 1990-luvulla Ruotsia kuohuttivat tapaukset, joissa suunnistajia kuoli yhtäkkiä metsään. Heillä todettiin hirvikärpäsenkin kantamaa Bartonella-bakteeria.

- Mutta bakteerin ja kuolemantapausten välinen yhteys on yhä epäselvä, Kari Heliövaara rauhoittelee.

Hän kuitenkin luonnehtii hirvikärpästä terveysriskiksi, koska laji tunnetaan niin huonosti.

- Sitäkään ei tiedetä, miksi sen puremasta tulee paukamia. (HäSa)

Kari Heliövaara, metsäeläintieteen professori

-----------------------------------------------------------------------------

Lyme borreliosis and Bartonella

By Barbara L. Fitzmaurice, R. N.

We are not textbook diseases anymore!

Co-infection with multiple vector-borne organisms may occur in animals and in humans. We now realize it is very possible to be infected with bacterial, rickettsial, parasitic, viral, and protozoal organisms following the attachment of a single tick. Borrelia burgdorferi, a spirochetal bacteria, other strains of Borrelia species, and additional infectious organisms such as the protozoa, Babesia spp.(1 (babesiosis), Francisella tularensis (tularemia), Rickettsia rickettsii (Rocky Mountain spotted fever)(1) and ehrlichiosis (an intracellular bacteria causing human monocytic ehrlichiosis (HME) and human granulocytic ehrlichiosis (HGE)), mycoplasma (parasitic bacteria), and Powassan-like virus also are spread by ticks.(2) More recently, bartonella, an intracellular organism transmitted via the tick, has also been found to infect humans.(3)(4)(5)

The organisms in the genus bartonella have emerged in importance as opportunistic pathogenic infections in humans. Seven species, with a possibility of an eighth, exist in the genus bartonella and are known to cause illness in humans: Bartonella bacilliformis, B. elizabethae, B. henselae, B. quintana, B. washoensis, B. vinsonii subsp. Berkhoffii, B. vinsonii subsp. Arupensis. (Table 1) A widening spectrum in the bartonella species and subspecies of organisms causes infections in mammals as well. Birds, which carry lice and ticks, no doubt play a major role in transporting and disseminating these infected vectors, resulting in widespread disease. Numerous animals, both domestic and wild, act as reservoirs for the bartonella species. With the apparent ability of insects also to act as bartonella reservoirs, a much higher prevalence of this infectious disease is becoming evident.

Another possibility is that many of the infectious diseases mentioned above could have the potential to be sexually transmitted. Research into transmission of some of the above diseases through other vectors, such as the mosquito,(6) flea, sand fly, and louse, as well as via blood transfusions,((9(10) mother to fetus transmission,(13)(14), and transmission through breast-feeding, has been documented. A few early studies looked at direct contact as a mode of transmission of spirochetes. (15) (19) It is possible that bartonella infections or the other pathogenic organisms found in Lyme disease patients may also be transmitted between species by other mechanisms than those known or suspected. (6) (12) Clearly, the growth in the numbers of ticks in the United States and worldwide is alarming. (11) Increasing tick populations, along with other vectors capable of transmitting Lyme disease and other infectious illnesses to humans, has reached a level that no prudent public or private healthcare professional should ignore.

The bartonella species are not free-living organisms and require a reservoir host that is transferred by vectors such as body lice, flies, and ticks. Fleas have been found infected with Bartonella henselae in both dogs and cats, indicating that Bartonella henselae may be transmitted to humans and pets via the flea vector. (15) (16) While researchers still dispute this, there is a growing number of reports of patients proving positive for bartonella infection having no history of contact with cats. Scratches from a cat and exposure to the saliva were thought to be the only means of transmission of bartonella infection for a very long period. It has since been established that fleas carry the organism in their midgut, and bartonella has also been found in the feces of fleas.(16) (21)(39) Other small and large animals that carry fleas and ticks may undoubtedly act as hosts as well. (Table 1)

Table 1 - The genus bartonella with species and subspecies listed. As research is ongoing, undoubtedly more strains will be discovered and more information will be forthcoming on the specific illnesses these organisms are capable of causing in humans.

Bartonella bacilliformis (also called Bartonellesis)

Flies in South America
Oroyo fever (acute hemolytic anemia), Carrion?s disease (chronic ? verruga peruana) (3)(15)(20)

B. Elizabethae
Tick and Rodent Endocarditis (26)

B. henselae (11 strains)*
Fleas, ticks, animals
Cat scratch disease, endocarditis, (3)(19) bacillary angiomatosis (24)

B. quintana (7 strains)*
Body louse, tick
Trench fever, endocarditis, (3)(23) bacillary angiomatosis (46)

B. clarridgeiae
Fleas, cats. Isolated from a patient
Found in cat scratch disease. Found in a patient with endocarditis

B. alsatica sp. nov.
Isolated from the blood of wild rabbits
Unknown if disease in humans

B. birtlesii
Isolated from small mammals
Unknown if disease in humans

B. bovis
Isolated from European & American ruminants
Unknown if disease in humans

B. capreoli
Isolated from European ruminants
Unknown if disease in humans

B. doshiae
Isolated from the blood of animals and man
Unknown if disease in humans

B. grahamii (5 strains)*
Isolated from the blood of animals
Neuroretinitis(54)

B. koehlerae
Isolated from the blood of animals
Unknown if disease in humans

B. peromysci
Isolated from the blood of animals
Unknown if disease in humans

B. schoenbuchii sp. nov.
Isolated from the blood of wild roe deer
(45)

B. talpae
Isolated from the blood of animals
Unknown if disease in humans

B. taylorii (6 strains)*
Isolated from the blood of animals
Unknown if disease in humans

B. tribocorum
Isolated from the blood of animals
Unknown if disease in humans

B. vinsonii subsp. arupensis
Isolated from the blood of animals and man
Valvular disease, heart, fever, and neurological signs(3)

B. vinsonii subsp. berkhoffii
Isolated from the blood of the canine, rodents, and ticks
Endocarditis(3)(19)(26)

B. vinsonii subsp. vinsonii
Isolated from the blood of animals, transmission via tick
Unknown if disease in humans

B. washoensis

Rodents, I. pacificus ticks

Myocarditis (3)

(1) (26) (27) (37) (43)*

Relationship of Bartonella Species

Similar protein profiles have been established and a dendrogram (comparison of relationships based on immunoreactive bands) demonstrated that the Bartonella species can be divided into three groups:

· Bartonella bacilliformis is distinct from the other bartonella species

· Bartonella grahamii, Bartonella taylorii, Bartonella doshiae, and Bartonella Vinsonii are related and form a cluster

· Bartonella henselae, Bartonella quintana, Bartonella elizabethae and Bartonella clarridgeiae also form a cluster

. (Bartonella henselae is related closely to Bartonella quintana, Bartonella clarridgeiae is closely related to Bartonella henselae, and Bartonella elizabethae is closely related to Bartonella quintana and Bartonella henselae)

ITS, or intergenic spacer sequencing, may be an effective method for the further sub-typing and identification of the Bartonella spp. For instance, B. henselae has further been found to have 11 strains of the organism.(43)(56)

Western blotting appears to be an effective method to identify the phenotype of the bartonella group down to the species.(43)

· Bartonella bacilliformes: Oroyo fever, or Carrion?s disease, is transmitted from the sand fly in South America and can cause severe progressive anemia and high fevers with muscle, tendon, and joint pain. Skin eruptions or internal lesions that bleed profusely may be present, and the result can be fatal. The organism attaches to red blood cells and destroys them. If disseminated into the brain, neurological problems may develop causing seizures, paralysis, and death. In 1926 research by H. Noguchi, the tick Dermacentor andersoni was experimentally infected with Bartonella bacilliformis, which then transmitted the organism to a non-human primate.(20)

The term ?bartonellosis? has been used to describe the frequently fatal syndrome caused by B. bacilliformis. It has only been reported in South America, although with the emergence and increase in illness due to vector-borne disease worldwide, it may someday have no boundaries. One treatment and another consideration worth noting is that chloramphenicol is effective against Salmonella, and this organism has been found as a secondary infection along with B. bacilliformis.(25)

· Trench fever due to Bartonella quinata (formerly Rickettsia, Rochalimaea) can be contracted after exposure to the body louse and may cause prolonged or recurrent fevers. Transmission commonly occurs when infected lice feces are rubbed into an open area on the skin or in the eyes. The organism can persist in humans for months after recovery and relapses have been reported as many as ten years later. This illness was seen in military personnel during World War I and World War II. The incubation period is 14-30 days, but problems may appear sooner. Onset is sudden, with fever, weakness, dizziness, and headache. There may be severe back and leg pains, bone pain, and an enlarged spleen. Fever may reach 40.5° C (105° F) and persist for five to six days. Fever has been reported to reoccur at intervals. Rash is possible. The liver and the spleen may enlarge, and recently endocarditis, an infection involving the heart, has been documented.(19)(22)(25) Recommendations for treatment are chloramphenicol and the tetracyclines, although currently there have been no studies to prove that this disease can be overcome completely.(1(19)(24)

· Bacillary angiomatosis (BA), due specifically to B. henselae and B. quintana, was the name used when first recognized in immunocompromised AIDS patients. These patients either developed nodules under the skin or vascular lesions, meaning bartonella infection had entered the blood vessels or lymph system. The nodules included papular, nodular, or polypoid lesions. (23) BA may also occur as a septicemia, infection that has disseminated into the blood, which if left untreated may lead to death. A patient with BA may have an increase in lesions, rashes, abscesses, chills, fever, sweats, lack of appetite, nausea, and vomiting as well as weight loss. BA is now reported to be an illness found in immunocompetent patients as well (32)

· B. elizabethae can cause endocarditis. B. vinsonii has been reported recently to be another cause of human endocarditis. Two Bartonella species, B. henselae and B. clarridgeiae, have been isolated from the blood of cats. B. henselae DNA has been amplified from fleas isolated from bacteremic cats. Transmission of B. henselae by the cat flea, or Ctenocephalides felis, has been demonstrated. Recently, B. clarridgeiae was isolated from the blood of a cat. It was present in the bloodstream of a healthy cat involved in a human case of cat-scratch disease (CSD) caused by B. henselae. It is not known whether B. clarridgeiae can be transmitted to man via cat or whether it actually does induce disease in humans.(26)(27) However, it is highly suspect since B. clarridgeiae antibodies recently have been found in a chest wall abscess.(35)

· Bartonella henselae, or cat -scratch disease (CSD), originally named Rochalimaea henselae in 1992, was renamed Bartonella henselae after the entire genus of Rochalimaea was merged with the genus of Bartonella in 1993. This organism is a gram-negative rod-like bacillus. Cat-scratch disease was described in 1950, but not until some 43 years later was a primary pathogen found. In the 1990s, it was determined that this infectious agent could be widespread in humans after AIDS patients were observed exhibiting symptoms that affected virtually every organ system in the body, including the brain, heart, lymph, bone, bone marrow, muscle, soft tissue, liver, and spleen. (20)(21)(25) The same organism has been identified as a cause of encephalitis following dissemination of Bartonella henselae into the central nervous system.

CSD can be transmitted by kittens and cats and, most likely, by fleas and ticks. This illness is closely related to Bacillary angiomatosis, which has mainly been seen in AIDS and other immunocompromised patients.(20)(27) It should be noted that the saliva of the cat might also contain the organism. Therefore, if an open area on the body is exposed to the Bartonella organism, transmission can also occur in that fashion.

Earlier papers discussed the idea that immunocompromised individuals would be the most susceptible population at risk for contracting cat-scratch fever if exposed to the organism Bartonella. First recognized in AIDS patients and later in individuals with chronic illnesses such as cancer, it has most recently been detected in patients with chronic infections including Lyme disease. This population of patients most likely would have more complications in fighting this infection. Still some physicians continue to insist that infection with a Bartonella species is a self-limiting illness in an otherwise healthy individual.

After a superficial scratch from cat or kitten, a raised lesion or papule may form near the point of injury, reportedly, in about half of the CSD patients. The lesion becomes red and crusty. One to two weeks later, swollen painful lymph glands, along with fever, may appear. Conjunctivitis, meningitis, or pneumonia, all serious complications, may develop.(24)

Patients complain of fatigue, headache, sore throat, swollen and painful lymph glands and, sometimes, loss of appetite, with weight loss due to nausea and vomiting occurring in some individuals. Reddish, berry-like lesions on the skin can bleed very easily if the skin is injured. In other patients, no rashes or lesions develop. Infections occur in bone, liver, and brain. Abscesses may form. Endocarditis may develop in AIDS patients or the immunocompromised patient infected with Bartonella henselae and Bartonella quinata. As this pathogenic organism may not be well recognized, it could present as a very serious illness in the immunocompetent person as well.(33)(34)

Other symptoms include inflammation of the optic nerve and the retina, myelitis leading to paraplegia, and cerebral arteritis, an inflammation of an artery in the brain. Cranial or peripheral nerve involvement may be present. Facial palsy or peripheral facial nerve paralysis, known as Bell?s palsy, has been commonly reported in patients with Lyme disease and is also reported in Cat Scratch Disease.(22)(24)(36))(37)(3(49)

Cats can be infected with Bartonella henselae but remain without symptoms. With the latest findings that a flea or tick may carry the disease and transmit it to humans, potential infection with this disease should not be overlooked. This is an important fact for all clinicians to take into account. Families that have pets or may have contact with small animals that carry lice and ticks need to take action to eliminate these parasites from their pets.

Testing and Diagnosing

?For many years, CSD has been clinically diagnosed when three of the following four criteria are met in a patient: 1) history of traumatic cat contact; 2) positive skin-test response to CSD skin-test antigen; 3) characteristic lymph node lesions; and 4) negative laboratory investigation for unexplained lymphadenopathy.? (32) Quoted from Russell Regnery, Ph.D., and Jordan Tappero, M.D., 1995

Blood serology has commonly been used to look for the antibodies to both Bartonella henselae and Bartonella quintana. It was not until fairly recently that testing for antibodies in other species was undertaken. Bartonella henselae can be cultured from lymph nodes or the papule area of a scratch. Positive antibody titers can help confirm the diagnosis, but may or may not be present. CT scans may be normal or EEG?s may show some slowing, but the all-important medical history and physical exam are essential in determining the diagnosis of cat-scratch disease. An antibody titer test may be ordered to see if the person is producing antibodies to Bartonella henselae. A polymerase chain reaction test (PCR) can be performed but it still may not reflect with absolute certainty an infection with the Bartonella organism unless histology and serology testing is also done. Using special techniques, the bacteria can sometimes be seen in a biopsy specimen from the affected body part.

Still, it is possible to have routine laboratory cultures reported as ?negative.? Bartonella organisms from the many species and strains have not all been differentiated, and so the exact infecting species or strain may not be known in patients. Enhanced methodologies in the future may help answer these questions and decrease confusion. Coxiella or Chlamydia are two infections that are difficult to differentiate from bartonella even with testing. All can be a cause of endocarditis, but different antibiotics are used in treatment. Development of reliable tests to distinguish between these organisms is very much needed.(44)

Spinal fluid may also show an increase in protein, but minimal pleocytosis (a small increase in the number of lymphocytes in cerebral spinal fluid) may be observed. New testing methods that distinguish between B. henselae and closely related B. quintana cells might be more sensitive in PCR testing. The organism itself can be viewed in tissues.(43)(44) Other illnesses due to Bartonella henselae are bacillary angiomatosis (BA) and Parinaud?s oculoglandular syndrome (eye involvement with red, irritated eye). There may be excessive tears, similar to conjunctivitis. Sometimes swelling of the lymph glands occurs nearby, often in front of the ear. A fever and generalized illness may be present.(3)

Using indirect fluorescence assay (IFA), IgG antibody positive titers in the acute phase of B. henselae infection have been reported to be high after two weeks. IgG antibodies were lower after 25 weeks. IgM antibodies demonstrated less sensitivity using IFA serology testing.(45) PCR sensitivity and specificity from the lesions or nodes, may be even more accurate if fine needle aspiration is employed. (32) Bartonella henselae and Bartonella quinata can be tested in the blood of immunocompromised patients by obtaining blood cultures and using special stains that are allowed to grow for 21 days or longer. This may delay much needed treatment. In summary, this infection can be present in the immunocompetent patient and not easily identified by a lab test alone.

It cannot be stressed enough how often misdiagnoses of Bartonella infections have occurred due to atypical onset and non-recognition of the widespread symptoms. A case study revealed that a four-year-old girl died even though treated aggressively for fevers and seizure. At autopsy, the little girl?s brain revealed marked cerebral edema and multiple granulomatous lesions as well as meningitis and encephalitis. Testing using PCR and Southern Blot was positive for Bartonella DNA.(40)

The pathogenic course of a bartonella infection can be very difficult to distinguish from the signs and symptoms of many bacteria, viruses, fungi, and protozoan infections. Gaubitz et al., reported a young woman who had been diagnosed with systemic lupus erythematosus and treated with increasing doses of steroids, but yet did not respond. Scratches on her arms from her cat led to suspicion of cat-scratch disease, and the illness was ultimately confirmed with additional blood tests. Treatment with clarithromycin was given and a rapid, favorable response resulted.(29)

Brain involvement may not be recognized as due to an infectious organism. A careful history, including potential exposure to cats or other animals, fleas, ticks, or other vectors may determine if serological testing for one of the bartonella species is necessary. Whole families can develop CSD. Multiple cases of encephalitis may raise the question if differing virulence among the strains of Bartonella henselae is a possibility. If antibodies to Bartonella henselae are detected in CSF, the organism may have directly invaded the central nervous system.(4

Treatment

An acute bartonella infection may respond to antimicrobial treatment even in immunocompromised individuals. Doxycycline, erythromycin, and rifampin are recommended antibiotics. Penicillin, gentamicin, ceftriaxone, ciprofloxacin, and azithromycin have been used and patients have responded favorably. Treatment for two weeks in immunocompetent individuals and six weeks in immunocompromised people is generally recommended. Relapses, associated with bacteremia, have been reported in immunocompromised people despite treatment for six weeks. (50)

"Because Bartonella species are highly susceptible to aminoglycosides, the usual recommendation of penicillin or ampicillin plus an aminoglycoside to treat blood culture-negative endocarditis will effectively treat Bartonella endocarditis. In one patient (patient 19), however, B. henselae was isolated after the completion of a course of aminoglycoside therapy. Some researchers have reported that ciprofloxacin is more effective.? (3) Rauolt, et al, 1996

According to the same sources, treatment is not generally needed except in an immunocompromised population and when neurological or liver involvement develops. CSD might be suspected if it has been previously diagnosed, and the patient has persistent complaints of not feeling well. Recurrence is possible.

When a scratch or a bite from a kitten or cat or other furred creature has occurred, warm compresses to the scratch and papule area should be applied after first cleaning with an antiseptic, such as peroxide. If the area becomes swollen, irritated, and uncomfortable, a doctor should be called. Purulent drainage may indicate an infection. If lymph nodes become swollen and painful, needle aspiration should be considered, as well as testing for potential infectious agents.

Rifampin, ciprofloxacin, gentamicin, and trimethoprim-sulfamethoxazole have demonstrated good results for CSD in a laboratory setting. Treatment failures, however, have been reported in some patients. In severe cases, gentamicin has shown some effectiveness.(25) Oral doses of erythromycin or doxycycline have been used over at least a three-month period with reported success. Infections involving the heart, liver or, in the case of severe disseminated infection, may require intravenous antibiotics, changed to orals after the infection is under some control. Combination antibiotics may be indicated.(25) There are reports on the varying duration of treatment, ranging from at least six weeks to six months or longer.

Because of the wide variations of antibiotics used against bartonella infections in both lab settings and actual patients, it is unclear which treatment is superior to another. Patient responses in objective and subjective outcomes have to guide the physician. Co-infections must be considered, because once an organism has invaded and produced an illness, a patient?s immune capabilities are at risk. There is no set protocol of treatment for many of the vector-borne diseases, especially if two or three are involved in a specific patients? illness. Treatment has to be individualized and followed closely by a doctor who is experienced in treating the full realm of vector-borne illnesses.

Summary

As more is learned about bartonella infections in patients already infected with Borrelia burgdorferi, the possibility exists that infection with this organism is one explanation for the chronicity of Lyme disease. The idea that short courses of antibiotics may cure the Lyme borreliosis infected victim when, in fact, various spirochetal strains are known to recur and persist, is illogical. With the added knowledge of co-infection, treatments must be individualized and no set protocol can be followed precisely. Being co-infected with a recurring or persistent bartonella infection, or even another infectious agent such as a Babesia spp., may help to explain prolonged illness in some of the Lyme borreliosis-infected population.(55)

We can no longer ignore some of the questions regarding bartonella infections and what role they may be playing in Lyme disease victims. There are many unknowns about bartonella infections as well as its various species and strains.

Does borreliosis play a role, due to the Borrelia spp. spirochetes and other vector-borne infections, in people diagnosed with chronic fatigue syndrome, fibromyalgia, or Gulf War Syndrome? Ticks, fleas, sand flies, and other insects, as well as household pets and the above mentioned illnesses and syndromes, may all be involved when the immune system becomes compromised and a person has had exposure to a pathogenic organism. Testing is not conclusive in many of the vector-borne diseases. Signs and symptoms can overlap or be misdiagnosed without thought being given to a chronic infection, let alone the full spectrum of infections.

A major problem exists - physicians in the United States and around the world do not adequately recognize the issue of the seriousness of tick-borne or other vector-borne illnesses. The vast majority of mainstream medical providers do not acknowledge that local ticks and other vectors that transmit pathogenic organisms can cause severe illness. The appropriate recognition of Lyme borreliosis and other opportunistic infections causing a host of continuing problems, manifested as chronic persistent disease, is essential for meaningful progress to be made.

Signs & Symptoms Involving Bartonella Infection

Scratches, bites from a cat or animal
Nausea, vomiting, weight loss

Rashes and/or lesion ? may or may not be present
Liver and/or spleen enlargement

Draining, purulent wound, may or may not be present
Headache

Respiratory difficulties, shortness of breath, cough
Heart ? chest pain, cough, irregular heart beat

Temperature ? may or may not be elevated
Memory loss

Generalized weakness. Limbs, whole body
Extreme fatigue

Pain ? muscle, tendons, joints
Hearing loss

Swollen lymph glands, may become tender, painful
Balance, equilibrium problems

Pain in limbs, disseminated throughout the body
Facial palsy

Difficulty with urination, bloody urine
Seizures

Retention of fluids, swelling in extremities
Vision problems, eye infections, red, runny

References

(1) Schouls LM, Van De Pol I, Rijpkema SG, Schot CS, Detection and identification of Ehrli

chia, Borrelia burgdorferi sensu lato, and Bartonella species in Dutch Ixodes ricinus ticks. J Clin Mi

crobiol 1999. Jul;37(7):2215-22 Research Laboratory for Infectious Diseases, National Institute of

Public Health and the Environment, Bilthoven, The Netherlands. L.M.Schouls@rivm.nl

http://www2.lymenet.org/domino/abstract ... 4c13c50ba4

82591852567d800047ac7?OpenDocument

(2) Burgdorfer, W. A review of Rocky Mountain spotted fever (tick-borne typhus), its agent, and its tick vectors in the United States. Journal of Medical Entomology, (1975). 12, 269-278.

(3) Information on Arboviral Encephalitides CDC, Division of Vector-borne Infectious Diseases,

http://www.cdc.gov/ncidod/dvbid/arbor/arbdet.htm

(4) Chang CC; Chomel BB; Kasten RW; Romano V; Tietze N Molecular evidence of Bartonella spp. in questing adult Ixodes pacificus ticks in California J Clin Microbiol 2001 Apr;39(4):1221-6 (ISSN: 0095-1137) Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, California 95616, USA.

http://jcm.asm.org/cgi/reprint/39/4/1221.pdf

http://jcm.asm.org/cgi/content/full/39/ ... smjournals

(5) Mitchell, Paul D.* Reed, Kurt D. and Hofkes, Jeanie M., Journal Of Clinical Microbiology, 1996 Mar., p. 724?727 Vol. 34, No. 3 0095-1137/96/$04.0010 Copyright q 1996, American Society for Microbiology Immunoserologic Evidence of Coinfection with Borrelia burgdorferi, Babesia microti, and Human Granulocytic Ehrlichia Species in Residents of Wisconsin and Minnesota Microbiology Section, Marshfield Laboratories, Marshfield, Wisconsin 54449

http://jcm.asm.org/cgi/reprint/34/3/724.pdf]

(6) Eskow E; Rao RV; Mordechai E Concurrent infection of the central nervous system by Borrelia burgdorferi and Bartonella henselae: evi-

dence for a novel tick-borne disease complex. Arch Neurol 2001 Sep;58(9):1357-63 (ISSN: 0003-9942) Hunterdon Medical Center,

Flemington, NJ, USA. http://archneur.ama-assn.org/issues/v58 ... 10093.html

(7) Halouzka J; Wilske B; Stunzner D; Sanogo YO; Hubalek Z Isolation of Borrelia afzelli from overwintering Culex pipiens biotype molestus mosquitoes Infection 1999;27(4-5):275-7 (ISSN:0300-8126) Institute od Vertebrate Biology, Academy of Sciences of the Czech Republic,

Brno. http://www.ncbi.nlm.nih.gov/entrez/quer ... t=Abstract

( Isolation of the spirochaete Borrelia afzelii from the mosquito Aedes vexans in the Czech Repub lic. Med Vet Entomol. 1998

Jan;12(1):103-5.PMID: 9513946 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/entrez/quer ... t=Abstract

(9) Pantanowitz L, Telford SR, Cannon ME. Tick-borne diseases in transfusion medicine. Department of Pathology (LP, MEC), Beth Israel Deaconess Medical Center, Harvard Medical School and Har vard School of Public Health (SRT), Boston, MA 02215, USA lpantanowitz@hotmail.com
http://www.blackwellsynergy.com/servlet ... 02.00358.x

(10) Geralyn Willan RN, Blood Products, Centre Universitaire de Santé McGill / McGill University Health Centre Hôpital Général de Montréal/ Montreal General Hospital 5.Infectious Disease Transmission ? Blood transfusions by http://www.mmi.mcgill.ca/sicu/files/bloodproduct.pdf

(11) Arguin PM, Singleton J, Rotz LD, Marston E, Treadwell TA, Slater K, et al. An investigation into the possibility of transmission of tick-borne pathogens via blood transfusion. Transfusion.

(12) LT Charmagne Goodman, MC, USNR; CAPT Angeline A. Lazarus, MC, USN; CDR Gregory mJ. Martin, MC, USN Manifestations of tick-borne illness Incidence and variety are increasing worldwideVOL 109 / NO 6 / JUNE 2001 / POSTGRADUATE MEDICINE http://www.postgradmed.com/issues/2001/ ... oodman.htm

(13) Agustín Estrada-Peña, Environmental Health Perspectives Volume 110, Number 7, July 2002 In creasing Habitat Suitability in the United States for the Tick that Transmits Lyme Disease: A Remot Sensing Approach Department of Parasitology, Faculty of Veterinary Medicine, Miguel Servet, Zaragoza, Spain http://ehpnet1.niehs.nih.gov/docs/2002/ ... tract.html

(14) Lavoie PE; Lattner BP; Duray PH; Barbour AG; Johnson HC. Culture positive seronegative transplacental Lyme borreliosis infantmortality. Arthritis Rheum 1987; Volume 30, Number 4, 3(Suppl):S50

(15) J. Elliott,1 Stephen C. Eppes,2 A and Joel D. Klein 2* Teratogen Update: Lyme Disease Daniel 1Department of Pediatrics, Thomas Jefferson University, Philadelphia, Pennsylvania 19107 Department of Pediatrics, Division of Infectious Disease, A I duPont Hospital for Children, Wilmington, Delaware 19899 TERATOLOGY 64:276?281 (2001) http://www.teratology.org/updates/64pg276.pdf

(16) Burgess EC, Amundson TE, Davis JP, Kaslow RA, Edelman R Am J Trop Med Hyg Volume 35 Issue 2 British Library Experimental

inoculation of Peromyscus spp. with Borrelia burgdorferi: evidence of contact transmission. Am J Trop Med Hyg 1986 Mar 35:2 355-9

http://www.ncbi.nlm.nih.gov:80/entrez/q ... t=Abstract

(17) Welch, D. F., Carroll, K. C., Hofmeister, E. K., Persing, D. H., Robison, D. A., Steigerwalt, A. G., Brenner, D. J. Isolation of a New

Subspecies, Bartonella vinsonii subsp. arupensis, from a Cattle Rancher: Identity with Isolates Found in Conjunction with Borrelia burgdor

feri and Babesia microti among Naturally Infected Mice. J. Clin. Microbiol. 37: 2598-2601 (1999).

http://jcm.asm.org/cgi/content/full/37/8/2598

(1 Hofmeister EK, Kolbert CP, Abdulkarim AS, Magera JM, Hopkins MK, Uhl JR, Ambyaye A, Telford SR 3rd, Cockerill FR 3rd,

Persing DH.JInfect Dis 1998 Feb;177(2):409-16 Cosegregation of a novel Bartonella species with Borrelia burgdorferi and Babesia microti

in Peromyscus leucopus, Department of Laboratory Medicine and Pathology, Mayo Foundation, Rochester, Minnesot 55905,

USA.Hofmeister.Erik@Mayo.edu http://www.ncbi.nlm.nih.gov/entrez/quer ... t=Abstract

(19) Anderson JF, Johnson RC, Magnarelli LA, Hyde FW, Myers JE.J Clin Microbiol 1986 Jan;

23(1):135-7 Peromyscus leucopus and Microtus pennsylvanicus

simultaneously infected with Borrelia burgdorferi and Babesia microti.

(20) Ha giwara MK, de Souza Zanutto M, Mamizuka EM, et al Experimental Infection And Hori

zontal Transmission Of Bartonella Henselae In Domestic Cats 26th WSAVA Congress Proceedings

August 8 - 11, 2001 Vancouver, British Columbia, Canada

http://www.vin.com/VINDBPub/SearchPB/Pr ... R00252.htm

(21) Noguchi, H. 1926. Etiology of Oroya fever. V. The experimental transmission of Bartonella

bacilliformis by ticks (Dermacentor andersoni). J. Exp. Med. 44:729-734.

(22) Higgins JA; Radulovic S; Jaworski DC; Azad AF Acquisition of the cat scratch disease agent

Bartonella henselae by cat fleas (Siphonaptera:Pulicidae). J Med Entomol 1996 May;33(3):490-5

(ISSN: 0022-2585) Department of Microbiology and Immunology, University of

Maryland Medical School, Baltimore 21201, USA.

(23) Ishida C; Tsuneoka H; Iino H; Murakami K; Inokuma H; Ohnishi T; Tsukahara M Bartonella

henselae infection in domestic cat and dog fleas Kansenshogaku Zasshi 2001

Feb;75(2):133-6 (ISSN: 0387-5911) Faculty of Health Sciences, Yamaguchi University School of

Medicine.

http://intapp.medscape.com/px/medlineap ... dings_file

=1&local_journals_only=0&searchstring=Bartonella+%2B+fleas

(24) Nair,* Tim G. Harrison,? Ian Hunt,* Norman K. Fry,? and Jon S. Friedland*? Prosthetic Valve

Endocarditis Caused by Bartonella quintana, Vol. 8, No. 2 February 2002
*Hammersmith Hospital, London, United Kingdom; ?PHLS Central Public Health Laboratory, Lon

don, United Kingdom; and ?Imperial College, London, United Kingdom

http://www.cdc.gov/ncidod/eid/vol8no2/01-0206.htm

(25) Karem KL. Immune aspects of Bartonella. Crit Rev Microbiol 2000;26(3):133-45 (ISSN: 1040-

841X) Viral and Rickettsial Zoonoses Branch, Division of Viral and Rickettsial Diseases, National

Center for Infectious Diseases, Centers for Disease Control and Prevention, Public Health Service,

U.S. Department of Health and Human Ser.

(26) The Merck Manual of Diagnostics and Therapy, Sec. 13; Ch 159, Rickettsial Diseases.

http://www.merck.com/pubs/mmanual/secti ... 9/159j.htm

(27) Burt E. Anderson*1 and Mark A. Neuman2 Bartonella spp. as Emerging Human Pathogens

Department of Medical Microbiology and Immunology, College of Medicine, University of South

Florida, Tampa, Florida 33612,1 and Department of Pathology and Laboratory Medicine, Naples

Community Hospital, Inc., Naples, Florida 33940,2

http://cmr.asm.org/cgi/reprint/10/2/203 ... lOJlpOjh9I

(2 Jensen WA; Fall MZ; Rooney J; Kordick DL; Breitschwerdt EB Rapid identification and differ-

entiation of Bartonella species using a single-step PCR assay. J Clin Microbiol 2000

May;38(5):1717-22 (ISSN: 0095-1137) Heska Corporation, Fort Collins, Colorado 80525, USA.

http://jcm.asm.org/cgi/reprint/38/5/1717.pdf

(29) Massei F, Messina F, Talini I, Massimetti M, Palla G, Macchia P, Maggiore G., Widening of the

clinical spectrum of Bartonella henselae infection as recognized through serodiagnostics. Diparti

mento di Medicina della Procreazione e della Eta Evolutiva, Universita di Pisa, Italy

(30) Gaubitz M, Herrmann M, Shahin M, Schotte H, Willeke P, Domschke W. Lupus

2001;10(12):883-5 Cat scratch disease (bartonellosis) mimicking an SLE flare.

Department of Medicine, University of Munster, Germany. gaubitz@uni-muenster.de

http://www.ncbi.nlm.nih.gov/entrez/quer ... s=11787880

&dopt=Abstract

(31) Raoult D, Fournier PE, Drancourt M, Marrie TJ, Etienne J, Cosserat J, et al. Diagnosis of 22

new cases of Bartonella endocarditis. Ann Intern Med 1996;125:646-52.

http://www.acponline.org/shell-cgi/prin ... rtonel.htm

(32) La Scola B; Raoult D Culture of Bartonella quintana and Bartonella henselae from human samples:

a 5-year experience (1993 to 1998). J Clin Microbiol 1999 Jun;37(6):1899-905 (ISSN: 0095-1137)

Unite des Rickettsies, CNRS UPRESA 6020, Faculte de Medecine, 13385 Marseille Cedex 05, France.

http://intapp.medscape.com/px/medlineap ... dings_file

=1&local_journals_only=0&searchstring=Bartonellosisagnosis

(33) Russell Regnery, Ph.D., and Jordan Tappero, M.D EID Volume 1 * Number 1 January-March

1995 Unraveling Mysteries Associated with Cat-Scratch Disease, Bacillary Angiomatosis, and Re-

lated Syndromes National Center for Infectious Diseases, Centers for Disease Control and Preven-

tion, Atlanta, Georgia, USA http://www.cdc.gov/ncidod/eid/vol1no1/regnery.htm

(34) Bacillary Angiomatosis Authored by Robert A Schwartz, MD, MPH, Professor and Head,

Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and

Community Health, UMDNJ-New Jersey Medical School Coauthored by W Clark Lambert,

MD, PhD, Professor and Head, Dermatopathology, Departments of Pathology and Dermatol

ogy, UMDNJ-New Jersey Medical School, Newark, New Jersey eMedicine Journal, November

2 2001, Volume 2, Number 11

http://www.emedicine.com/derm/topic44.htm

(35) Modi SP, Eppes SC, Klein JD Cat-scratch disease presenting as multifocal osteomyelitis with

thoracic abscess Pediatr Infect Dis J 2001 Oct;20(10):1006-7 (ISSN: 0891-3668)

http://intapp.Medscape.com/px/medlineap ... l_holdings

_file=1&local_journals _only=0&searchstring=Catscratch+disease+presenting+as+multifocal+

osteomyelitis

(36) Margileth AM, Baehren DF. Chest-wall abscess due to cat-scratch disease (CSD) in an

adult with antibodies to Bartonella clarridgeiae: case report and review of the thoracopulmonary

manifestations of CSD. Department of Pediatrics, Mercer University School of Medicine, Macon,

Georgia, USA Therapy Clin Infec Dis 1998 Aug;27(2):353-7

(37) Maurin M; Birtles R; Raoult D Current knowledge of Bartonella species. Eur J Clin Microbiol

Infect Dis 1997 Jul;16(7):487-506 (ISSN: 0934-9723) Unite des Rickettsies, CNRS UPRESA

6020, Universite de la Mediterrance, Faculte de Medecine, Marseille, France.

http://intapp.medscape.com/px/medlineap ... oldings_fi

le=1&local_journals_only=0&searchstring=Bartonella+%2B+fleas

(3 PEDIATRICS Vol. 101 No. 5 May 1998, p. e13 ELECTRONIC ARTICLE: Cat Scratch Disease

Presenting With Peripheral Facial Nerve Paralysis Robert S. Walter Division of General Pediat-

rics Department of Pediatrics Thomas Jefferson University duPont Hospital for Children Wil

mington, DE 19899 Stephen C. Eppes Division of Infectious Diseases Department of Pediatrics

Thomas Jefferson University duPont Hospital for Children Wilmington, DE 19899

http://www.pediatrics.org/cgi/content/full/101/5/e13

(39) Arisoy ES, Correa AG, Wagner ML, Kaplan SL. Clin Infect Dis 1999 Apr;28(4):778-84 Hepato-

splenic cat-scratch disease in children: selected clinical features and treatment. Department of

Pediatrics, Baylor College of Medicine, Texas Children?s Hospital, Houston, USA

http://www.journals.uchicago.edu/CID/jo ... 78.web.pdf

(40) Jared M. Frandson, MPH, Julie Rawlings, MPH, Christine R. Burgess, MPH, Kate A. Hen

dricks, MD, MPH&TM; Texas Department of Health, Austin. Cat-Scratch Disease in Texas.

2000. Infect Med 17(10):690-694.

http://id.medscape.com/SCP/IIM/2000/v17 ... .fran.html

(41) Gerber JE, Johnson JE, Scott MA, Madhusudhan KT., Fatal meningitis and encephalitis due to

Bartonella henselae bacteria Journal of Forensic Sciences, Volume: 47 Issue: 3 Year: 2002

Pages: 640-644

(42) Abbott et al. (1997) Experimental and natural infection with Bartonella henselae in cats. Comp.

Immunol. Microbiol. Infect. Dis. 20:41-51.

(43) Kordick et al. (1995) Prolonged Bartonella bacteremia in cats associated with cat-scratch dis-

ease patients. J. Clin. Microbiol. 33:3245-3251.

(44) Pierre Houpikian and Didier Raoult* Journal of Clinical Microbiology, August 2001, p. 2768-

2778, Vol. 39, No. 80095-1137/01/$04.00+0 DOI: 10.1128/JCM.39.8.2768-2778.2001 Copyright ©

2001, American Society for Microbiology. All rights reserved. 16S/23S rRNA Intergenic Spacer Re-

gions for Phylogenetic Analysis, Identification, and Subtyping of Bartonella Species Unité des Rick

ettsies, CNRS-UPRES-A 6020, Faculté de Médecine de Marseille, 13385 Marseille Cedex, France

Corresponding author.Mailing address: Unité des Rickettsies, Faculté de Médecine, 27 boulevard

Jean Moulin, 13006 Marseille, France. Phone: 33 4 91 38 55 17. Fax: 33 4 91 38 77 72.

E-mail: Didier.Raoult@medecine.univ-mrs.fr.

http://jcm.asm.org/cgi/content/full/39/8/2768#FN150

(45) Zhongxing Liang, Bernard La Scola, Hubert Lepidi, and Didier Raoult* Clinical and Diagnostic

Laboratory Immunology, 1071-412X/01/$04.0010 DOI: 10.1128/CDLI.8.4.847?849.2001 July 2001,

p. 847?849 Vol. 8, No. 4 Copyright © 2001, American Society for Microbiology. All Rights Re-

served. Production of Bartonella Genus-Specific Monoclonal Antibodies Unite´ des Rickettsies,

CNRS UPRES-A 6020, Faculte´ de Me´decine, Universite´ de la Mediterrane´e, 13385 Marseille

Ce´dex, France Received 26 October 2000/Returned for modification 22 January 2001/Accepted 3

April 2001

http://cdli.asm.org/cgi/reprint/8/4/847.pdf

(46) KUSABA1), Hiroshi YOSHIDA1), Michihiro SUMINO1) & Michio SATA2) 1) Longitudinal Study

of Serological Response to Bartonella henselae by Indirect Fluorescence Assay in Cat Scratch Dis-

ease Nobuhide Department of Medicine, Yame General Hospital 2)Second Department of

Medicine, Kurume University School of Medicine, Kurume Language JA Page 557-561 Received

JAN 9, 2001 Accepted APR 13, 2001

http://www.kansensho.or.jp/journal/2001/075070557e.html

(47) The Beth Israel Deconess Medical Housestaff Manual,

http://home-dev.caregroup.org/UGmanual/ ... ctions.htm

(4 Ralf Schüleina,b, Anja Seuberta,b, Christian Gilleb, Christa Lanzb, Yves Hansmannc, Yves Piémontc, and

Christoph Dehioa,b Invasion and persistent intracellular colonization of erythrocytes. A unique para-

sitic strategy of the emerging pathogen Bartonella. a Biozentrum of the University of Basel, Department

of Molecular Microbiology, CH-4056 Basel, Switzerland b Max Planck Institute for Biology, Department of

Infection Biology, D-72076 Tübingen, Germany c Institute of Bacteriology, Faculty of Medicine, University

Louis Pasteur, F-67000 Strasbourg, France Correspondence to: Christoph Dehio, Biozentrum of the University

of Basel, Dept. of Molecular Microbiology, Klingelbergstrasse 70, CH-4056 Basel, Switzerland. Tel:41-61-

267-2140 Fax:41-61-267-2118 E-mail:christoph.dehio@unibas.ch. J Exp Med. 2001 May 7;193(9):1077-

86. PMID: 11342592 [PubMed - indexed for MEDLINE]

http://www.jem.org/cgi/content/full/193/9/1077

(49) Hercik K, Melter O, Janecek J, Branny P. Mol Cell Probes 2002 Feb;16(1):49-56 In situ detection

of Bartonella henselae cells.Division of Cell and Molecular Microbiology, Institute of Microbiology,

Czech Academy of Sciences, Prague, Czech Republic.

http://www.ncbi.nlm.nih.gov/entrez/quer ... list_uids=

12005447&dopt=Abstract

(50) Cassandra D. Salgado and Martin E. Weisse Transverse Myelitis Associated with Probable Cat-

Scratch Disease in a Previously Healthy Pediatric Patient Clinical Infectious Diseases 2000;31:609-

611 Department of Pediatrics, West Virginia University, Morgantown

http://www.journals.uchicago.edu/CID/jo ... 94179.html

(51) Brigid Kane 41st Interscience Conference on Antimicrobial Agents and Chemotherapy Daily Ses-

sion Coverage: Clueless in Chicago: When Diagnosis is Difficult, Chicago, Tuesday, December 18,

2001 http://www.medscape.com/viewarticle/420053

(52) Authors: Hubalek Z, Halouzka J, Juricova Z Title: Investigation of haematophagous arthropods

for borreliae--summarized data, 1988-1996. Source: Folia Parasitol (Praha) 1998;45(1):67-72
Organization: Institute of Landscape Ecology, Academy of Sciences of the Czech Republic, Brno,

Czech Republic.

(53) Characterization of Bartonella Strains from Russia and the USA Leading Institute: Gamalei

Institute of Epidemiology and Microbiology, Moscow, Russia Supporting institutes: Moscow Medi-

cine Academy, Moscow, Russia Collaborators: US Department of Health & Human Services /

Centers for Disease Control and Prevention, Atlanta, GA, USA

http://www.tech-db.ru/istc/db/projects.nsf/prjn/2223

(54) van Tooren RM, van Leusen R, Bosch FH. Neth J Med 2001 Nov;59(5):218-24 Culture negative

endocarditis combined with glomerulonephritis caused by Bartonella species in two immunocompe-

tent adults. St. Lucas/Andreas Ziekenhuis, Amsterdam, The Netherlands.

http://www.ncbi.nlm.nih.gov/entrez/quer ... list_uids=

11705641 &dopt=Abstract

(55) Kerkhoff, F. T., A. M. C. Bergmans, A
Viimeksi muokannut soijuv päivämäärä Su Loka 25, 2009 18:04, muokattu yhteensä 4 kertaa
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Ma Syys 21, 2009 10:10

Keuhkosiirron saaneelle henkilölle kehittyi bartonella (2009).

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 - in process]
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Ma Syys 21, 2009 23:23

Bartonella voi aiheuttaa uveiitin.

Suom.huom. Uveiitti on usein systeemisen immunologisen tai systeemisen infektiotaudin ilmentymä... Uveiitti ei ole spesifinen tauti vaan yhteinen nimi värikalvon, sädekehän ja suonikalvon tulehdukselle. Yleisemmin se tarkoittaa minkä tahansa silmänsisäisen rakenneosan tulehdusta lasiainen ja verkkokalvo mukaan luettuina. Tulehdukseen voi olla ilmeinen syy: silmään kohdistuva vamma, silmänsisäinen leikkaus tai sarveis- tai kovakalvon tulehduksen leviäminen silmänsisäisiin kudoksiin.

...Potilaan silmä on valonarka ja verestää perikorneaalialueelta tai silmää särkee ehkä vain lievästi mutta potilas valittaa liikkuvia hiutaleita näkökentässään ja näön heikkenemää.


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-Salpetriere Hospital, AssistancePublique-Hopitaux de Paris, Paris. PMID: 19548998 [PubMed - as supplied by publisher]
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Ma Syys 21, 2009 23:36

Bartonella voi aiheuttaa sydämen sisäkalvon tulehduksen ihmisille ja eläimille.

Ann N Y Acad Sci. 2009 May;1166:120-6. Bartonella endocarditis: a pathology shared by animal reservoirs and patients. Chomel BB, Kasten RW, Williams C, Wey AC, Henn JB, Maggi R, Carrasco S, Mazet J,Boulouis HJ, Maillard R, Breitschwerdt EB. Department of Population Health and Reproduction, School of Veterinary Medicine,University of California, Davis, California 95616, USA. bbchomel@ucdavis.edu Bartonellae were first recognized to cause endocarditis in humans in 1993 whencases caused by Bartonella quintana, B. elizabethae, and B. henselae werereported. Since the first isolation of Bartonella vinsonii subspecies berkhoffiifrom a dog with endocarditis, this organism has emerged as an important pathogenin dogs and an emerging pathogen in people. Subsequently, four types of B.vinsonii subsp. berkhoffii have been described, all of which have beenassociated with endocarditis in dogs. A limited number of dog endocarditis caseshave also been associated with B. clarridgeiae, B. washoensis, B. quintana, andB. rochalimae. The second canine B. clarridgeiae endocarditis case is presented.The clinical and pathological characteristics of Bartonella endocarditis in dogsare similar to disease observed in humans, more often affecting the aorticvalve, presenting with highly vegetative lesions with accompanyingcalcification, and in most instances high antibody titers. Pathological featuresin dogs include a combination of fibrosis, mineralization, endothelialproliferation, and neovascularization with variable inflammation. Endocarditishas also been described in animal species, which are the natural reservoir ofspecific Bartonella species, once thought to be solely healthy carriers of thesepathogens. A few Bartonella endocarditis cases, including B. henselae, have beenreported in cats in the USA and Australia. The second case of B. henselae typeHouston I identified in the USA is presented. Furthermore, two cases of B. bovisendocarditis were recently described in adult cows from France. Finally,on-going investigation of valvular endocarditis in free-ranging Alaskan seaotters suggests the involvement of Bartonella species. PMID: 19538271 [PubMed - in process]
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Su Loka 04, 2009 17:38

Borrelia- ja bartonellabakteerit voivat aiheuttaa erilaisia ongelmia silmissä, esim. silmähermossa. Alla on aihetta käsitteleviä tutkimuksia.

Kolme bartonella-tutkimusta: Bartonella voi aiheuttaa erilaisia ongelmia silmiin; glaukooma, näönmenetys, neuroretiniitti.



1. Secondary unilateral glaucoma and neuroretinitis: atypical manifestation of cat-scratch disease.

Ziemssen F, Bartz-Schmidt KU, Gelisken F.

Jpn J Ophthalmol. 2006 Mar-Apr;50(2):177-9. No abstract available.

PMID: 16604397 [PubMed - indexed for MEDLINE]


2: Bartonella henselae infection associated with neuroretinitis, central retinal artery and vein occlusion, neovascular glaucoma, and severe vision loss.

Gray AV, Michels KS, Lauer AK, Samples JR.

Am J Ophthalmol. 2004 Jan;137(1):187-9.

PMID: 14700670 [PubMed - indexed for MEDLINE]


3. Bartonellaa ja borrelioosia sairastavalla neuroretiniitti.


Eye (2009) 23, 1607; doi:10.1038/eye.2008.288; published online 12 September 2008

Neuroretinitis secondary to concurrent infection with cat scratch disease and lyme disease
Conflict of interest: None Funding: None

P K Gupta1, R Patel2 and M T Bhatti1,3

1Department of Ophthalmology, Duke University Eye Center and Duke University Medical Center, Durham, NC, USA
2Department of Ophthalmology, Medical College of Georgia, Augusta, GA, USA
3Department of Medicine, Division of Neurology, Duke University Medical Center, Durham, NC, USA
Correspondence: MT Bhatti, E-mail: tariq.bhatti@duke.edu

-----------------------------------------------------------------------------

Kolme bartonellakantaa, mukaanlukien Bartonella henselae, aiheuttavat toisinaan vasoproliferatiivisia kasvaimia silmän retinaan.

Research Highlight
Nature Reviews Microbiology 7, 406 (June 2009) | doi:10.1038/nrmicro2156

Type IV secretion: A sprouting interest in Bartonella
Sheilagh Molloy

Three Bartonella species, including Bartonella henselae, infect endothelial cells and can cause the formation of benign vasoproliferative tumours in humans in a manner that is reminiscent of tumour angiogenesis. Previously, our understanding of how Bartonella species trigger this complex process has been hindered by the fact that the existing animal and cell culture models do not directly recapitulate this feature of Bartonella infection. Writing in Cellular Microbiology, Scheidegger and colleagues now report on the creation of a new in vitro model of Bartonella-induced angiogenesis.

Scheidegger and colleagues decided to adapt an existing three-dimensional cell culture model of angiogenesis. Human umbilical vein endothelial cells (HUVECs) were infected with B. henselae at a high multiplicity of infection for 24 hours. The infected cells were then grown overnight in a humidified atmosphere as hanging drops in endothelial growth medium containing methylcellulose. These growth conditions led to the formation of endothelial cell spheroids, which were then embedded within a collagen gel matrix. The effects of different factors on angiogenesis could then be quantified by assessing the formation of capillary-like projections, or sprouts, by the spheroids.


CFSE

DAPI

bepA?G

bepA?G + pbepA

Light microscopy images of spheroids infected either with a bepA?G mutant or an isogenic strain that expresses BepA (bepA?G + pbepA). The cells have been stained for nuclei (using DAPI (4',6-diamidino-2-phenylindole)) or entire cells (using CFSE (carboxyfluorescein succinimidyl ester)).Images courtesy of F.Scheidegger, University of Basel, Switzerland.

B. henselae uses a VirB/D4 type IV secretion system (T4SS) to transport Bartonella effector proteins (Beps) into host cells, and seven Beps (BepA?BepG) have been identified to date. Scheidegger et al. began work with their new in vitro model by pre-infecting the HUVECs with wild-type B. henselae, a B. henselae mutant strain that lacks the VirB/D4 T4SS and a bepA?bepG mutant strain that lacks all known effectors. A comparison of the cumulative length of the capillary sprouts formed revealed that although there is a basal level of B. henselae-induced angiogenesis that is independent of the VirB/D4 T4SS, there is also a strong VirB/D4-and Bep-dependent response. The authors went on to analyse the angiogenic response to isogenic strains of bepA?G mutants that expressed the individual bep genes on a plasmid in trans and to isogenic mutants that carried in-frame deletions of the individual bep genes. Taken together, the results showed that two Beps, BepA and BepD, have pro-angiogenic activity and that one Bep, BepG, has anti-angiogenic activity.

This new in vitro model has enabled researchers to begin to make progress on understanding the molecular events that underlie B. henselae-triggered angiogenesis. Further work using this system will hopefully bring us closer to answering the key question of whether angiogenesis is a cause or consequence of Bartonella infection.

References and links
ORIGINAL RESEARCH PAPER
Scheidegger, F. et al. Distinct activities of Bartonella henselae type IV secretion effector proteins modulate capillary-like sprout formation. Cell. Microbiol. 12 Mar 2009 (doi: 10.1111/j.1462-5822.2009.01313.x

FURTHER READING
Dehio, C. Bartonella?host cell interactions and vascular tumour formation. Nature Rev. Microbiol. 3, 621?631 (2005)

-----------------------------------------------------------------------------

Englanti 2009. Bartonella aiheutti potilaalle imusolmuketaudin (lymfadenopatia):



Int J STD AIDS. 2009 Aug;20(: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 SW10 9NH.

We report the case of a patient who presented to a clinic for evaluation ofinguinal lymphadenopathy. Histology of the lymph nodes revealed micoabscessformation suggesting infection with Lymphogranuloma venereum (LGV) or Bartonellahenselae - the causative agent in cat scratch disease (CSD). The patientrecalled no preceding animal exposure. Clinical and serological findingsinitially suggested early LGV but convalescent serology supported CSD. Thisserves as an important reminder that B. henselae infection should be considereda cause of regional lymphadenopathy in individuals suspected of having LGV. http://eutils.ncbi.nlm.nih.gov/entrez/e ... rlinksPMID: 19625597 [PubMed - in process]

-----------------------------------------------------------------------------

Borreliabakteerin aiheuttamat silmämuutokset voivat olla erilaisia tulehduksellisia tiloja. Bakteeri voi aiheuttaa myös näköhermosairauden.

Borreliabakteeri aiheutti 57-vuotiaalle saksalaiselle miehelle silmätulehduksen joka ei parantunut suonensisäisellä keftriaksonihoidolla (Rocephalin).



Klin Monatsbl Augenheilkd. 1998 Dec;213(6)

Pars plana vitrectomy in Borrelia burgdorferi endophthalmitis


Meier P, Blatz R, Gau M, Spencker FB, Wiedemann
Klinik und Poliklinik für Augenheilkunde der Universität Leipzig.

BACKGROUND: Ocular manifestations of Lyme borreliose present with unusual forms of conjunctivitis, keratitis, optic nerve disease, uveitis, vitritis and rarely endophthalmitis.

CASE REPORT: A 57-year-old man working as logger in Sax-ony- nhalt suffering from an endophthalmitis on his left eye was referred to us. The vision of his left eye was intact light perception and hand motions. The slit-lamp examination revealed severe inflammation of the anterior chamber with hypopyon, posterior synechiae, and opacity of the posterior lens capsule. Funduscopy showed no red reflex, no retinal details. In the local hospital serum analysis was performed and showed in Western-Blot IgM- and IgG- ntibodies against Borrelia burgdorferi. Despite of intravenous application of ceftriaxon for 14 days panuveitis persisted, and endophthalmitis developed when antibiotic therapy was finished.

RESULTS: During pars plana vitrectomy a sharply delineated cystic lesion containing yellowish fluid was revealed, and creamy yellow fluid was aspirated. Microscopically in hematoxylineosin stained slides of the aspirate structures consistent with Borrelia burgdorferi were found. Postoperatively vision increased to 1/15. Despite of a second intravenous ceftriaxon treatment for 14 days we observed a retinal vasculitis in the follow up of 6 months.

CONCLUSIONS: Despite intravenous ceftriaxon-therapy borrelia burgdorferi must have survived in the vitreous body. Further investigations are required with respect to the use of other antibiotics or immunosuppressives.

PMID: 10048013


Espanja 2009. 64-vuotiaalla naisella esiintyi verkkokalvolla tarkan näön alueella muutoksia (macular star) sekä näköhermon turvotusta. Potilaalla oli positiivinen Bartonella henselae -löydös.

24-vuotiaalla naisella ilmeni molemminpuolinen näköhermon turvotus. Potilaalla oli positiivinen klamydialöydös.

Bartonella on yleisin neuroretiniitin aiheuttaja. Yleisimmät löydökset: papillan turvotus, makulassa muutoksia (macular star), lasimainen tulehdus, AV-puutos, verenvuotoa hermosäikeissä, pumpulimainen erite. Antibioottien tehosta ei ole varmaa tietoa mutta suun kautta otettava siprofloksasiini on osoittautunut tehokkaaksi.

Suom.huom. Fluorokinolonien haitoista tulee jatkuvasti uutta tietoa. Siksi niiden aiheuttamista mahdollisista haitoista on syytä olla tietoinen.

Kyseisen antibioottiryhmän on todettu aiheuttavan joillekin silmäongelmia - kaksoiskuvia näkökentässä. Fluorokinolonien aiheuttamista jännetulehduksista ja jänteiden repeämistä on kirjallisuudessa useita mainintoja. Lääkettä käyttäneiden kokemuksia on asian tiimoilta runsaasti.

Antibiooteista klaritromysiini ja fluorokinolonit (erityisesti siprofloksasiini) ovat useimmin yhteydessä riskiin sairastua maniaan. Siprofloksasiinin aiheuttamista jännevaurioista raportoidaan myös toistuvasti. Alla aiheeseen liittyviä tutkimuksia esim. vain viikon mittaisen siprofloksasiinin käytön jälkeen henkilöllä todettiin (4 kk antibiootin käyttämisestä) kipua ja turvotusta akilles-jänteessä. Koepala vahvisti jännevauriot.



http://www.medscape.com/viewarticle/410546_3

-----------------------------------------------------------------------------

Arch Soc Esp Oftalmol. 2009 Aug;84(8 ):389-94. [Neuroretinitis. Clinical cases.] [Article in Spanish] Valverde-Gubianas M, Ramos-Lopez JF, Lopez-Torres JA, Toribio-Garcia M,Milla-Penalver C, Galvez Torres-Puchol J, Medialdea-Marcos S. Servicio de Oftalmologia, Hospital Universitario Virgen de las Nieves, Granada,Espana.

OBJECTIVE: Evaluate the etiology and the most frequent funduscopic alterationsof the neuroretinitis.

METHODS: We present the case of a woman 24 years old witha 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 .
(Arch Soc Esp Oftalmol 2009; 84: 389-394). Publication Types:English Abstract http://eutils.ncbi.nlm.nih.gov/entrez/e ... rlinksPMID: 19728239 [PubMed - in process]

-----------------------------------------------------------------------------


Fluorokinolonien haittoja käsitteleviä tutkimuksia:


Fluoroquinolones Linked to Diplopia

INFORMATION FROM INDUSTRY
Assess clinically focused product information on Medscape.
Click Here for Product Infosites ? Information from Industry.NEW YORK (Reuters Health) Sep 01 - New research suggests that fluoroquinolones may cause diplopia in some patients.

"According to World Health Organization criteria, the relationship between fluoroquinolone therapy and diplopia is 'possible'," conclude co-authors Dr. Frederick W. Fraunfelder and Dr. Frederick T. Fraunfelder from the Oregon Health and Science University, Portland.

"This causality assessment," explain the father-and-son researchers, "is based on the time relationship of drug administration and adverse drug reaction (ADR) development, the multiple positive dechallenge and rechallenge reports, and the plausible mechanism by which diplopia could occur: possible tendinitis of the extraocular muscles."

As reported in the September issue of Ophthalmology, the authors assessed the link between fluoroquinolone use and diplopia by analyzing 171 case reports from the National Registry of Drug-Induced Ocular Side Effects, World Health Organization, and Food and Drug Administration.

The reports involved 76 male patients, 91 females, and 4 patients for whom gender was not specified. The dosages varied between the different fluoroquinolones used, but usually the median dose was within the recommended range for the specific agent.

The median time from fluoroquinolone use to diplopia was 9.6 days, with a range of 1 day to 5 months. Concomitant tendinitis was seen in 17 patients. Forty-nine patients were 60 years or older, 1 subject had renal cysts, and 4 were using systemic anti-inflammatory steroids.

According to a statement from the authors, medication was discontinued in 53 patients, and diplopia resolved in all 53.

"Clinicians are encouraged to be aware of fluoroquinolone-associated diplopia and should consider stopping therapy after consultation with the prescribing physician if diplopia occurs," the authors conclude.

Also, they advise, fluoroquinolone-associated ocular effects should be reported to the National Registry of Drug-Induced Ocular Side Effects (www.eyedrugregistry.com).

Ophthalmology 2009.

-----------------------------------------------------------------------------

Antimicrobial Agents and Chemotherapy, February 2000, p. 261-266, Vol. 44, No. 2
Ultrastructure of Achilles Tendons of Rats Treated with Ofloxacin and Fed a Normal or Magnesium-Deficient Diet
Mehdi Shakibaei, 1Kerstin Pfister, 2 Rudolf Schwabe, 2 JÝrgen Vormann,3 and Ralf Stahlmann 2 ,* Institute of Anatomy, 1Institute of Clinical Pharmacology and Toxicology, 2and Institute of Molecular Biology and Biochemistry, 3Benjamin Franklin Medical Center, Freie Universität
Berlin, 14195 Berlin, Germany

ABSTRACT
Fluoroquinolones can cause tendinitis and tendon rupture. However, toxicological as well as clinical information on quinolone-induced tendopathy is scarce. We performed extensive electron microscopic studies with Achilles tendon specimens from ofloxacin-treated rats. The drug was given at a dose of 1,200 mg/kg (body weight) orally. Juvenile Wistar rats received one or three oral doses each of 1,200 mg of ofloxacin/kg (body weight)/day.
Three days after treatment, the tenocytes of their Achilles tendons showed degenerative alterations, such as multiple vacuoles and vesicles in the cytoplasm that had developed due to swellings and dilatations of cell organelles. Other indications of cell degradation were the occurrence of cell debris and cell detachment from the extracellular matrix accompanied by a loss of cell-matrix interaction.
The tenocytes of juvenile Wistar rats that had been treated at day 36 with a single oral dose of 1,200 mg of ofloxacin/kg (body weight) and sacrificed either 3 or 6 months later exhibited similar degenerative alterations. The number of degenerative alterations of tenocytes after ofloxacin treatment was considerably higher in rats that had received a magnesium-deficient diet than in rats with normal magnesium status. Of the adult rats that had been treated once, 5 times, and 10 times with ofloxacin and killed 1 day later, only those with the 10-times treatment showed a significantly increased number of degeneratively altered tenocytes.

In summary, effects observed in tendons show similar pathological features as described earlier in cartilage, indicating that quinolone-induced arthropathy and quinolone-induced tendopathy probably are different clinical manifestations of the same toxic effect on cellular components of connective tissue structures.

The full article is copyrighted by the publisher. If you to to the American Microbiological Society website , you can find out how to obtain the full article.

-----------------------------------------------------------------------------

* Corresponding author. Mailing address: Division of Biological Sciences, The University of Montana, 32 Campus Dr. 4824, Missoula, MT 59812-4824. Phone: (406) 243-6145. Fax: (406) 243-4304. E-mail: scott.samuels@umontana.edu .

Present address: Department of Medical Microbiology & Immunology, University of Wisconsin, Madison, WI 53706.

Present address: Department of Virology, Bristol-Myers Squibb Company, Wallingford, CT 06492.

Present address: Center for Microbial Pathogenesis, University of Connecticut Health Center, Farmington

-----------------------------------------------------------------------------

http://www.medscape.com/viewarticle/410546_3

Another patient had pain and swelling of one Achilles tendon 9 months after only a 1-week course of ciprofloxacin (500 mg bid). Biopsy of the tendon was done 4 months after the onset of symptoms. Histologic examination revealed abnormal fiber arrangement and structure with fibrotic areas, hypercellularity with some nuclei being more rounded, neovascularization, and increased glycosaminoglycans in the extracellular matrix.[4] These histologic findings are similar to those in tendon overuse injuries in athletes.[4]

Pefloxacin-Induced Achilles Tendon Toxicity in Rodents: Biochemical Changes in

In Vitro Discrimination of Fluoroquinolones Toxicity on Tendon Cells: Involvem

Magnesium deficiency and quinolone damage - horses

: Vet Pathol. 2001 Mar;38(2):143-8. Links
In vitro evidence for effects of magnesium supplementation on quinolone-treated horse and dog chondrocytes.Egerbacher M, Wolfesberger B, Gabler C.
Institute of Histology and Embryology, University of Veterinary
Medicine, Vienna, Austria.

Quinolones and magnesium deficiency cause similar lesions in joint cartilage of young animals. Chondrocytes cultivated in the presence of quinolones and in Mg-free medium show severe alterations in cytoskeleton and decreased ability to adhere to the culture dish. We investigated whether Mg2+ supplementation can prevent quinolone- ediated effects on chondrocytes in vitro. Chondrocytes cultivated in Dulbecco's modified Eagle's medium/HAM's F-12 medium were treated with ciprofloxacin (80 and 160 microg/ml) and enrofloxacin (100 and 150 microg/ml). Mg2+ was added at a concentration of 0.0612 mg/ml (MgCl) and 0.0488 mg/ml (MgSO4) or a triple dose. In addition, cells were cultivated in Mg-free medium and accordingly treated with Mg2+ supplementation. After 5 days in culture, the number of adherent cells per milliliter was determined. The number of chondrocytes in quinolone-treated groups decreased to 12-36% that of the control group within the culture period. With Mg2+ supplementation, the number of attached cells increased to 40-70% that of control cells. The threefold dose of Mg2+ led to better results than did the single dose. Cell proliferation tested by immunohistochemical staining with Ki67 (clone MIB5) decreased from 70% in control groups to 55%, 48%, and 30% in enrofloxacin-treated groups in a concentration dependent manner (50, 100, and 150 microg/ml). Addition of Mg2+ did not increase the rate of cell proliferation.

These results suggest that a great part of quinolone-induced damage
is due to magnesium complex formation, as Mg2+ supplementation is able to reduce the effects in vitro. However, quinolone effects on cell proliferation seem to be an independent process that is not influenced by magnesium supplementation

-----------------------------------------------------------------------------
J Clin Psychopharmacol. 2002 Feb;22(1):71-81. Links Antimicrobial-induced mania (antibiomania): a review of spontaneous reports.Abouesh A, Stone C, Hobbs WR.

Southern Virginia Mental Health Institute, Danville, VA 24541, USA.

The authors reviewed reported cases of antibiotic-induced manic episodes by means of a MEDLINE and PsychLit search for reports of antibiotic-induced mania. Unpublished reports were requested from the World Health Organization

(WHO) and the Food and Drug Administration (FDA). Twenty-one reports of antimicrobial-induced mania were found in the literature. There were 6 cases implicating clarithromycin, 13 implicating isoniazid, and 1 case each implicating erythromycin and amoxicillin. The WHO reported 82 cases. Of these, clarithromycin was implicated in 23 (27.6%) cases, ciprofloxacin in

12 (14.4%) cases, and ofloxacin in 10 (12%) cases. Cotrimoxazole, metronidazole, and erythromycin were involved in 15 reported manic episodes.

Cases reported by the FDA showed clarithromycin and ciprofloxacin to be the most frequently associated with the development of mania. Statistical analysis of the data would not have demonstrated a significant statistical correlative risk and was therefore not undertaken. Patients have an increased risk of developing mania while being treated with antimicrobials.

Although this is not a statistically significant risk, physicians must be aware of the effect and reversibility. Further research clearly is required to determine the incidence of antimicrobial-induced mania, the relative risk factors of developing an antimicrobial-induced manic episode among various demographic populations, and the incidence of patients who continue to have persistent affective disorders once the initial episode, which occurs while the patient is taking antibiotics, subsides. The authors elected to name this syndrome "antibiomania."

PMID: 11799346 [PubMed - indexed for MEDLINE]


Bartonella voi aiheuttaa uveiitin.

Suom.huom. Uveiitti on usein systeemisen immunologisen tai systeemisen infektiotaudin ilmentymä... Uveiitti ei ole spesifinen tauti vaan yhteinen nimi värikalvon, sädekehän ja suonikalvon tulehdukselle. Yleisemmin se tarkoittaa minkä tahansa silmänsisäisen rakenneosan tulehdusta lasiainen ja verkkokalvo mukaan luettuina. Tulehdukseen voi olla ilmeinen syy: silmään kohdistuva vamma, silmänsisänen leikkaus tai sarveis- tai kovakalvon tulehduksen leviäminen silmänsisäisiin kudoksiin.

...Potilaan silmä on valonarka ja verestää perikorneaalialueelta tai silmää särkee ehkä vain lievästi mutta potilas valittaa liikkuvia hiutaleita näkökentässään ja näön heikkenemää.



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-Salpetriere Hospital, AssistancePublique-Hopitaux de Paris, Paris. PMID: 19548998 [PubMed - as supplied by publisher]
-----------------------------------------------------------------------------------------------------------------
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Su Loka 04, 2009 18:38

USEITA BARTONELLAA KÄSITTELEVIÄ TUTKIMUKSIA:

Jopa yli kolmasosa Pohjois-Puolan järvialueen jyrsijöistä kantaa bartonellaa. Asialla on merkitystä myös ihmisten sairastumisriskejä kartoitettaessa.


Vector-Borne and Zoonotic Diseases

Bartonella spp. Infection in Rodents from Different Habitats in the Mazury Lake District, Northeast Poland

-----------------------------------------------------------------------------
To cite this paper:
Renata Welc-Faleciak, Anna Paziewska, Anna Bajer, Jerzy M. Behnke, Edward Sinski. Vector-Borne and Zoonotic Diseases. August 1, 2008, 8(4): 467-474. doi:10.1089/vbz.2007.0217.

-----------------------------------------------------------------------------
Renata Welc-Faleciak
Department of Parasitology, Institute of Zoology, University of Warsaw, Warsaw, Poland.
Anna Paziewska
Department of Parasitology, Institute of Zoology, University of Warsaw, Warsaw, Poland.
Anna Bajer
Department of Parasitology, Institute of Zoology, University of Warsaw, Warsaw, Poland.
Jerzy M. Behnke
School of Biology, University Park, University of Nottingham, Nottingham, United Kingdom.
Edward Siński
Department of Parasitology, Institute of Zoology, University of Warsaw, Warsaw, Poland.

Four rodent species (Clethrionomys glareolus, Apodemus flavicollis, Microtus arvalis, M. oeconomus) were captured in the period 2004?2006 in the Mazury Lake District, Northeast Poland, to determine the prevalence and genetic diversity of Bartonella species. The presence of bartonellae was assessed using polymerase chain reaction (PCR) with primers CS140f and BhCS1137n, amplifying a fragment of the gltA gene. Bartonella DNA was detected in 313 (30.6%) of 1024 rodents sampled: in 181 C. glareolus, 68 A. flavicollis, 50 M. arvalis, and 14 M. oeconomus, representing prevalence of 31.0%, 42.2%, 32.9%, and 11.1%, respectively. Comparison of the Bartonella gltA gene sequences from 38 isolates revealed six phylogenetic subgroups, out of 15 unique gltA sequences, and therein from one to five genotypic variants with homology of 88.6?99.1%. Six of 13 (46.2 %) isolates from C. glareolus were identical to B. grahamii, species associated with human illness. These results have important public health implication, notably in relation to the risk of infection in humans following exposure to rodent bartonellae.

-----------------------------------------------------------------------------

Bartonellan voi saada kissan puremasta tai raapaisusta. Tauti on ongelmallinen erityisesti sellaisille henkilöille joiden immuunipuolustus ei toimi kunnolla. Joitakin tautitapauksia on todettu myös Ruotsissa.


Emerg Infect Dis. 2008 Dec;14(12):1943-4. Bartonella henselae Antibodies after Cat Bite. Westling K, Farra A, Jorup C, Nordenberg A, Settergren B, Hjelm E. Karolinska Institutet, Stockholm, Sweden (K. Westling, A. Farra, C. Jorup, B.Settergren); and University Hospital, Uppsala, Sweden (A. Nordenberg, E. Hjelm).

To the Editor: Bartonella henselae is the causative agent of cat-scratchdisease, which is the most common form of human bartonellosis (1). Inimmunocompromised patients, e.g., HIV-infected patients, B. henselae can giverise to longstanding fever, bacillary angiomatosis, and peliosis hepatitis (2).Domestic cats are the reservoir for B. henselae, and cat fleas transmit theorganism between cats (3). The seroprevalence and culture findings of Bartonellaspp. in cats have been shown to be low in Sweden (4,5) compared with warmerareas (6). Cat-scratch disease is most often spread from cats to humans byscratches, but other forms of transmission, including cat bites, have beensuggested (7).

PMID: 19046527 [PubMed - in process]

-----------------------------------------------------------------------------

Tavalliset eurooppalaiset rotat kantavat mukanaan kirppuja joista
on löydetty bartonellabakteeria (bartonellaa on toisinaan myös
punkeissa). Bartonella voi aiheuttaa vakavia terveysongelmia, esim.
sydäntauteja, perna-, keskushermostotulehduksia.


Scientists discover 21st century plague

Bacteria that can cause serious heart disease in humans are being spread by
rat fleas, sparking concern that the infections could become a bigger
problem in humans. Research published in the December issue of the Journal
of Medical Microbiology suggests that brown rats, the biggest and most
common rats in Europe, may now be carrying the bacteria.

Since the early 1990s, more than 20 species of Bartonella bacteria have been
discovered. They are considered to be emerging zoonotic pathogens, because
they can cause serious illness in humans worldwide from heart disease to
infection of the spleen and nervous system.

"A new species called Bartonella rochalimae was recently discovered in a
patient with an enlarged spleen who had travelled to South America," said
Professor Chao-Chin Chang from the National Chung Hsing University in
Taiwan. "This event raised concern that it could be a newly emerged zoonotic
pathogen. Therefore, we decided to investigate further to understand if
rodents living close to human environment could carry this bacteria."

Scientists have found that rodents carry several pathogenic species of
Bartonella, such as B. elizabethae, which can cause endocarditis and B.
grahamii, which was found to cause neuroretinitis in humans. Although
scientists are unsure about the main route of transmission, these infections
are most likely to be spread by fleas. Ctenophthalmus nobilis, a flea that
lives on bank voles, was shown to transmit different species of Bartonella
bacteria. These pathogens have also been found in fleas that live on
gerbils, cotton rats and brown rats.

"We analysed bacteria found in Rattus norvegicus in Taiwan. The brown rat is
also the most common rat in Europe," said Professor Chang. "By analysing the
DNA of the bacteria, we discovered a strain that is most closely related to
B. rochalimae, which has been isolated recently from a human infection in
the United States".

The researchers took samples from 58 rodents, including 53 brown rats, 2
mice (Mus musculus) and 3 black rats (Rattus rattus). 6 of the rodents were
found to be carrying Bartonella bacteria; 5 of these were brown rats. Four
of the rodents were carrying B. elizabethae, which can cause heart disease
in humans, and one of the black rats was found to be harbouring B.
tribocorum. However, the scientists noticed one strain that had not been
identified in rodents previously. The strain was finally shown to be close
to B. rochalimae.

"Because of the small sample size used in this study, we cannot say for sure
that the common brown rat is spreading B. rochalimae," said Professor Chang.
"However, several different Bartonella bacteria are surely transmitted by
rodents. These results raise concerns about the existence of other
reservoirs and vectors for this emerging infection. This certainly warrants
further investigation."

Source: Society for General

-----------------------------------------------------------------------------

1. Bartonella henselae aiheuttaa ns. kissanraapimataudin. Bartonellan diagnostiikassa käytetyt serologiset testit ovat yhtä epäluotettavia kuin borrelioositestitkin - herkkyys n. 35 %. PCR-testin herkkyys osoittautui allaolevassa tutkimuksessa jonkin verran paremmaksi (56 %) B. henselaen aiheuttamissa rauhastulehdustapauksissa.

2. Bartonella voi aiheuttaa esim. akuutin aivotulehduksen. Allaolevassa tapauksessa 9-vuotiaalle pojalle kehittyi aivotulehdus. Kohtaukset pysyivät kurissa vuoden ajan karpamatsepiini-hoidolla (esim. epilepsian hoidossa yleisesti käytetty lääke). Puoli vuotta hoidon lopettamisesta oireet palasivat. Hoito aloitettiin uudelleen.



Pathol Biol (Paris). 2008 Oct 6; [Epub ahead of print]

[The diagnosis of cat scratch disease associated adenitis: Diagnostic value of serology and polymerase chain reaction.]

[Article in French]

Eglantin F, Hamdad F, El Samad Y, Monge AS, Sevestre H, Eb F, Schmit JL.

Service de maladies infectieuses et tropicales, CHU Nord, place Victor- auchet, 80054 Amiens, France.

The diagnosis of cat scratch disease (CSD) associated adenitis relies classically on the association of clinical, epidemiological and bacteriological criteria. The polymerase chain reaction (PCR) looks like a more competitive diagnostic trial than serology. We evaluated the sensitivity, specificity and predictive positive and negative values of serology in routine diagnosis of CSD.

A retrospective study over five years was led among patients presenting a suspicion of CSD and having a serology and/or a PCR. The Gold standard for diagnosis was PCR. The serological tests of Bartonella henselae was performed once in 482 patients, of which 2% (11 out of 482) were positive, and twice in only 39 patients (8%). The PCR diagnosis method for B. henselae was performed in biopsy of specimen lymph nodes in 28 patients and 14 out of 28 were positive. In nine patients, the diagnosis was exclusively made by PCR. Among the 14 patients whose PCR was negative, two had a positive serology and in three others patients, the serology was not performed. The sensitivity of serology was 35%, this confirms the low sensitivity of the serology in the CSD diagnosis. The diagnosis was confirmed in 56% of cases where PCR was performed. This led us to propose to perform systematically the PCR test for B. henselae in case of adenitis possibly associated with CSD.

PMID: 18842353 [PubMed - as supplied by publisher]


Emerg Med J. 2008 Oct;25(10):703-4. Cat scratch disease presenting as acute encephalopathy. Cherinet Y, Tomlinson R. Department of Paediatrics, Bristol Royal Hospital for Children, Paul O'GormanBuilding, Upper Maudlin Street, Bristol BS28BJ, UK. yonasc@hotmail.com An unusual case of primary meningo-encephalitis followed by partial complexseizure in a 9-year-old boy was found to be a symptom of cerebral Bartonellahenselae infection or cat scratch disease. Despite one clinical relapse at 4weeks post-presentation, he remained seizure free on carbamazepine for one year.Six months after stopping carbamazepine, however, he developed deja vu phenomenaand absence seizures with EEG abnormality. Restarting carbamazepine improved hissymptoms. PMID: 18843081 [PubMed - in process]

-----------------------------------------------------------------------------


Kuuden henkilön verinäytteistä löydettiin bartonellaa. Henkilöillä esiintyi kroonisia neurologisia oireita kuten ataksiaa, muistinmenetystä, vapinaa jne.


JOURNAL OF CLINICAL MICROBIOLOGY, Sept. 2008, p. 2856?2861 Vol. 46, No. 9
0095-1137/08/$08.00 0 doi:10.1128/JCM.00832-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.
Bartonella sp. Bacteremia in Patients with Neurological and
Neurocognitive Dysfunction
E. B. Breitschwerdt,1* R. G. Maggi,1 W. L. Nicholson,2 N. A. Cherry,1 and C. W. Woods3
Intracellular Pathogens Research Laboratory, Center for Comparative Medicine and Translational Research, College of
Veterinary Medicine, North Carolina State University, Raleigh, North Carolina1; Rickettsial Zoonoses Branch,
Centers for Disease Control and Prevention, Atlanta, Georgia2; and Duke University Medical Center,
Durham, North Carolina3
Received 1 May 2008/Returned for modification 16 June 2008/Accepted 10 July 2008

We detected infection with a Bartonella species (B. henselae or B. vinsonii subsp. berkhoffii) in blood samples
from six immunocompetent patients who presented with a chronic neurological or neurocognitive syndrome
including seizures, ataxia, memory loss, and/or tremors. Each of these patients had substantial animal contact
or recent arthropod exposure as a potential risk factor for Bartonella infection.

Additional studies should be performed to clarify the potential role of Bartonella spp. as a cause of chronic neurological and neurocognitive
dysfunction.

-----------------------------------------------------------------------------


Bartonellabakteerin aiheuttama infektio aiheutti hevoselle keskenmenon.


Vet Pathol. 2009 Jan 13. [Epub ahead of print] Links

Identification of Bartonella henselae in an Aborted Equine Fetus.

Johnson R, Ramos-Vara J, Vemulapalli R.

Purdue University, 406 S. University, West Lafayette, IN, 47907, United States of America.

This report describes the characterization of a Bartonella henselae abortion in an equine fetus by gross, histologic, immunohistochemical, ultrastructural, and molecular methods.

Bartonella henselae can cause cat scratch disease, bacillary angiomatosis, bacillary peliosis, and endocarditis in humans and other animals. The bacterium has been isolated from several mammalian species, but only recently from equids. However, it has not been linked to abortion in equids. An aborted equine fetus exhibited necrosis and vasculitis in multiple tissues, with intralesional Gram-negative, short to spirilar, bacteria. Nucleotide sequence analysis of the bacterial 16S rRNA gene amplified from the DNA extracted from fetal tissues revealed 99.9% identity to that of B. henselae. The presence of B. henselae in the fetal tissues was further confirmed by PCR amplification and nucleotide sequence analysis of other Bartonella species-specific genes. Microorganisms were immunohistochemically labeled with a monoclonal antibody to B. henselae and characterized ultrastructurally. Attempts to detect known causative agents of equine abortion were unsuccessful. Given the severity of vasculitis and association of the bacterium with lesions, we conclude that B. henselae infection caused the abortion of this foal.
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Su Loka 04, 2009 18:50

Bartonella aiheutti 7-vuotiaalle tytölle silmäongelmia, neuroretiniitin:


Eur J Ophthalmol. 2009 Mar-Apr;19(2):307-9. Bartonellosis causing bilateral Leber neuroretinitis: a case report. Hernandez-Da-Mota S, Escalante-Razo F. Clinica David, Unidad Oftalmologica, Morelia, Michoacan and General Hospital"Dr. Miguel Silva," SSA, Morelia, Michoacan - Mexico.

PURPOSE. Bartonella henselae is the causal agent of cat scratch disease and onevariation in its presentation is Leber neuroretinitis. The unilateral presenceof exudation as a macular star and papilledema represent its most commonpresentation.

METHODS. Observational case report. A 7-year-old girl presented asudden decrease of visual acuity and bilateral macular exudation (macular star)as well as choroiditis.

RESULTS. A complete recovery of visual acuity was seenafter a 6-week follow-up. Erythromycin plus deflazacort treatment was given.

CONCLUSIONS. The present case represents an unusual variety of cat scratchdisease. This represents a challenge in the differential diagnosis of diseasessuch as Lyme disease and tuberculosis among others.

PMID: 19253255 [PubMed - in process]

-----------------------------------------------------------------------------

Italialaisesta miehestä löytyi bartonella. Bakteeri aiheutti miehelle lymfadeniitin.


Journal of Clinical Microbiology, March 2009, p. 862-864, Vol. 47, No. 3
0095-1137/09/$08.00+0 doi:10.1128/JCM.01012-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

CASE REPORT

Isolation and Characterization of Bartonella quintana from the Parotid Gland of an Immunocompetent Man
Giustina Vitale,1 Salvatore Incandela,2 Cinzia Incandela,2 Anna Micalizzi,1 and Pasquale Mansueto1*
Dipartimento di Medicina Clinica e delle Patologie Emergenti, University of Palermo, Palermo, Italy,1 Dipartimento di Scienze Otorinolaringoiatriche, University of Palermo, Palermo, Italy2

Received 28 May 2008/ Returned for modification 1 October 2008/ Accepted 22 December 2008

We describe a case of the isolation of Bartonella quintana from the parotid gland of an apparently healthy man. Pathological examination showed intraparotid granulomatous abscessual lymphadenitis. Diagnosis was made on the basis of high titers of immunoglobulin G (IgG) and IgM antibodies and of culture isolation of a causative agent from parotid aspirate

Corresponding author. Mailing address: Dipartimento di Medicina Clinica e delle Patologie Emergenti, University of Palermo, Via del Vespro, 141-90127 Palermo, Italy. Phone: 39 (091) 6552970. Fax: 39 (091) 6555995. E-mail: pamansu@unipa.it

Published ahead of print on 7 January 2009.

-----------------------------------------------------------------------------

Bartonella henselae saattaa aiheuttaa esim. luuydintulehduksen, luumädän.


Rev Med Interne. 2009 Mar 18; [Epub ahead of print] [Cat scratch disease with bone involvement: A case report and literaturereview.] [Article in French] Roubaud-Baudron C, Fortineau N, Goujard C, Le Bras P, Lambotte O. Service de medecine interne, CHU de Bicetre, 78, rue du General-Leclerc, 94275Le Kremlin-Bicetre, France.

INTRODUCTION: Cat scratch disease is an infectious disease caused by Bartonellahenselae. Most of the patients present with a lymphadenopathy associated with alocal infection at the site of the cat scratch. Disseminated infection isu ncommon.

CASE REPORT: We report an immunocompetent 61-year-old woman whopresented with a systemic cat scratch disease including a multifocalosteomyelitis. Diagnosis was confirmed by PCR on the adenopathy. A literaturereview identified 51 other cases of osteomyelitis associated with cat scratchdisease, 14 of those confirmed by PCR.

CONCLUSION: Bone involvement in catscratch disease is rare, especially in adults. The diagnosis should be suspectedon the basis of patient questioning. The antibiotherapy and the place of surgeryare discussed.

PMID: 19303175 [PubMed - as supplied by publisher]
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Su Loka 04, 2009 18:58

Bartonella aiheuttaa sekä lemmikeille, esim. kissat ja koirat, sekä ihmisille lukuisia terveysongelmia, esim. sydäntulehduksia, rytmihäiriöitä, erilaisia silmäoireita kuten tulehduksia jne. Bartonella voi tarttua eläimestä ihmiseen esim. niissä olevien kirppujen tai punkkien välityksellä.


Bartonella spp. in pets and effect on human health.

http://www.thefreelibrary.com/Bartonell ... 0143341162

Among the many mammals infected with Bartonella spp., pets representa large reservoir for human infection because most Bartonella spp. infecting them are zoonotic Zoonotic
A disease which can be spread from animals to humans.

Mentioned in: Zoonosis . Cats are the main reservoir for Bartonella henselae Bartonella henselae Rochalimaea henselae Infectious disease A slender, fastidious coccobacillary bacterium of the normal flora of cats associated with bacteremia, endocarditis, cat-scratch disease, bacillary angiomatosis, peliosis hepatis; it may affect , B. clarridgeiae, and B. koehlerae. Dogs can be infected with B. vinsonii subsp, berkhoffii, B. henselae, B. clarridgeiae, B. washoensis, B. elizabethae, and B. quintana. The role of dogs as an important reservoir of Bartonella spp. is less clear than for cats, because domestic dogs are more likely to be accidental hosts, at least in nontropical regions. Nevertheless, dogs are excellent sentinels for human infections because a similar disease spectrum develops in dogs. Transmission of B. henselae by cat fleas is better understood, although new potential vectors (ticks and biting flies) have been identified. We review current knowledge on the etiologic agents, clinical features, and epidemiologic characteristics of these emerging zoonoses Zoonoses

Infections of humans caused by the transmission of disease agents that naturally live in animals. People become infected when they unwittingly intrude into the life cycle of the disease agent and become unnatural hosts. .

Bartonella spp. are fastidious

1. Possessing or displaying careful, meticulous attention to detail.

2. Difficult to please; exacting.

3. Having complex nutritional requirements. Used of microorganisms. , hemotropic, gram-negative bacteria that are mainly transmitted by vectors. Among the 11 species or subspecies subspecies, also called race, a genetically distinct geographical subunit of a species. See also classification. known or suspected to be pathogenic for humans, 6 have been isolated from pet dogs and cats (Table 1). Domestic cats are the principal reservoir for Bartonella henselae, the main agent of cat-scratch disease Cat-Scratch Disease Definition

Cat-scratch disease is an uncommon infection that typically results from a cat's scratch or bite. Most sufferers experience only moderate discomfort and find that their symptoms clear up without any lasting harm after a B. clarridgeiae, which has been suspected in a few cases of CSD; and B. koehlerae, recently reported as the cause of human endocarditis endocarditis (ĕn'dōkärdī`tĭs), bacterial or fungal infection of the endocardium (inner lining of the heart) that can be either acute or subacute. (1,4). Domestic dogs could be one of the reservoirs for B. vinsonii subsp, berkhoffii (reported as B. v. berkhoffii thereafter) because as it can cause prolonged bacteremia bacteremia: see septicemia.

-----------------------------------------------------------------------------
Bacteremia

Presence of bacteria in the blood. Short-term bacteremia follows dental or surgical procedures, especially if local infection or very high-risk surgery releases bacteria from isolated sites. in this species (5,6). Dogs can also be infected with B. henselae, B. clarridgeiae, B. washoensis, and B. elizabethae (2). Recently, 2 cases of endocarditis caused by B. quintana were diagnosed (P. Kelly et al., unpub, data). As with human disease, the clinical spectrum of Bartonella infection in dogs is expanding (2). Fleas play a major role in the transmission of feline Bartonella (7), but other potential vectors, such as ticks and biting flies have been recently identified to harbor Bartonella DNA DNA: see nucleic acid.

-----------------------------------------------------------------------------
DNA
or deoxyribonucleic acid

One of two types of nucleic acid (the other is RNA); a complex organic compound found in all living cells and many viruses. It is the chemical substance of genes. , including B. henselae (8,9). This article provides an update on the etiologic agents, new clinical features, and evolving epidemiologic characteristics of these emerging zoonoses. We will not discuss the diagnosis, treatment, and prevention of Bartonella infections, as several recent review articles have been written on this subject (1,2,10).

Feline Bartonella Species

B. henselae

Since the first isolation of B. henselae from a domestic cat in the early 1990s, several studies have been conducted worldwide to determine the importance of cats as a reservoir of this bacterium (reviewed in [2]). Prevalence of infection varies considerably among cat populations (strays of pets) with an increasing gradient from low in cold climates (0% in Norway) to high in warm and humid climates (68% in the Philippines) (2). At least 2 genotypes have been identified and designated Houston-1 (type I) and Marseille (previously BATF BATF
abbr.

Bureau of Alcohol, Tobacco, and Firearms ) (type II) (1,2). The respective prevalence of these 2 genotypes varies considerably among cat populations from different areas. B. henselae type Marseille is the dominant type in cat populations in the western United States Noun 1. western United States - the region of the United States lying to the west of the Mississippi River
West

Santa Fe Trail - a trail that extends from Missouri to New Mexico; an important route for settlers moving west in the 19th century , western Europe (France, Germany, Italy, the Netherlands, United Kingdom), and Australia, whereas type Houston-1 is dominant in Asia (Japan and the Philippines) (reviewed in [2]). However, within a given country, the prevalence may also vary among cat populations. For instance, in France, Marseille type was the most common type in cats from the Nancy and Paris areas, whereas type Houston-1 was the main genotype in cats from Lyon or Marseille (references cited in [2]). However, a few studies in western Europe and Australia have reported that most human cases of CSD were caused by B. henselae type Houston-1, despite the fact that type Marseille was found to be the dominant type in the cat population, which suggests that type Houston-1 strains could be more virulent to humans (2). Cats are usually bacteremic bac·te·re·mi·a
n.
The presence of bacteria in the blood.

-----------------------------------------------------------------------------

bacte·re for weeks to months, but some cats have been reported to be bacteremic for >1 year. Young cats ([less than or equal to] 1 year) are more likely than older cats to be bacteremic (11), and stray cats are more likely to be bacteremic than pet cats (1,2).

The clinical description of CSD was first reported in France by Debre et al. in 1950, but the etiologic agent was identified only in 1992 (1,2,6). The annual number of cases in the United States has been estimated to be between 22,000 and 24,000, with [approximately equal to] 2,000 cases that require hospitalization, and thousands of cases may occur yearly in Europe. In various studies, the seroprevalence seroprevalence Immunology The proportion of a population that is seropositive?ie, has been exposed to a particular pathogen or immunogen; the seropositivity of a population is calculated as the number of individuals who produce a particular antibody divided of antibodies to B. henselae in healthy persons has ranged from 3.6% to 6% (Table 2) and could be higher in some specific population groups, such as veterinarians, children, or elite orienteers (orienteering orienteering

Cross-country footrace in which each participant uses a map and compass to navigate between checkpoints along an unfamiliar course. Introduced in Sweden in 1918, it later spread throughout Europe. World championships have been held since 1966. is a sport in which participants compete to find points in the landscape using a map and compass). Table 2 gives comparative B. henselae seroprevalence data for cat and healthy human populations from selected countries, which suggests that seroprevalence is low in both cats and humans at northern latitudes and increases in warmer climates (11-24). Such data are informative and cannot exclude possible serologic se·rol·o·gy
n. pl. se·rol·o·gies

1. The science that deals with the properties and reactions of serums, especially blood serum.

2. cross-reactivity with some other Bartonella spp.

Despite the fact that B. henselae infection can cause meningitis and encephalitis encephalitis (ĕnsĕf'əlī`təs), general term used to describe a diffuse inflammation of the brain and spinal cord, usually of viral origin, often transmitted by mosquitoes, in contrast to a bacterial infection of the meninges , only 1 case of a fatal infection has been reported (5). CSD is more frequently observed in persons <20 years of age and in persons who own a young cat (<1 year of age, especially if this cat is infested in·fest
tr.v. in·fest·ed, in·fest·ing, in·fests

1. To inhabit or overrun in numbers or quantities large enough to be harmful, threatening, or obnoxious: with fleas) of in persons who have been scratched or bitten by a cat (1,2,6). In immunocompetent im·mu·no·com·pe·tent
adj.
Having the normal bodily capacity to develop an immune response following exposure to an antigen.

----------------------------------------------------------------------------

im persons, CSD is mainly characterized by a benign regional lymphadenopathy lymphadenopathy /lym·phad·e·nop·a·thy/ (-op´ah-the) disease of the lymph nodes.

----------------------------------------------------------------------------

angioimmunoblastic lymphadenopathy , angioimmunoblastic lymphadenopathy with dysproteinemia . Usually after a cat scratch, a papule papule /pap·ule/ (pap´ul) a small, circumscribed, solid, elevated lesion of the skin.pap´ular

----------------------------------------------------------------------------

pap·ule
n. pl. and then a pustule pustule /pus·tule/ (pus´tul) a small, elevated, circumscribed, pus-containing lesion of the skin.pus´tular
----------------------------------------------------------------------------

pus·tule
n.
1. develop within 7 to 12 days at the injection site, followed by a regional lymphadenopathy (usually involving a single lymph node lymph node

Small, rounded mass of lymphoid tissue contained in connective tissue. They occur all along lymphatic vessels, with clusters in certain areas (e.g., neck, groin, armpits). ) 1-3 weeks later that can persist for few weeks to several months. Low-grade fever, malaise, and aching are often reported; in some instances, headache, anorexia, and splenomegaly splenomegaly /sple·no·meg·a·ly/ (-meg´ah-le) enlargement of the spleen.

----------------------------------------------------------------------------

congestive splenomegaly Banti's disease; splenomegaly secondary to portal hypertension. can occur. Abscessed lymph nodes Lymph nodes
Small, bean-shaped masses of tissue scattered along the lymphatic system that act as filters and immune monitors, removing fluids, bacteria, or cancer cells that travel through the lymph system. are reported occasionally. In 5% to 9% of CSD patients, atypical manifestations may develop, including Parinaud oculoglandular syndrome, encephalitis, endocarditis, hemolytic anemiaHemolytic Anemia Definition

Red blood cells have a normal life span of approximately 90-120 days, at which time the old cells are destroyed and replaced by the body's natural processes.
..... Click the link for more information., hepatosplenomegaly, glomerulonephritis glomerulonephritis: see nephritis. , pneumonia, relapsing bacteremia, and osteomyelitis osteomyelitis (ŏs'tēōmī'əlī`tĭs), infection of the bone and bone marrow. Direct infection of bone usually occurs through open fractures, penetrating wounds, or surgical operations. .

On the basis of serologic testing or polymerase chain reaction polymerase chain reaction (pŏl`ĭmərās') (PCR), laboratory process in which a particular DNA segment from a mixture of DNA chains is rapidly replicated, producing a large, readily analyzed sample of a piece of DNA; the process is (PCR PCR polymerase chain reaction.

----------------------------------------------------------------------------

PCR
abbr.
polymerase chain reaction

-----------------------------------------------------------------------------

Polymerase chain reaction (PCR) ), several recent publications have associated B. henselae with uveitis uveitis

Inflammation of the uvea, the middle coat of the eyeball. Anterior uveitis, involving the iris or ciliary body (containing the muscle that adjusts the lens) or both, can lead to glaucoma and blindness. , focal retinal phlebitis phlebitis (fləbī`tĭs), inflammation of a vein. Phlebitis is almost always accompanied by a blood clot, or thrombus, in the affected vein, a condition known as thrombophlebitis (see thrombosis). , neuroretinitis, retinal and optical nerve neovascularization, and retinal artery and vein occlusions. Neurologic forms are rare, and patients usually completely recover within 1 year without sequelaesequelae Clinical medicine The consequences of a particular condition or therapeutic intervention
..... Click the link for more information.. Hepatosplenomegaly and osteolytic osteolytic adjective Causing bone breakdown bone lesions have been described in persons seropositiveseropositive /se·ro·pos·i·tive/ (-poz´i-tiv) showing positive results on serological examination; showing a high level of antibody.

----------------------------------------------------------------------------

se·ro·pos·i·tive
adj.
..... Click the link for more information. for B. henselae. Pseudotumoral lesions involving the mammary glands, the liver, or the spleen and, recently, glomerulonephritis and cases of monoclonal and biclonal gammopathy biclonal gammopathy Oncology The presence of 2 clonal expansions?IgG > IgA > IgM, in the same Pt;2⁄3 of BGs are of undetermined significance;1⁄3 have also been associated with B. henselae antibodies. Cases of prolonged fever without adenopathy, chronic fatigue, hemolytic anemia, thrombocytopenic purpura thrombocytopenic purpura
n.
See idiopathic thrombocytopenic purpura. , Henoch-Schonlein purpuraHe·noch-Schönlein purpura
n.
A form of nonthrombocytopenic purpura occurring most commonly in boys and associated with pain or swelling of the joints, colic, vomiting of blood, passage of bloody stools, and sometimes inflammation of the kidneys.
..... Click the link for more information. syndrome, pleuritis, pneumonia, and even paronychia paronychia /par·onych·ia/ (par?-ah-nik´e-ah) inflammation involving the folds of tissue around the fingernail.

-----------------------------------------------------------------------------

par·o·nych·i·a
n.
Inflammation of the tissue surrounding a nail. have been reported in patients who were seropositive for B. henselae (1,2). Usually, these clinical manifestations disappear in a few weeks to a few months. Bacteremia is rarely detected in immunocompetent persons. Several cases of endocarditis have been associated with B. henselae infection, most frequently in persons with preexisting pre·ex·ist or pre-ex·ist
v. pre·ex·ist·ed, pre·ex·ist·ing, pre·ex·ists

v.tr.
To exist before (something); precede: Dinosaurs preexisted humans.

v.intr. valvular valvular /val·vu·lar/ (val´vu-ler) pertaining to, affecting, or of the nature of a valve.

-----------------------------------------------------------------------------

val·vu·lar
adj.
Relating to, having, or operating by means of valves or valvelike parts. lesions. Besides B. henselae, most human cases of Bartonella endocarditis are caused by B. quintana, but a few cases of endocarditis or myocarditis Myocarditis Definition

Myocarditis is an inflammatory disease of the heart muscle (myocardium) that can result from a variety of causes. While most cases are produced by a viral infection, an inflammation of the heart muscle may also be instigated by have been associated with B. elizabethae (1 case), B. vinsonii berkhoffii (1 case), B. vinsonii arupensis (1 case), B. koehlerae (1 case), B. washoensis (1 case), and B. alsatica (1 case) (Table 3).

In immunocompromised immunocompromised /im·mu·no·com·pro·mised/ (-kom´pro-mizd) having the immune response attenuated by administration of immunosuppressive drugs, by irradiation, by malnutrition, or by certain disease processes (e.g., cancer). patients, B. henselae infection can cause prolonged fever, prolonged bacteremia, or both (1,2,6). Bacillary angiomatosis Bacillary Angiomatosis Definition

A life-threatening but curable infection that causes an eruption of purple lesions on or under the skin that resemble Kaposi's sarcoma. or peliosis is usually observed in highly immunocompromised persons (low CD4 count), who often are infected with HIV HIV (Human Immunodeficiency Virus), either of two closely related retroviruses that invade T-helper lymphocytes and are responsible for AIDS. There are two types of HIV: HIV-1 and HIV-2. HIV-1 is responsible for the vast majority of AIDS in the United States. . Several severe infections have also been reported in organ transplant recipients (1,2).

The clinical spectrum of the infection in cats has not been fully investigated, but naturally infected cats primarily seem to be healthy carriers of the bacterium (1,2,6). However, cases of uveitis and rare cases of endocarditis have been molecularly associated with infection caused by B. henselae. Seropositive cats were more likely to have kidney disease and urinary tract infections, stomatitis Stomatitis Definition

Inflammation of the mucous lining of any of the structures in the mouth, which may involve the cheeks, gums, tongue, lips, and roof or floor of the mouth. , and lymphadenopathy. In experimentally infected cats, fever, lymphadenopathy, mild neurologic signs, and reproductive disorders have been reported.

B. clarridgeiae

B. clarridgeiae was first isolated in the United States from the pet cat of an HIV-positive patient (25). This Bartonella sp. has been less frequently isolated from domestic cats than B. henselae because it appears to be more difficult to isolate and is unevenly distributed in cat populations worldwide. A B. clarridgeiae prevalence of 17% to 36% among all Bartonella isolates was reported in studies conducted in France, the Netherlands, the Philippines, and Thailand (2,22). However, B. clarridgeiae represented [less than or equal to] 10% of all isolates from domestic cats in the southeastern United States, Japan, or Taiwan (2) and has never been isolated in studies conducted in Europe, Australia, and North America (2). No specific pathologic features have been associated with natural infection in cats. However, in experimentally coinfected cats (B. henselae type II and B. clarridgeiae), clinical signs were minimal, and gross necropsy necropsy /nec·rop·sy/ (nek´rop-se) examination of a body after death; autopsy.

-----------------------------------------------------------------------------

nec·rop·sy
n.
See autopsy.

----------------------------------------------------------------------------

necropsy

examination of a body after death. See also autopsy. results were unremarkable, but histopathologic examination showed peripheral lymph node hyperplasia, splenic splenic /splen·ic/ (splen´ik) pertaining to the spleen.

----------------------------------------------------------------------------

splen·ic
adj.
Of, in, near, or relating to the spleen.

-----------------------------------------------------------------------------

splenic

pertaining to the spleen. follicular fol·lic·u·lar
adj.
1. Relating to, having, or resembling a follicle or follicles.

2. Affecting or growing out of a follicle or follicles. hyperplasia, lymphocytic cholangitis/pericholangitis, lymphocytic hepatitis, lymphoplasmacytic myocarditis, and interstitial lymphocytic nephritis nephritis (nəfrī`təs), inflammation of the kidney. The earliest finding is within the renal capillaries (glomeruli); interstitial edema is typically followed by interstitial infiltration of lymphocytes, plasma cells, eosinophils, and a (26). In humans, B. clarridgeiae has never been isolated or detected by molecular methods. However, B. clarridgeiae could be a minor causative agent of CSD, as the presence of B. clarridgeiae antibodies were reported in a suspect case of CSD and in a patient with a chest-wall abscess abscess, localized inflamation associated with tissue necrosis. Abscesses are characterized by inflamation, which is due to the accumulation of pus in the local tissues, and often painful swelling. (reviewed in [2]). Furthermore, anti-flagella (FlaA)--specific antibodies against B. clarridgeiae were detected by immunoblotting immunoblotting,
n the immunologic methods for isolating and quantitatively measuring immunoreactive substances. When used with immune reagents such as monoclonal antibodies, the process is known generically as Western blot analysis. in 28 (3.9%) of 724 patients with lymphadenopathy but in none of 100 healthy controls. However, substantial cross-reactivity between B. henselae and B. clarridgeiae detected by indirect fluorescence antibody assay was noted in human sera in a recent study from Japan (2).

B. koehlerae

B. koehlerae is a Bartonella sp. that has rarely been isolated from domestic cats worldwide, as it is a very fastidious bacterium (2,4). Until recently, it had been isolated only from 2 cats in California and 1 cat in France (2,4,27). The first human case of B. koehlerae endocarditis was reported from Israel in 2004 (2). Furthermore, these authors were able to isolate B. koehlerae from a bacteremic stray cat from that country.

B. quintana and B. bovis

A few suspect cases of CSD and cases of bacillary angiomatosis or endocarditis have been associated with B. quintana, for which the only risk factor identified was a contact with cats or cat fleas (3). Furthermore, the identification of B. quintana DNA in cat fleas (28 ) and recently in the dental pulp of a cat (3) has raised the question as to whether cats might be a possible source of human infection. However, B. quintana has not yet been isolated from naturally infected cats anywhere in the world where epidemiologic studies have been conducted to detect Bartonella-bacteremic cats. Similarly, 2 cats infected with B. quintana did not become bacteremic but seroconverted (29). Subsequently, both cats became bacteremic when challenged with B. henselae.

A few cases of B. bovis (formerly B. weissii) infections have been reported in cats from Illinois and Utah in the United States (1). The epidemiologic role of cats for this organism is still unknown.

Dogs as Sentinels for Human Infections?

Dogs can be infected with B. v. berkhoffii, B. henselae, B. clarridgeiae, B. washoensis, B. elizabethae, and B. quintana (2, P. Kelly et al., unpub. data). However, the role of dogs as a major reservoir of Bartonella spp. is not clear. Current evidence suggests that domestic dogs are more likely to be accidental hosts of various Bartonella spp., at least in nontropical regions. Nevertheless, domestic dogs could be one of the reservoirs for B. v. berkhoffii, as it causes prolonged bacteremia in this species (5, 6). The epidemiologic situation is quite distinct between tropical areas where several studies have shown a high prevalence of B. v. berkhoffii antibodies, especially in stray dogs, and more northern latitudes, where very low antibody prevalence has been detected in domestic dogs, especially among pets. In sub-Saharan Africa, seroprevalence of 26% in dogs in Senegal and up to 65% in native dogs from Sudan has been reported (1). In North Africa, we found that 38% of 147 dogs from Morocco were seropositive for B. v. berkhoffii (30). In 113 dogs from the Reunion Island, in the Indian Ocean, a seroprevalence of 18% was reported in stray dogs, whereas only 3% of dogs examined at veterinary clinics were seropositive, and no dog was bacteremic (31). In Thailand, 38% of sick dogs who exhibited fever, anemia, or thrombocytopenia Thrombocytopenia Definition

Thrombocytopenia is an abnormal drop in the number of blood cells involved in forming blood clots. These cells are called platelets. were seropositive for B. v. berkhoffii (1). On the contrary, studies in the United States and Europe reported a seroprevalence of <5% in domestic dogs; selected dog populations were at higher risk, including rural dogs and government working dogs (2). However, concerns about false-positive results in animals should be raised, as specificity and sensitivity of the tests for dogs have not been fully evaluated. In California, B. v. berkhoffii has rarely been isolated from domestic dogs or detected by PCR, whereas coyotes (Canis latrans) appear to be a reservoir of this pathogen, as 35% of the coyotes tested in California were seropositive, and 28% of the coyotes tested within a highly disease-endemic region of California were bacteremic (2).

In domestic dogs, B. v. berkhoffii is a cause of endocarditis (6) and, as in humans, the clinical spectrum of the infection attributed to this organism is expanding. B. v. berkhoffii is now associated with cardiac arrhythmias, endocarditis and myocarditis, granulomatous granulomatous /gran·u·lom·a·tous/ (-lom´ah-tus) containing granulomas.

-----------------------------------------------------------------------------

Granulomatous
Resembling a tumor made of granular material. lymphadenitis Lymphadenitis Definition

Lymphadenitis is the inflammation of a lymph node. It is often a complication of a bacterial infection of a wound, although it can also be caused by viruses or other disease agents. , granulomatous rhinitis Rhinitis Definition

Rhinitis is inflammation of the mucous lining of the nose.
Description

Rhinitis is a nonspecific term that covers infections, allergies, and other disorders whose common feature is the location of their symptoms. , and epistaxis epistaxis /ep·i·stax·is/ (-stak´sis) nosebleed; hemorrhage from the nose, usually due to rupture of small vessels overlying the anterior part of the cartilaginous nasal septum.

----------------------------------------------------------------------------

ep·i·stax·is
n. (6,32). In both humans and dogs, Bartonella-associated cases of endocarditis usually involve the aortic valve and are characterized by massive vegetative vegetative /veg·e·ta·tive/ (vej?e-ta?tiv)
1. of, pertaining to, or characteristic of plants.

2. concerned with growth and nutrition, as opposed to reproduction.

3. lesions (33). Based on serologic evidence, infection with B. v. berkhoffii may also cause immune-mediated hemolytic anemia, neutrophilic neutrophilic /neu·tro·phil·ic/ (-fil´ik)
1. pertaining to neutrophils.

2. stainable by neutral dyes.

----------------------------------------------------------------------------

neutrophilic

1. pertaining to neutrophils.

2. stainable by neutral dyes. or granulomatous meningoencephalitis, neutrophilic polyarthritis, cutaneous vasculitis, and uveitis in dogs (2).

Some other Bartonella spp. have infrequently been isolated from domestic dogs. B. clarridgeiae and B. washoensis were isolated from cases of endocarditis (1,2), and B. henselae was isolated for the first time from a dog from Gabon (34). In the Gabon study, B. clarridgeiae was isolated from 5 of 258 dogs tested (1.9%), which suggests a possible reservoir role for this Bartonella sp. in Africa (34). B. henselae, B. elizabethae, and B. clarridgeiae DNA has also been detected from a few sick dogs with various clinical abnormalities (Table 3) (1,2,6). Endocarditis caused by B. quintana was recently diagnosed in a dog from the United States and a dog from New Zealand (P. Kelly et al., unpub. data). Two recent studies reported a B. henselae antibody prevalence of 10% in healthy dogs in the eastern United States (35) and a prevalence of 14% of dogs in Zimbabwe (36). A much higher prevalence (27%) in sick dogs from the eastern United States was reported (35), which contrasts with the low B. henselae seroprevalence (<2%) in dogs examined at a university teaching hospital in northern California (37). A case-control study conducted on 305 dogs (102 dogs seropositive for B. henselae, B. v. berkhoffii, or B. clarridgeiae and 203 seronegative seronegative /se·ro·neg·a·tive/ (-neg´ah-tiv) showing negative results on serological examination; showing a lack of antibody.

-----------------------------------------------------------------------------

se·ro·neg·a·tive
adj. dogs) suggested an association between the seropositive status and lameness, arthritis-related lameness, splenomegaly, and nasal discharge/epistaxis (37).

Unlike the domestic cat, for which clinical manifestations of natural infection is rarely documented, a wide range of clinical and pathologic abnormalities develop in dogs that are very similar to those observed in humans (32). Therefore, this species is an excellent sentinel and an important comparative model for human infections. To date, all Bartonella spp. identified in sick dogs are also pathogenic or potentially pathogenic in humans.

Beyond the Fleas: New Emerging Vectors

The primary mode of transmission of B. henselae to humans is through a cutaneous cutaneous /cu·ta·ne·ous/ (ku-ta´ne-us) pertaining to the skin.

----------------------------------------------------------------------------

cu·ta·ne·ous
adj.
Of, relating to, or affecting the skin.

-----------------------------------------------------------------------------
Cutaneous
Pertaining to the skin. trauma caused mainly by the scratch of a cat. Transmission is less likely to occur by cat bite; shedding of B. henselae in cat saliva has not been clearly documented. The possibility of direct transmission of B. henselae to humans by the cat flea is something that has not been proven experimentally and is mainly hypothetical. However, the presence of cat fleas (Ctenocephalides felis) is essential for the maintenance of the infection within the cat population (6). B. henselae has been shown to multiply in the digestive system of the cat flea and survive several days in the flea feces (reviewed in [2]). Experimentally, only cats inoculated with flea feces compared to those on which fleas were deposited in retention boxes or that were fed fleas became bacteremic (38 ). Therefore, the main source of infection appears to be flea feces that are infected by contaminated cat claws.

Beside the cat flea, new possible vectors have been suggested. Bartonella DNA, including B. henselae, has been detected in Ixodes ricinus ticks collected on humans (9) and in I. scapularis ticks collected in households of persons coinfected with B. henselae and Borrelia burgdorferi (reviewed in [2]). B. quintana, B. henselae, and B. v. berkhoffii DNA were also detected in questing L pacificus ticks in California, and a few human cases of B. henselae infection were temporally related to a tick exposure in the United States (reviewed in [2]). Tick exposure was reported asa risk factor associated with CSD in humans (39). Similarly, tick exposure was determined to be a risk factor associated with B. v. berkhoffii seropositivity Seropositivity is the presence of a certain antibody in a blood sample. A patient with seropositivity for a particular antigen or agent is termed seropositive. in dogs (40). Additional indirect support for ticks as vectors of B. v. berkhoffii in dogs relates to serologic or PCR evidence of concurrent infections with various tickborne organisms (6,33). The specific role of ticks in Bartonella transmission requires additional study, but several recent publications have reported a high prevalence of Bartonella spp. infection in ticks from various parts of the world. Finally, B. henselae type Marseille DNA was recently detected in a stable fly (8 ).

Conclusion

The number of zoonotic Bartonella species identified in the last 15 years has increased considerably. Pets have been identified as a notable reservoir of Bartonella species (i.e., cats and B. henselae or dogs and B. v. subsp. berkhoffii in the tropics tropics, also called tropical zone or torrid zone, all the land and water of the earth situated between the Tropic of Cancer at lat. 23 1-2°N and the Tropic of Capricorn at lat. 23 1-2°S. ) and may play an important role as source for human infection. Furthermore, domestic dogs may represent excellent sentinels for Bartonella infection because of the wide diversity of the Bartonella spp. identified in canines, all of which are human pathogens. A better understanding of the modes of transmission and vectors involved in dog bartonellosis is an urgent priority to implement appropriate parasite control measures for pets.

References

(1.) Chomel BB, Boulouis HJ, Breitschwerdt EB. Cat scratch disease cat scratch disease
n.
An infectious disease that may follow the scratch or bite of a cat, producing localized inflammation of lymph nodes and a low-grade fever. Also called benign inoculation lymphoreticulosis, cat scratch fever. and other zoonotic Bartonella infections. J Am Vet Med Assoc. 2004;224:1270-9.

(2.) Boulouis HJ, Chang CC, Henn JB, Kasten RW, Chomel BB. Factors associated with the rapid emergence of zoonotic Bartonella infections. Vet Res. 2005;36:383-410.

(3.) La VD, Tran-Hung L, Aboudharam G, Raoult D, Drancourt M. Bartonella quintana in domestic cat. Emerg Infect Dis. 2005; 11:1287-9.

(4.) Avidor B, Graidy M, Efrat G, Leibowitz C, Shapira G, Schattner A, et al. Bartonella koehlerae, a new cat-associated agent of culture-negative human endocarditis. J Clin Microbiol. 2004;42:3462-8.

(5.) Kordick DL, Breitschwerdt EB. Persistent infection of pets within a household with three Bartonella species. Emerg Infect Dis. 1998;4:325-8.

(6.) Breitschwerdt EB, Kordick DL. Bartonella infection in animals: carriership, reservoir potential, pathogenicity, and zoonotic potential for human infection. Clin Microbiol Rey. 2000;13:428-38.

(7.) Chomel BB, Kasten RW, Floyd-Hawkins K, Chi B, Yamamoto K, Roberts-Wilson J, et al. Experimental transmission of Bartonella henselae by the cat flea. J Clin Microbiol. 1996;34:1952-6.

(8.) Chung CY, Kasten RW, Paff SM, Van Horn BA, Vayssier-Taussat M, Boulouis HJ, et al. Bartonella spp. DNA associated with biting flies from California. Emerg Infect Dis. 2004; 10:1311-3.

(9.) Sanogo YO, Zeaiter Z, Caruso G, Merola F, Shpynov S, Brouqui P, et al. Bartonella henselae in Ixodes ricinus ticks (Acari: Ixodida) removed from humans, Belluno province, Italy. Emerg Infect Dis. 2003;9:329-32.

(10.) Rolain JM, Brouqui P, Koehler JE, Maguina C, Dolan MJ, Raoult D. Recommendations for treatment of human infections caused by Bartonella species. Antimicrob Agents Chemother. 2004;48: 1921-33.

(11.) Chomel BB, Abbott RC, Kasten RW, Floyd-Hawkins KA, Kass PH, Glaser CA, et al. Bartonella henselae prevalence in domestic cats in California: risk factors and association between bacteremia and antibody titers. J Clin Microbiol. 1995;33:2445-50.

(12.) Holmberg M, McGill S, Ehrenborg C, Wesslen L, Hjelm E, Darelid J, et al. Evaluation of human seroreactivity to Bartonella species in Sweden. J Clin Microbiol. 1999;37:1381-4.

(13.) Kumasaka K, Arashima Y, Yanai M, Hosokawa N, Kawano K. Survey of veterinary professionals for antibodies to Bartonella henselae in Japan. Rinsho Byori. 2001;49:906-10.

(14.) Kikuchi E, Maruyama S, Sakai T, Tanaka S, Yamaguchi F, Hagiwara T, et al. Serological serological

pertaining to or emanating from serology.

-----------------------------------------------------------------------------

serological test
one involving examination of blood serum usually for antibody. investigation of Bartonella henselae infections in clinically cat-scratch disease-suspected patients, patients with cardiovascular diseases, and healthy veterinary students in Japan. Microbiol Immunol. 2002;46:313-6.

(15.) Noah DL, Kramer CM, Verbsky MP, Rooney JA, Smith KA, Childs JE. Survey of veterinary professionals and other veterinary conference attendees for antibodies to Bartonella henselae and B. quintana. J Am Vet Med Assoc. 1997;210:342-4.

(16.) Maruyama S, Boonmar S, Morita Y, Sakai T, Tanaka S, Yamaguchi F, et al. Seroprevalence of Bartonella henselae and Toxoplasma gondii among healthy individuals in Thailand. J Ver Med Sci. 2000;62:635-7.

(17.) Massei F, Messina F, Gori Gori (gô`rē), city (1989 pop. 68,924), central Georgia. It has food processing plants. Mentioned in the 7th cent. as Tontio, it was later named after a fortress. Gori passed to Russia in 1801. Stalin was born in the city. L, Macehia P, Maggiore G. High prevalence of antibodies to Bartonella henselae among Italian children without evidence of cat scratch disease. Clin Infect Dis. 2004;38:145-8.

(18.) Al-Majali AM, Al-Qudah KM. Seroprevalence of Bartonella henselae and Bartonella quintana infections in children from Central and Northern Jordan. Saudi Med J. 2004;25:1664-9.

(19.) Hjelm E, McGill S, Blomqvist G. Prevalence of antibodies to Bartonella henselae, B. elizabethae and B. quintana in Swedish domestic cats. Scand J Infect Dis. 2002;34:192-6.

(20.) Maruyama S, Kabeya H, Nakao R, Tanaka S, Sakai T, Xuan X, et al. Seroprevalence of Bartonella henselae, Toxoplasma gondii, FIV FIV

feline immunodeficiency virus. and FeLV infections in domestic cats in Japan. Microbiol Immunol. 2003;47:147-53.

(21.) Jameson P, Greene C, Regnery R, Dryden M, Marks A, Brown J, et al. Prevalence of Bartonella henselae antibodies in pet cats throughout regions of North America. J Infect Dis. 1995;172:1145-9.

(22.) Maruyama S, Sakai T, Morita Y, Tanaka S, Kabeya H, Boonmar S, et al. Prevalence of Bartonella species and 16s rRNA gene types of Bartonella henselae from domestic cats in Thailand. Am J Trop Med Hyg. 2001;65:783-7.

(23.) Fabbi M, De Giuli L, Tranquillo M, Bragoni R, Casiraghi M, Genchi C. Prevalence of Bartonella henselae in Italian stray cats: evaluation of serology Serology

The division of biological science concerned with antigen-antibody reactions in serum. It properly encompasses any of these reactions, but is often used in a limited sense to denote laboratory diagnostic tests, especially for syphilis. to assess the risk of transmission of Bartonella to humans. J Clin Microbiol. 2004;42:264-8.

(24.) Al-Majali AM. Seroprevalence of and risk factors for Bartonella henselae and Bartonella quintana infections among pet cats in Jordan. Prev Ver Med. 2004;64:63-71.

(25.) Clarridge JE 3rd, Raich TJ, Pirwani D, Simon B, Tsai L, Rodriguez-Barradas MC, et al. Strategy to detect and identify Bartonella species in routine clinical laboratory yields Bartonella henselae from human immunodeficiency virus-positive patient and unique Bartonella strain from his cat. J Clin Microbiol. 1995;33:2107-13.

(26.) Kordick DL, Brown TT, Shin K, Breitschwerdt EB. Clinical and pathologic evaluation of chronic Bartonella henselae or Bartonella clarridgeiae infection in cats. J Clin Microbiol. 1999;37:153-47.

(27.) Rolain JM, Fournier PE, Raoult D, Bonerandi JJ. First isolation and detection by immunofluorescence Immunofluorescence

A technique that uses a fluorochrome to indicate the occurrence of a specific antigen-antibody reaction. The fluorochrome labels either an antigen or an antibody. assay of Bartonella koehlerae in erythrocytes Erythrocytes
Red blood cells.

Mentioned in: Bartonellosis

-----------------------------------------------------------------------------
erythrocytes (ē·rithˑ·rō·sīts),
n.pl red blood cells. from a French cat. J Clin Microbiol. 2003;41:4001-2.

(28.) Rolain JM, Franc M, Davoust B, Raoult D. Molecular detection of Bartonella quintana, B. koehlerae, B. henselae, B. clarridgeiae, Rickettsia rickettsia (rĭkĕt`sēə), any of a group of very small microorganisms, many disease-causing, that live in vertebrates and are transmitted by bloodsucking parasitic arthropods such as fleas, lice (see louse), and ticks. felis, and Wolbachia pipientis in cat fleas, France. Emerg Infect Dis. 2003;9:338-42.

(29.) Regnery RL, Rooney JA, Johnson AM, Nesby SL, Manzewitsch P, Beaver K, et al. Experimentally induced Bartonella henselae infections followed by challenge exposure and antimicrobial therapy in cats. Am J Vet Res. 1996;57:1714-9. Erratum [Latin, Error.] The term used in the Latin formula for the assignment of mistakes made in a case.

After reviewing a case, if a judge decides that there was no error, he or she indicates so by replying, "In nollo est erratum in: Am J Vet Res. 1997;58:803.

(30.) Henn, JB, VanHorn BA, Kasten RW, Kachani M, Chomel BB. Bartonella vinsonii subsp, berkhoffii antibodies in Moroccan dogs. Am J Trop Med Hyg. 2006; in press.

(31.) Muller S, Boulouis HJ, Viallard J, Beugnet F. Epidemiological survey of canine bartonellosis to Bartonella vinsonii subsp, berkhoffii and canine monocytic ehrlichiosis in dogs on the Island of Reunion. Rev Med Vet. 2004; 155:377-80.

(32.) Breitschwerdt EB, Hegarty BC, Maggi R, Hawkins E, Dyer P. Bartonella species as a potential cause of epistaxis in dogs. J Clin Microbiol. 2005;43:2529-33.

(33.) MacDonald KA, Chomel BB, Kittleson MD, Kasten RW, Thomas WP, Pesavento E A prospective study of canine infective endocarditis in northern California (1999-2001): emergence of Bartonella as a prevalent etiologic agent. J Vet Intern Med. 2004; 18:56-64.

(34.) Gundi Gundis (family Ctenodactylidae) are a group of small, stocky rodents found in Africa. The family comprises 4 genera and 5 species (Speke's Gundi, Felou Gundi, Desert Gundi, North African Gundi and Mzab Gundi). They are herbivorous. VA, Bourry O, Davous B, Raoult D, La Scola B. Bartonella clarridgeiae and B. henselae in dogs, Gabon. Emerg Infect Dis. 2004; 10:2261-2.

(35.) Solano-Gallego L, Bradley J, Hegarty B, Sigrnon B, Breitschwerdt E. Bartonella henselae IgG antibodies are prevalent in dogs from southeastern USA. Vet Res. 2004;35:585-95.

(36.) Kelly PJ, Eoghain GN, Raoult D. Antibodies reactive with Bartonella henselae and Ehrlichia canis in dogs from the communal lands of Zimbabwe. J S Afr Vet Assoc. 2004;75:116-20.

(37.) Henn JB, Liu CH, Kasten RW, VanHorn BA, Beckett LA, Kass PH, et al. Seroprevalence of antibodies against Bartonella species and evaluation of risk factors and clinical signs associated with seropositivity in dogs. Am J Vet Res. 2005;66:688-94.

(38.) Foil L, Andress E, Freeland RL, Roy AF, Rutledge R, Triche PC, O'Reilly KL. Experimental infection of domestic cats with Bartonella henselae by inoculation of Ctenocephalides felis (Siphonaptera: Pulicidae) feces. J Med Entomol. 1998;35:625-8.

(39.) Zangwill KM, Hamilton DH, Perkins BA, Regnery RL, Plikaytis BD, Hadler JL, et al. Cat scratch disease in Connecticut. Epidemiology, risk factors, and evaluation of a new diagnostic test. N Engl J Med. 1993;329:8-13.

(40.) Pappalardo BL, Correa MT, York CC, Peat CY, Breitschwerdt EB. Epidemiologic evaluation of the risk factors associated with exposure and seroreactivity to Bartonella vinsonii in dogs. Am J Vet Res. 1997;58:467-71.

Bruno B. Chomel, * Henri-Jean Boulouis, ([dagger]) Soichi Maruyama, ([double dagger]) and Edward B. Breitschwerdt ([section])

* University of California, Davis The University of California, Davis, commonly known as UC Davis, is one of the ten campuses of the University of California, and was established as the University Farm in 1905. , California, USA; ([dagger]) Microbiologie-Immunologie, Ecole Nationale Veterinaire d'Alfort, Maisons-Alfort, France; ([double dagger]) Nihon University, Kanagawa, Japan; and ([section]) North Carolina State University History


Main article: History of North Carolina State University

The North Carolina General Assembly founded NC State on March 7, 1887 as a land-grant college under the name North Carolina College of Agriculture and Mechanic Arts. College of Veterinary Medicine, Raleigh, North Carolina For other uses of this name, see Raleigh.
Raleigh (IPA: /ˈrɑli/, ral-ee) is the capital of the State of North Carolina and the county seat of Wake County. , USA

Dr Chomel is the director of the World Health Organization/Pan American Health Organization Collaborating Center on New and Emerging Zoonoses at the University of California, Davis. His research focuses on Bartonella infections in domestic animals and wildlife and their impact on human health.

Address for correspondence: Bruno B. Chomel, Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA 95616, USA; fax: 530-752-2377; email: bbchomel@ucdavis.edu

All material published in Emerging Infectious Diseases is in the public domain and may be used and reprinted without special permission; proper citation, however, is required.
Table 1. Species and subspecies of Bartonella that are confirmed or
potential human pathogens

Bartonella sp. Primary reservoir Vector

B. bacilliformis Human Sandfly (Lutzomia
verrucarum)
B. quintana Human Body louse (Pediculus
humanis)
B. elizabethae Rat (Rattus norvegicus) Oriental rat flea
(Xenopsylla cheopis)
B. grahamii Wild mice Rodent fleas
(Clethrionomys
giareolus, Microtus
agrestis, Apodemus
flavicollis)
B. henselae Cat (Felis catus) Cat flea
(Ctenocephalides
felis)
B. clarridgeiae Cat Cat flea
B. koehlerae Cat Cat flea
B. vinsonii subsp. Coyote (Canis latrans), Unknown (ticks?)
berkhoffii dog (C. familiaris)
B. vinsonii subsp. White-footed mouse Unknown (fleas?,
arupensis (Peromyscus leucopus) ticks?)
B. washoensis California ground Unknown (fleas?)
squirrel (Spermophilus
beecheyii)
B. alsatica Rabbit Unknown (flea?)

Bartonella sp. Accidental host Reference

B. bacilliformis None (1,2)
B. quintana Cat, dog, monkey (1-3, P. Kelly et
al., unpub. data) *
B. elizabethae Human, dog (2)
B. grahamii Human (1,2)
B. henselae Human, dog (1,2)
B. clarridgeiae Human?, dog (1,2)
B. koehlerae Human (2,4)
B. vinsonii subsp. Human (5,6)
berkhoffii
B. vinsonii subsp. Human (1,2)
arupensis
B. washoensis Human, dog (2)
B. alsatica Human (D. Raoult, pers.
comm.)

* Also reported by O'Rourke LG, Pitulle C, Hegarty BC, Kraycirik S,
Killary KA, Grosenstein P, et al. Bartonella quintana in cynomolgus
monkey (Macaca fascicularis). Emerg Infect Dis. 2005;11:1931-4.

Table 2. Bartonella henselae seroprevalence in various cat and human
populations from selected countries *

Cat seroprevalence (%)

Country Stray Pet Reference

Sweden NA 1 (19)
Japan NA 8.8-15.1; northern, (20)
0-2; central
10.9-12.6; southern,
18-24
United States 81 27.9 (11,21)
Thailand 27.6 ([dagger]) NA (22)
Italy 39.0 43.5 (23)
Jordan NA 32.0 (24)

Human seroprevalence (%)

Country Healthy Other Reference

Sweden 1 NA (12)
Japan 4.5 11.0-15.0 (13,14)
(veterinarians)
United States 3.6-6 7.0 (veterinarians) (15)
Thailand 5.5 NA (16)
Italy NA 8.5-61.6 (children) (17)
Jordan NA NA (18 )

* NA, not available.

([dagger]) Prevalence of bacteremic cats; no data available on
seroprevalence.

Table 3. Clinical aspe of Bartonella infections in humans and dogs

Symptoms

Bartonella sp. Humans

B. clarridgeiae Cat-scratch disease
B. elizabethae Endocarditis,
neuroretinitis
B. henselae Cat-scratch disease, endocarditis, bacillary
anglomatosis, peliosis hepatis, granulomatous
hepatitis, pseudotumoral
lesions, arthritis, arthralgia, osteomyelitis,
nodules, erythema, cutaneous petechiae, uveitis,
neuroretinitis, purpura (Henoch-Schonlein),
glomerulonephritis, perionyxis, periodontitis
B. grahamii Neuroretinitis, bilateral retinal artery branch
occlusions
B. koehlerae Endocarditis
B. vinsonii subsp. Bacteremia, fever, arthralgia, neurologic
arupensis disorders, endocarditis
B. vinsonii subsp. Endocarditis
berkhoffii
B. washoensis Fever, myocarditis
B. quintana Fever, bacteremia, endocarditis, bacillary
angiomatosis

Symptoms

Bartonella sp. Dogs

B. clarridgeiae Endocarditis, lymphocytic hepatitis
B. elizabethae Lethargy, anemia, weight loss

B. henselae Granulomatous hepatitis, peliosis hepatis,
epistaxis
B. grahamii Not diagnosed in dogs
B. koehlerae Not diagnosed in dogs
B. vinsonii subsp. Not diagnosed in dogs
arupensis
B. vinsonii subsp. Endocarditis, myocarditis, arrhythmia,
berkhoffii uveitis, choroiditis, limping, splenomegaly,
polyarthritis, epistaxis
B. washoensis Endocarditis
B. quintana Endocarditis
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Su Loka 04, 2009 19:04

Bartonellan alalaji, B. washoensis, on aiheuttanut ihmisille aivokalvontulehdusta. Artikkelin potilas sai tartunnan KIRPUNPUREMASTA.

J. Clin. Microbiol. doi:10.1128/JCM.00511-09

published online ahead of print on 13 May 2009
05/26/09

Meningitis Due to a Bartonella washoensis-like Human Pathogen

Will Probert*, Janice K. Louie, James R. Tucker, Rose Longoria, Robin Hogue, Silvia Moler, Margot Graves, Heather J. Palmer, Joseph Cassady, and Curtis L. Fritz
Microbial Diseases Laboratory, and Viral and Rickettsial Disease Laboratory, and Infectious Diseases Branch, Division of Communicable Disease Control, Center for Infectious Diseases, California Department of Public Health, Richmond, CA, 94804; and Yuba County Public Health Department, Marysville, CA, 95901
* To whom correspondence should be addressed. Email: Will.Probert@cdph.ca.gov .

We report the second human case of infection caused by an organism identified as the proposed Bartonella species, B. washoensis. The organism was isolated from the blood of a patient presenting with meningitis and early sepsis. Oropsylla montana fleas were implicated as the vector for disease transmission in this case.


--------------------------------------------------------------------------------

Bartonella: Munuaissiirron saanut potilas sairastui bartonellaan. Potilas sai lyhyen antibioottikuurin (atsitromysiini), mutta oireet palasivat kahdeksan kuukauden kuluttua.

Cat-scratch disease relapse in a kidney transplant recipient.

Rheault MN, van Burik JA, Mauer M, Ingulli E, Ferrieri P, Jessurun J, Chavers BM.

Department of Pediatrics, University of Minnesota, Minneapolis, MN 55455, USA.

Cat-scratch disease, an infectious illness infrequently reported in kidney transplant patients, is caused by the organism Bartonella henselae and is transmitted through contact with cats or kittens. It is a self-limited disorder in the general pediatric population. Here we present a case of unsuspected cat-scratch disease in a pediatric kidney transplant patient who presented with fever and lymphadenopathy. Eight months after treatment with a short course of azithromycin, the patient developed a recurrence of cat-scratch disease. We emphasize that the evaluation of a young immunocompromised kidney transplant patient presenting with fever and lymphadenopathy should include unusual infections such as cat-scratch disease. We review the diagnosis and treatment of this uncommon infection in the organ transplant population.

PMID: 17239132 [PubMed - indexed for MEDLINE]

soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Su Loka 04, 2009 19:07

Lähetetty: Maa Kes 08, 2009 4:20 Viestin aihe:

--------------------------------------------------------------------------------

http://www.tiede.fi/arkisto/artikkeli.p ... 86&vl=2002

Julkaistu Tiede-lehden numerossa 3/2002


Suunnistus särkee sydämen ? ainakin Ruotsissa.
Klamydiaa ja punkkia syytellään


Moni paniikki rantautuu jostain syystä meille Ruotsista. Vuonna 1992 sydämen-tykytystä aiheuttivat niin sanotut suunnistuskuolemat: Ruotsissa oli kilpasuunnistajaa menehtynyt mystisesti vuosina 1979?1992.


Ruotsalaistutkijat syyttivät äkkikuolemista suunnistajien parissa riehuvaa keuhkoklamydiaepidemiaa. Klamydia voi aiheuttaa flunssan ja tulehduttaa sydän-ihaksen, jolle rasitus on viimeinen niitti.


Teoria jäi todistamatta, mutta Ruotsin urheilujohto määräsi suunnistajat harjoituskieltoon. Myös suomalaiskollegat pääsivät klamydiatestiin. Nuhaneniä kehotettiin välttämään urheilua.


Uusin ja todennäköisin syyllinen on Bartonella-bakteeri, joka aiheuttaa punkkien ja kirppujen välityksellä leviäviä infektioita. Muutamat bakteerikannat vaurioittavat myös sydänlihasta. Metsissä mönkivä on vaaravyöhykkeessä.


Bakteeria on löytynyt neljän suunnistaja-vainaan sydämestä. Kolmanneksella ruotsalaissuunnistajista on veressään Bartonellan vasta-aineita, valtaväestöstä vain joka kymmenennellä. Bartonellaa ei osattu alun perin epäillä, koska laboratoriotestissä se voi antaa samanlaiset tulokset kuin keuhkoklamydia.



http://www.karjalainen.fi/Karjalainen/U ... 68641.html


? Bartonella-bakteeria on löydetty Keski-Euroopassa lähinnä metsäkauriista ja sen takia on pohdittu, että bakteeri voisi levitä hirvikärpäseenkin. Hirvikärpänen pudottaa siipensä ja on lentokyvytön löydettyään isäntäeläimen, jossa asua, joten mahdollisuus, että tauti leviäisi kärpäsestä eteenpäin on pieni, vanhempi tutkija Sauli Härkönen Metsäntutkimuslaitokselta puolestaan sanoo.




http://www.saunalahti.fi/arnoldus/vektorit.html

Hietasääskistä Phlebotomus verrucarum-laji välittää bartonellooseja. Bartonella bacilliformis aiheuttaa Etelä-Amerikassa Carriónin tautia, joka ilmenee kahtena muotona. Niistä Oroya-kuume on äkillinen anemiaa sekä luu- ja nivelkipuja aiheuttava kuumetauti, jossa on hoitamattomana suuri kuolleisuus. Verruca peruana ?taudissa, joka ilmaantuu usein Oroya-kuumeen jälkeen mutta toisinaan myös ilman sitä, on punoittavaa papulaista ihottumaa.



http://www.metsastajaliitto.fi/liitteet ... _4_s18.pdf

Vielä pahempaa on, jos hirvikärpästen myötä ihmiseen leviää joku todella vaarallinen tauti. Keski-Euroopassa hirvikärpästen on todettu levittämän mm. bakteeria, joka aiheuttaa sydänlihastulehduksen. Toinen tämän riesan levittämä bakteeri voi aiheuttaa unitautia. Samaa sairautta levittävät Afrikassa tsetsekärpäset. Ruotsissa kuoli selittämättömällä tavalla 1990-luvulla useita nuoria, kovakuntoisia suunnistajia harjoituslenkeillään tai kilpailuissa metsään. Tarkoissa selvityksissä menehtymisen syyksi todettiin Bartonella-bakteerin aiheuttama sydänlihastulehdus. Asian paljastuttua jotkut epäilivät bakteerin levittäjäksi hirvikärpästä, tieteellistä näyttöä asiasta ei kuitenkaan saatu. Vasta hiljakkoin on selvinnyt, että kyseinen bakteeri voi todellakin levitä hirvikärpästen välityksellä, joten syy-yhteys voi pitää paikkansa.


http://www.iltasanomat.fi/uutiset/ulkom ... id=1620127

Brittitutkijat ovat tulleet siihen tulokseen, että Euroopassa yleinen isorotta saattaa kantaa "21. vuosisadan ruttoa".

Journal of Medical Microbiology -lehdessä julkaistun tutkimuksen mukaan isorotan mukana kulkevissa kirpuissa leviävät bakteerit saattavat muodostua suureksi ongelmaksi ihmisille.

Kirpuissa on havaittu Bartonella-suvun bakteereita. Tutkimus nimittää mahdollista vitsausta "21. vuosisadan rutoksi".

Brittitukijoiden mukaan patogeeniset bakteerit saattavat aiheuttaa useita tauteja aina sydänvaivoista pernainfektioihin ja hermosairauksiin.

- Uusi laji nimeltä Bartonella rochalimae löydettiin taannoin potilaasta, jolla oli laajentunut perna, professori Chao-Chin Chang sanoi Telegraphin mukaan.



http://www.ept.tkk.fi/Teaching/S01104/S ... teerit.pdf

Vaativat Gram-negatiiviset bakteerit

Brucella
Rochalimeae/Bartonella
Chlamydia
Rickettsia
Mycoplasma



http://www.amazon.com/Bartonella-Diagno ... 66&sr=8-2# by James L. Schaller M.D. (Paperback - May 30, 2008)
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Ma Loka 12, 2009 13:29

23-vuotias nainen valitti näkökyvyn samenemista. Hän oli saanut aiemmin useita hyönteisten puremia sekä kissanraapaisuja. Hänellä havaittiin verkkokalvon valtimon tukkeuma sekä valkeita alueita verkkokalvossa. Bartonellavasta-aineet olivat koholla. Hän sai 10 päivän siprofloksasiini kuurin (500 mg x 2). Viiden viikon kuluttua hoidosta hänelle ilmaantui kömpelyyttä, yöllisiä kohtauksia, muistin ja havintokyvyn heikkenemistä. Aivojen magneettikuvassa (MRI) havaittiin muutoksia esim. lisääntynyttä signaaliherkkyyttä oikealla puolella. Hoidoksi kirjoitettiin atsitromysiiniä 250 mg kolmen päivän ajaksi sekä siprofloksasiinia 500 mg x 2 kolmen viikon ajan. Oireet hävisivät.


http://journals.lww.com/jneuro-ophthalm ... _in.4.aspx

CASE REPORT
A 23-year-old woman complained of blurred vision, nasally in the OD. Two weeks earlier she had been ill with fever but did not recall any lymphadenopathy. She had been bitten and scratched many times by her 12-week-old kitten. On examination, she had normal visual acuity, with an inferonasal visual field defect in her OD. Funduscopy showed a small superotemporal branch retinal artery occlusion in the OD, with white spots in the inferonasal and inferotemporal retina, and 1 to 2+ vitreous cells (Fig. 1). The OS showed a single white spot. The work-up, which had negative findings, included transthoracic echocardiography, complete blood cell count, sedimentation rate, rapid plasma reagin, prothrombin time, partial thromboplastin time, factor VIII, protein C and S levels, antinuclear antibody, lupus anticoagulant, and Lyme and toxoplasma titers. Bartonella IgG titers were elevated at 1:1024, and the patient was prescribed a course of ciprofloxacin 500 mg twice a day for 10 days
.
Fig. 1
Image ToolsDuring the next month, the patient had two nocturnal seizures, clumsiness, and a decrease in memory and attention. Magnetic resonance imaging (MRI) of the brain (Fig. 2) performed 5 weeks after the onset of the branch retinal artery occlusion and 5 days after the onset of neurologic symptoms, showed increased signal intensity in the right parietal lobe on T2-weighted, fluid attenuation inversion recovery, and proton density sequences. The lesion did not become enhanced. Diffusion-weighted imaging findings were normal.

Fig. 2
Image ToolsThe complete blood cell count, sedimentation rate, prothrombin time, partial thromboplastin time, thyroid-stimulating hormone, and antinuclear antibody test results were again normal. A repeat Bartonella IgG titer was 1:2048. A lumbar puncture showed two white blood cells per microliter, no red blood cells per microliter, a protein level of 17 mg/dL, and a glucose level of 58 mg/dL. An awake and an asleep electroencephalogram did not reveal any epileptiform activity. Repeat MRI performed a week after the initial imaging showed that the lesion in the right parietal lobe gray matter was resolving, and diffusion-weighted imaging findings remained normal. A cervical and intracranial magnetic resonance angiography scan was also normal. The patient was treated with azithromycin 250 mg every day for 3 days, another course of ciprofloxacin 500 mg twice a day for 21 days, and enteric-coated aspirin. She recovered neurologic function and has remained seizure free. Her visual function remains unchanged.

Back to Top | Article Outline

DISCUSSION
Cat-scratch disease is a systemic infectious disease manifesting with fever, tender lymphadenopathy, and generalized malaise (1,5). The causative organism is a pleomorphic, gram-negative bacillus (6) initially thought to be Afipia felis (7) but recognized in 1992 to be a newly identified organism, Bartonella (formerly Rochalimaea) henselae (2,8-10). A closely related organism, B. quintana can also cause clinical CSD (2,11,12). Serologic testing (13) is currently the main investigational modality for confirming this diagnosis (2). The incidence of CSD in the United States has been estimated at approximately 22,000 cases per year (14).

The pathologic response is variable and depends on the patient's immune status. Immunocompetent patients show a suppurative, granulomatous response (6), and the CSD bacilli can be seen inside blood vessel walls with special stains (6) and electron microscopy (15). Immunocompromised patients show a vasculoproliferative response termed bacillary angiomatosis (16).

A typical case of CSD in the immunocompetent host has a characteristic clinical course (1,2). It starts with a scratch from a kitten, followed by development of a nontender papule at the site of the scratch over the next week, then regional lymph node enlargement over the next 2 weeks, which may be tender. Patients may be relatively well and afebrile or may experience a variety of systemic complaints, including fever, anorexia, malaise, arthralgia, myalgia, and abdominal, neck, and back pain. Other complications of CSD include ophthalmic, neurologic, bone, and abdominal involvement.

The eye is the most commonly affected nonlymphatic organ (17). Parinaud oculoglandular syndrome is the most common ocular manifestation, occurring in up to 5% of patients, and manifesting with unilateral eye redness, foreign body sensation, and tearing, with associated cervical or preauricular lymph node enlargement (1,2). Other ophthalmic manifestations include uveitis, vitreous inflammation, retinitis, neuroretinitis, and optic disc edema (18 ). Focal retinochoroiditis may occur in the absence of disc edema or macular exudates, and this may give rise to intraretinal hemorrhage, branch retinal artery or vein occlusions, or localized serous retinal detachment. Our patient's ocular involvement with branch retinal artery occlusion and associated vitreous cells is typical.

Neurologic complications occur in only about 2% to 3% of patients with CSD (4) and include encephalopathy, cranial nerve paresis, spinal cord involvement, and peripheral neuritis (3,4,19).

Encephalopathy, first described in CSD in 1952 (20), is the most common, occurring in about 90% of all patients with neurologic manifestations (4,19). Although relatively benign compared with other causes of encephalopathy, it is an important complication, with patients presenting with seizures, often leading to status epilepticus, which may be difficult to control. The mental state of these patients ranges from lethargy or even coma to agitation and confusion (3,4,19). Carithers and Margileth (3) described a transient combative behavior in which patients reacted to physical contact by hitting out at medical staff and parents, a behavior that they claim was undocumented in other forms of encephalopathy. Focal neurologic signs such as weakness, numbness, or ataxia may be present. The prognosis for cat-scratch encephalopathy is generally good, and the vast majority of patients recover without sequelae (3,4,19). Some patients, however, have persistent seizures (19,21) or focal neurologic deficits (22), and a case has been described in which the patient became demented (23).

This report extends the range of intracerebral involvement and neuroimaging findings that can be attributed to bartonellosis. The majority of case series regarding cat-scratch encephalopathy date from before the modern era of neuroimaging. In the largest reported series, by Carithers and Margileth (3), 61 cases of patients with cat-scratch encephalopathy were collected from 1959 to 1987 (3). Of these, only 33 patients, slightly more than half, received a computed tomographic (CT) brain scan, and these scans were described as not diagnostic or showed transient abnormalities. Only six patients had MRI performed; five of these scans were normal and one abnormal. The abnormality was localized to the occipital lobe and was also noted on a CT scan of the brain. Unfortunately, there are no further descriptions of the lesion and no indication as to whether those patients who had normal MRI scans also had CT scans.

To date, 64 patients have been reported with cat-scratch encephalopathy about whom imaging information is documented (Table 1) (3,11,12,19,21-37). Only 12 of these patients (18.8%) had imaging abnormalities. (Two patients were subsequently proven by polymerase chain reaction to have B. quintana rather than B. henselae as the etiologic agent of CSD [11,12]). Of the 12 patients with imaging abnormalities (Table 1), 4 had abnormalities on CT scan, with MRI either not performed or not reported (19,22,30,31), 2 had abnormalities on both CT and MRI scans (3,11), 2 had abnormalities on MRI scan undetectable by CT (23,37), and 4 had abnormalities on MRI scan with no information provided regarding brain CT (12,21,34,36). Of the abnormalities, one was described as focal changes in the occipital area (3), two were believed to be occipital infarctions (19,22), two were diffuse white matter lesions (23,34), and three were abnormalities involving the basal ganglia and thalami (11,12,21). In three patients who were immunocompromised and, properly speaking, had cerebral bacillary angiomatosis rather than cat-scratch encephalopathy, imaging revealed a left temporal lesion in one patient (30), multifocal parenchymal and leptomeningeal involvement in another (36), and a left basal ganglia lesion in the third (31). There were no details on the MRI abnormalities in the last case (37). In none of the imaging reports is there a description of a gray-matter lesion similar to that of our patient-a lesion involving the gray matter, seen on T2-weighted, fluid attenuation inversion recovery, and proton density sequences, lacking enhancement or evidence of acutely restricted diffusion.

Table 1
Image ToolsThe wide range of cerebral pathologic lesions that may manifest in patients with cat-scratch encephalopathy has led to a number of theories regarding pathophysiology. It has been suggested that there are two forms of central nervous system involvement: (1) a diffuse, reversible encephalopathy with absence of focal neurologic findings, normal imaging, and benign outcome; and (2) a focal encephalopathy, with lateralizing findings on both examination and imaging, with the potential for long-term neurologic sequelae (19). The diffuse encephalopathy is thought to be the result of remote effects such as a neurotoxin or an immune-mediated process rather than from direct invasion of brain parenchyma. Other authorities (4,35) agree that direct invasion of the central nervous system seems unlikely, because cerebrospinal fluid analysis is usually normal and because recovery is generally rapid even in the absence of antibiotic therapy. Lewis and Tucker (19) favor a toxic mechanism because of the abrupt onset of neurologic dysfunction and equally prompt resolution of symptoms. To date, however, there have been no further data to support their hypothesis.

In support of the mechanism of direct bacterial invasion, recent polymerase chain reaction techniques have identified Bartonella DNA in cerebrospinal fluid, beyond the blood-cerebrospinal fluid barrier, in both immunocompetent (11) and immunocompromised (31) patients. In two immunocompromised patients, direct bacterial invasion has also been proven on brain biopsy, by the Warthin-Starry stain in one patient (30) and using polymerase chain reaction techniques in the other (36). Bartonella-specific immunoglobulin has also been found in the cerebrospinal fluid, clearly supporting the hypothesis that bacterial invasion can occur (31). These reports have included patients with both normal (11,30) and abnormal (36) cerebrospinal fluid, as well as normal (11) and abnormal neuroimaging findings (11,30,31,36).

A vasculitic process as a basis for focal encephalopathy was also proposed by Lewis and Tucker (19). Indeed, one patient reported with a stroke was the first case of cat-scratch encephalopathy with an imaging abnormality, presumably secondary to vasculitis (22). This 7-year-old girl presented with the sudden onset of expressive aphasia and a dense right hemiparesis. A brain CT scan showed a hypodense area around the left internal capsule consistent with an infarction. An angiogram performed 6 days later showed beading and irregularity of the left internal carotid artery and the left middle cerebral artery, suggestive of a localized cerebral arteritis. Another patient with a stroke underwent cerebral arteriography 14 days after the onset of symptoms (19), but this proved normal, and it was speculated that an earlier arteriogram might have demonstrated a transient arteritis. Certainly, in the retina, a vasculitic appearance with focal retinochoroiditis, cotton wool spots, and arterial and venous thrombosis, such as in our patient, is well described (17). One immunocompromised patient developed intraretinal hemorrhages and cotton wool spots in the retina consistent with B. henselae infection, and a retinal biopsy detected B. henselae DNA (38 ). Thus, it seems possible that a vasculitis may represent either an immunemediated phenomenon or direct invasion of the bacteria into the blood vessels. This would not be surprising, especially given the known affinity of B. henselae for epithelial cells (14) and the demonstrated presence of the bacilli within blood vessel walls on pathologic specimens (6,14). In our patient, the parietal lobe lesion demonstrated on imaging cannot represent acute ischemia, given the normal diffusion-weighted imaging findings 5 days after the onset of neurologic symptoms. There was no gross evidence of vasculitis by magnetic resonance angiography, but cerebral arteriography was not performed. The patient's MRI findings might be compatible with direct invasion of the cerebral cortex, but no biopsy confirmation is available. Our patient would also appear to be an exception to the generalization that patients with focal encephalopathy and with imaging abnormalities have permanent neurologic sequelae.
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » La Loka 17, 2009 06:50

BARTONELLA

"Bartonellabakteeri ei ole harvinainen. Sitä esiintyy kaikkialla maailmassa. Bartonella heikentää elimistön immuunipuolustusta voimakkaasti. Siksi on epätodennäköistä että henkilö jolla on borrelioosin lisäksi bartonella elimistössään, tulisi kuntoon ennen kuin bartonella on hoidettu...

Mahdollisia oireita esim: päänsärky, näköhäiriöitä, sydänongelmia, suolisto-ongelmia, jalkapohjakipuja, yöhikoilua, polttavaa tunnetta, suurentuneet imusolmukkeet, kylmät kädet/jalat, kurkkukipu, unettomuus, ärtyneisyys jne.

Hoito: keftin, doksisykliini, septra, cumanda, neilikkaöljy, houttynia jne."



http://lymenaide.wordpress.com/2009/10/07/bartonella/

Bartonella is a bacterium that causes illness, the most commonly known of which is a disease called ?Cat Scratch Fever.? Thousands of known cases of Bartonella occur in the U.S. each Year, with the vast majority of known cases due to bites from fleas that infest cats or infected dogs (may also occur directly from bites and scratches from infected dogs or cats). Bartonella can also be transmitted by ticks that transmit Lyme Disease. In fact, in a study published recently, deer ticks from New Jersey had a higher prevalence of Bartonella organisms than of Lyme organisms. (1)

It is unclear whether the organism that we see transmitted along with Lyme disease is actually a Bartonella species (such as B. henselae or B. quintana) or is ?Bartonella-Like Organism? (BLO) that is yet to be fully identified. While BLO has features similar to organisms in the Bartonella family, it also has features slimiar to the Mycoplasma and the Francisella (causes tularemia) families. (1)

It has been said that Bartonella is the most common of all tick-borne pathogens. Indeed, there seems to be a fairly distinct clinical syndrome when this type of organism is present in the chronic Lyme patient . However, several aspect of this infection seem to indicate that this tick-associated strain of Bartonella is different from that described as ?cat scratch disease?. For example, in patients who fit the clinical picture, standard Bartonella blood testing in commonly non-reactive. Furthermore, the usual Bartonella medications do not work for this- they suppress the symptoms but do not permanently clear them. For these reasons I (Dr Burrascano) like to refer to this as a ?Bartonella-like organism? (BLO), rather than assume it is a more common species. (2)

Incidentally, animal studies show that Bartonella may be transmitted across the placenta. No human studies have been done. (2)

Bartonellosis is often mild but in serious cases it can affect the whole body. Early signs are fever, fatigue, headache, poor appetite, and an unusual, streaked rash. Swollen glands are typical, especially around the head, neck and arms. Burrascano suspects bartonellosis when neurologic symptoms are out of proportion to the other systemic symptoms of chronic Lyme. He also notes gastritis, lower abdominal pain, sore soles, and tender subcutaneous nodules along the extremities. Lymph nodes may be enlarged and the throat can be sore. (3)

Bartonella are bacteria that live inside cells; they can infect humans, mammals, and a wide range of wild animals. Not all Bartonella species cause disease in humans. Bartonella henselae causes an important emerging infection first reported in 1990 and described as a new species in 1992. It is mainly carried by cats and causes cat-scratch disease, endocarditis, and several other serious diseases in humans. (3)

Bartonella bacteria are known to be carried by fleas, body lice and ticks. Scientists suspect that ticks are a source of infection in some human cases of bartonellosis. People with tick bites and no known exposure to cats have acquired the disease. People who recall being bitten by ticks have been co-infected with Lyme and Bartonella. More research needs to be done to establish the role of ticks in spreading the disease. (3)

Babesia and Bartonella are not little addendums to Lyme disease, but are often far more serious than Lyme disease. Any physician who is not well-versed in these two killing infections perhaps should not be considered competent enough to treat patients with flea and tick infections. These infections do not circle around planet ?Lyme? like small moons, instead, they are their own huge planets that cause massive consequences to the human body. (4)

In my experience (Dr. Schaller), Bartonella is profoundly agitating and causes all possible psychiatric troubles. Some patients feel like they have gasoline in their veins and are highly reactive and grossly sensitive. I also believe Babesia and Lyme disease, to a lesser extent, can also cause very diverse psychiatric troubles. (5)

It is important to realize that Bartonella is not rare. It is all over the world and only those living in the polar ice caps are immune to the risk of infection. I (Dr. Schaller) personally believe based on newer and more aggressive testing that it is more common than Lyme disease. Many are falsely diagnosed with Babesia because they are tired and fatigued, and yet this is a highly common symptom of Bartonella reported in vast numbers of studies. It is a major contributing infection to chronic fatigue and Fibromyalgia symptom clusters. (6)
You should appreciate that it is unlikely you will ever be cured of Lyme in the presence of Bartonella. Why? Bartonella is a massive immune suppressing bacteria. It can float attached to Red Blood Cells in vast numbers and not even cause a cold or fever. Just imagine, bacteria are floating in your blood and you might not have any fever at all! If you had Staph or Strep in your blood at these levels you would likely be dead in 48 hours unless you were pumped full of antibiotics in an ICU. So how is it this huge elephant floats in vast numbers and causes no severe fever and no disastrous signs of deadly sepsis?infected blood throughout the body with massive inflammation. It is because it has ways of shutting down the immune system. It violates many rules of bacteria behavior and this is one reason it has been so seriously missed until recent years. (6)

Treatments include-
ceftin, ciprofloxacin, mycobutin, levaqin, septra, doxycycline, omnicet, cumanda, clove bud oil, houttuynia, banderol

Symptoms-
ice pick like headaches
photophobia
anxiety
reflex sympathetic dystorphy
cardiac problems
gut problems
plantar fascial pain
burning pain
night sweats
weight loss
neurological symptoms
foot pain, sore soles
enlarged lymph nodes
rash that looks like red or purple stretch marks PHOTOS
cold hands and feet
intestinal infection
blood thickning
sore throat
agitation
insomnia
confusion
lower abdominal pain

1. http://flash.lymenet.org/scripts/ultima ... 062704;p=0
2. http://www.lymediseaseresource.com/BurrGuide2008.pdf
3. http://www.lymedisease.org/lyme101/coin ... nella.html
4. http://lymeinfo.wordpress.com/2009/04/1 ... an-part-1/
5. http://www.personalconsult.com/articles ... dlyme.html
6. http://74.125.155.132/custom?q=cache:4m ... le-coop-np
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Su Loka 25, 2009 17:57

Useita tutkimuksia bartonellan aiheuttamista oireista silmissä esim. erilaisia tulehduksia, glaukooma, verkkokalvon irtoaminen, näköhermon turvotus jne:

Tutkimukset koonnut
Soile Juvonen TTT


pn J Ophthalmol. 2006 Mar-Apr;50(2):177-9.
Secondary unilateral glaucoma and neuroretinitis: atypical manifestation of cat-scratch disease.
Ziemssen F, Bartz-Schmidt KU, Gelisken F.

PMID: 16604397 [PubMed - indexed for MEDLINE]
________________________________________
Am J Ophthalmol. 2004 Jan;137(1):187-9.
Bartonella henselae infection associated with neuroretinitis, central retinal artery and vein occlusion, neovascular glaucoma, and severe vision loss.
Gray AV, Michels KS, Lauer AK, Samples JR.
Casey Eye Institute, Oregon Health & Science University, Portland 97201-4197, USA.

PURPOSE: To report a case of Bartonella henselae infection. DESIGN: Observational case report. METHODS: Review of the clinical, laboratory, photographic, and angiographic records of a patient with cat scratch disease associated with central retinal artery and vein occlusion, neovascular glaucoma, and severe vision loss. RESULTS: A 21-year-old man had no light perception in the left eye secondary to concurrent central retinal artery and vein occlusion believed to have resulted from infection with Bartonella henselae. Forty days later, he developed neovascular glaucoma in the left eye. CONCLUSION: Ocular complications associated with Bartonella henselae infection may include central retinal artery and vein occlusion, neovascular glaucoma, and severe vision loss.

PMID: 14700670 [PubMed - indexed for MEDLINE]

Bilateral panuveitis with serous retinal detachment
Ramharter A, Kremser B.
Ophthalmologe. 2009 Apr;106(4):351-5. German.
PMID: 18696078 [PubMed - indexed for MEDLINE]
Related Articles
Bartonella henselae infection presenting as a unilateral acute maculopathy.
Wimmersberger Y, Baglivo E.
Klin Monatsbl Augenheilkd. 2007 Apr;224(4):311-3.
PMID: 17458800 [PubMed - indexed for MEDLINE]
Related Articles

Serous macular detachment as an atypical sign in cat scratch disease
Asensio-Sánchez VM, Rodríguez-Delgado B, García-Herrero E, Cabo-Vaquera V, García-Loygorri C.
Arch Soc Esp Oftalmol. 2006 Dec;81(12):717-9. Review. Spanish.
PMID: 17199167 [PubMed - indexed for MEDLINE]
Related Articles Free article at journal site
4:
Bartonella henselae bacilli detected in vitrectomy aspirates in a patient with massive vitreous opacity with total retinal detachment.
Matsuo T, Notohara K.
Ocul Immunol Inflamm. 2006 Feb;14(1):47-9.
PMID: 16507491 [PubMed - indexed for MEDLINE]
Related Articles
5:
Macular hole in cat scratch disease.
Albini TA, Lakhanpal RR, Foroozan R, Holz ER.
Am J Ophthalmol. 2005 Jul;140(1):149-51.
PMID: 16038666 [PubMed - indexed for MEDLINE]
Related Articles
6:
[Cat-scratch disease neuroretinitis]
Donnio A, Buestel C, Ventura E, Merle H.
J Fr Ophtalmol. 2004 Mar;27(3):285-90. French.
PMID: 15039632 [PubMed - indexed for MEDLINE]
Related Articles Free article at journal site
7:
Submacular exudates with serous retinal detachment caused by cat scratch disease.
Matsuo T, Kato M.
Ocul Immunol Inflamm. 2002 Jun;10(2):147-50.
PMID: 12778351 [PubMed - indexed for MEDLINE]
Related Articles
8:
An uncommon presentation of Bartonella-associated neuroretinitis.
Besada E, Woods A, Caputo M.
Optom Vis Sci. 2002 Aug;79(8 ):479-88.
PMID: 12199539 [PubMed - indexed for MEDLINE]
Related Articles
9:
Unilateral neuroretinitis and periparillary serous retinal detachment in cat-scratch disease.
Saatci AO, Oner FH, Kargi A, Kavukcu S.
Korean J Ophthalmol. 2002 Jun;16(1):43-6.
PMID: 12162517 [PubMed - indexed for MEDLINE]
Related Articles Free article at journal site
10:
Optic disk edema associated with peripapillary serous retinal detachment: an early sign of systemic Bartonella henselae infection.
Wade NK, Levi L, Jones MR, Bhisitkul R, Fine L, Cunningham ET Jr.
Am J Ophthalmol. 2000 Sep;130(3):327-34.
PMID: 11020412 [PubMed - indexed for MEDLINE]
Related Articles
11:
Acute multifocal retinitis.
Cunningham ET Jr, Schatz H, McDonald HR, Johnson RN.
Am J Ophthalmol. 1997 Mar;123(3):347-57.
PMID: 9063244 [PubMed - indexed for MEDLINE]
Related Articles
12:
Diagnostic and therapeutic challenges.
McDonald HR, Schatz H, Johnson RN.
Retina. 1997;17(6):547-50. No abstract available.
PMID: 9428019 [PubMed - indexed for MEDLINE]
Related Articles
1:
[Neuroretinitis. Clinical cases.]
Valverde-Gubianas M, Ramos-López JF, López-Torres JA, Toribio-García M, Milla-Peñalver C, Gálvez Torres-Puchol J, Medialdea-Marcos S.
Arch Soc Esp Oftalmol. 2009 Aug;84(8 ):389-94. Spanish.
PMID: 19728239 [PubMed - in process]
Related Articles
2:
[Bilateral panuveitis with serous retinal detachment]
Ramharter A, Kremser B.
Ophthalmologe. 2009 Apr;106(4):351-5. German.
PMID: 18696078 [PubMed - indexed for MEDLINE]
Related Articles
3:
Ocular bartonella infections.
Roe RH, Michael Jumper J, Fu AD, Johnson RN, Richard McDonald H, Cunningham ET.
Int Ophthalmol Clin. 2008 Summer;48(3):93-105. Review. No abstract available.
PMID: 18645403 [PubMed - indexed for MEDLINE]
Related Articles
4:
Severe occlusive vasculitis as a complication of cat scratch disease.
Berguiga M, Abouzeid H, Bart PA, Guex-Crosier Y.
Klin Monatsbl Augenheilkd. 2008 May;225(5):486-7.
PMID: 18454406 [PubMed - indexed for MEDLINE]
Related Articles
5:
[Serous macular detachment as an atypical sign in cat scratch disease]
Asensio-Sánchez VM, Rodríguez-Delgado B, García-Herrero E, Cabo-Vaquera V, García-Loygorri C.
Arch Soc Esp Oftalmol. 2006 Dec;81(12):717-9. Review. Spanish.
PMID: 17199167 [PubMed - indexed for MEDLINE]
Related Articles Free article at journal site
6:
Secondary unilateral glaucoma and neuroretinitis: atypical manifestation of cat-scratch disease.
Ziemssen F, Bartz-Schmidt KU, Gelisken F.
Jpn J Ophthalmol. 2006 Mar-Apr;50(2):177-9. No abstract available.
PMID: 16604397 [PubMed - indexed for MEDLINE]
Related Articles
7:
Bartonella henselae bacilli detected in vitrectomy aspirates in a patient with massive vitreous opacity with total retinal detachment.
Matsuo T, Notohara K.
Ocul Immunol Inflamm. 2006 Feb;14(1):47-9.
PMID: 16507491 [PubMed - indexed for MEDLINE]
Related Articles
8:
Pattern visual evoked potentials in eyes with disc swelling due to cat scratch disease-associated neuroretinitis.
Chai Y, Yamamoto S, Hirayama A, Yotsukura J, Yamazaki H.
Doc Ophthalmol. 2005 Mar-May;110(2-3):271-5.
PMID: 16328936 [PubMed - indexed for MEDLINE]
Related Articles
9:
Cat scratch disease in two brothers.
Foroozan R.
J Neuroophthalmol. 2004 Jun;24(2):186-7. No abstract available.
PMID: 15179075 [PubMed - indexed for MEDLINE]
Related Articles
10:
[Cotton wool spots in a 16-year-old girl]
Pieh C, Ness T, Lagrèze WA.
Ophthalmologe. 2005 May;102(5):524-6. German. No abstract available.
PMID: 15095109 [PubMed - indexed for MEDLINE]
Related Articles
11:
Retinal and optic nerve neovascularization associated with cat scratch neuroretinitis.
Mason JO 3rd.
Retina. 2004 Feb;24(1):176-8. No abstract available.
PMID: 15076968 [PubMed - indexed for MEDLINE]
Related Articles
12:
Images in clinical medicine. Optic neuritis due to Bartonella henselae infection.
Herz AM, Lahey JM.
N Engl J Med. 2004 Jan 8;350(2):e1. No abstract available.
PMID: 14711929 [PubMed - indexed for MEDLINE]
Related Articles
13:
Submacular exudates with serous retinal detachment caused by cat scratch disease.
Matsuo T, Kato M.
Ocul Immunol Inflamm. 2002 Jun;10(2):147-50.
PMID: 12778351 [PubMed - indexed for MEDLINE]
Related Articles
14:
[Severe retinal phlebitis in ocular bartonellosis]
Díaz-Valle D, Toledano Fernández N, Arteaga Sánchez A, Miguélez Sánchez R, Pascual Allen D.
Arch Soc Esp Oftalmol. 2003 Apr;78(4):223-6. Spanish.
PMID: 12743848 [PubMed - indexed for MEDLINE]
Related Articles Free article at journal site
15:
Mass lesions of the posterior segment associated with Bartonella henselae.
Kawasaki A, Wilson DL.
Br J Ophthalmol. 2003 Feb;87(2):248-9. No abstract available.
PMID: 12543767 [PubMed - indexed for MEDLINE]
Related Articles Free article in PMC | at journal site
16:
An uncommon presentation of Bartonella-associated neuroretinitis.
Besada E, Woods A, Caputo M.
Optom Vis Sci. 2002 Aug;79(8 ):479-88.
PMID: 12199539 [PubMed - indexed for MEDLINE]
Related Articles
17:
Focal retinal phlebitis as a presenting sign of systemic Bartonella henselae infection.
Chang MS, Lee SS, Cunningham ET Jr.
Retina. 2001;21(3):280-1. No abstract available.
PMID: 11421028 [PubMed - indexed for MEDLINE]
Related Articles
18:
Pars plana vitrectomy for epiretinal membrane secondary to cat scratch neuroretinitis.
Canzano JC, Lim JI.
Retina. 2001;21(3):272-3. No abstract available.
PMID: 11421023 [PubMed - indexed for MEDLINE]
Related Articles
19:
Images in clinical medicine. Bartonella neuroretinitis.
Earhart KC, Power MH.
N Engl J Med. 2000 Nov 16;343(20):1459. No abstract available.
PMID: 11078771 [PubMed - indexed for MEDLINE]
Related Articles
20:
Optic disk edema associated with peripapillary serous retinal detachment: an early sign of systemic Bartonella henselae infection.
Wade NK, Levi L, Jones MR, Bhisitkul R, Fine L, Cunningham ET Jr.
Am J Ophthalmol. 2000 Sep;130(3):327-34.
PMID: 11020412 [PubMed - indexed for MEDLINE]
Related Articles
21:
Cat scratch disease: posterior segment manifestations.
Eggenberger E.
Ophthalmology. 2000 May;107(5):817-8. No abstract available.
PMID: 10811065 [PubMed - indexed for MEDLINE]
Related Articles
22:
Diagnostic and therapeutic challenges.
McDonald HR.
Retina. 1999;19(6):558-62. No abstract available.
PMID: 10606459 [PubMed - indexed for MEDLINE]
Related Articles
23:
Cat-scratch neuroretinitis.
Lombardo J.
J Am Optom Assoc. 1999 Aug;70(8 ):525-30.
PMID: 10506816 [PubMed - indexed for MEDLINE]
Related Articles
24:
Bilateral Bartonella-associated neuroretinitis.
Wade NK, Po S, Wong IG, Cunningham ET Jr.
Retina. 1999;19(4):355-6. No abstract available.
PMID: 10458308 [PubMed - indexed for MEDLINE]
Related Articles
25:
Cat scratch disease: posterior segment manifestations.
Solley WA, Martin DF, Newman NJ, King R, Callanan DG, Zacchei T, Wallace RT, Parks DJ, Bridges W, Sternberg P Jr.
Ophthalmology. 1999 Aug;106(8 ):1546-53.
PMID: 10442903 [PubMed - indexed for MEDLINE]
Related Articles
26:
Presumed ocular bartonellosis.
Kerkhoff FT, Ossewaarde JM, de Loos WS, Rothova A.
Br J Ophthalmol. 1999 Mar;83(3):270-5.
PMID: 10365031 [PubMed - indexed for MEDLINE]
Related Articles Free article in PMC | at journal site
27:
Bartonella henselae infection associated with peripapillary angioma, branch retinal artery occlusion, and severe vision loss.
Gray AV, Reed JB, Wendel RT, Morse LS.
Am J Ophthalmol. 1999 Feb;127(2):223-4.
PMID: 10030575 [PubMed - indexed for MEDLINE]
Related Articles
28:
Optic disk edema with a macular star.
Ghauri RR, Lee AG.
Surv Ophthalmol. 1998 Nov-Dec;43(3):270-4.
PMID: 9862313 [PubMed - indexed for MEDLINE]
Related Articles
29:
Cat-scratch disease manifesting as unifocal helioid choroiditis.
Pollock SC, Kristinsson J.
Arch Ophthalmol. 1998 Sep;116(9):1249-51. No abstract available.
PMID: 9747695 [PubMed - indexed for MEDLINE]
Related Articles
30:
Bartonella serology for patients with intraocular inflammatory disease.
Rothova A, Kerkhoff F, Hooft HJ, Ossewaarde JM.
Retina. 1998;18(4):348-55. Erratum in: Retina 1999;19(3):260.
PMID: 9730179 [PubMed - indexed for MEDLINE]
Related Articles
31:
Use of retinal biopsy to diagnose Bartonella (formerly Rochalimaea) henselae retinitis in an HIV-infected patient.
Warren K, Goldstein E, Hung VS, Koehler JE, Richardson W.
Arch Ophthalmol. 1998 Jul;116(7):937-40.
PMID: 9682711 [PubMed - indexed for MEDLINE]
Related Articles
32:
Leber's neuroretinitis in a patient with serologic evidence of Bartonella elizabethae.
O'Halloran HS, Draud K, Minix M, Rivard AK, Pearson PA.
Retina. 1998;18(3):276-8. No abstract available.
PMID: 9654422 [PubMed - indexed for MEDLINE]
Related Articles
33:
Retinal and choroidal manifestations of cat-scratch disease.
Ormerod LD, Skolnick KA, Menosky MM, Pavan PR, Pon DM.
Ophthalmology. 1998 Jun;105(6):1024-31. Review.
PMID: 9627652 [PubMed - indexed for MEDLINE]
Related Articles
34:
Bartonella henselae neuroretinitis in cat scratch disease. Diagnosis, management, and sequelae.
Reed JB, Scales DK, Wong MT, Lattuada CP Jr, Dolan MJ, Schwab IR.
Ophthalmology. 1998 Mar;105(3):459-66.
PMID: 9499776 [PubMed - indexed for MEDLINE]
Related Articles
35:
Inflammatory mass of the optic nerve head associated with systemic Bartonella henselae infection.
Cunningham ET Jr, McDonald HR, Schatz H, Johnson RN, Ai E, Grand MG.
Arch Ophthalmol. 1997 Dec;115(12):1596-7. No abstract available.
PMID: 9400801 [PubMed - indexed for MEDLINE]
Related Articles
36:
Acute multifocal retinitis.
Cunningham ET Jr, Schatz H, McDonald HR, Johnson RN.
Am J Ophthalmol. 1997 Mar;123(3):347-57.
PMID: 9063244 [PubMed - indexed for MEDLINE]
Related Articles
37:
Diagnostic and therapeutic challenges.
McDonald HR, Schatz H, Johnson RN.
Retina. 1997;17(6):547-50. No abstract available.
PMID: 9428019 [PubMed - indexed for MEDLINE]
Related Articles
38:
Bartonella henselae-associated acute multifocal retinitis in a patient with acquired immunodeficiency syndrome.
Jones MR, Cunningham ET Jr.
Retina. 1997;17(5):457-9. No abstract available.
PMID: 9355199 [PubMed - indexed for MEDLINE]
Related Articles
39:
Bilateral optic disc edema and multifocal retinal lesions without loss of vision in cat scratch disease.
Bafna S, Lee AG.
Arch Ophthalmol. 1996 Aug;114(8 ):1016-7. No abstract available.
PMID: 8694710 [PubMed - indexed for MEDLINE]
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Ma Loka 26, 2009 10:11

Artikkeli borrelia- ja bartonellabakteereista sekä bartonellan hoidosta.

Ps. Artikkeli käännetään jossakin vaiheessa suomeksi.

Lyme borreliosis and Bartonella

By Barbara L. Fitzmaurice, R. N.

Co-infection with multiple vector-borne organisms may occur in animals and in humans. We now realize it is very possible to be infected with bacterial, rickettsial, parasitic, viral, and protozoal organisms following the attachment of a single tick. Borrelia burgdorferi, a spirochetal bacteria, other strains of Borrelia species, and additional infectious organisms such as the protozoa, Babesia spp.(18 ) (babesiosis), Francisella tularensis (tularemia), Rickettsia rickettsii (Rocky Mountain spotted fever)(1) and ehrlichiosis (an intracellular bacteria causing human monocytic ehrlichiosis (HME) and human granulocytic ehrlichiosis (HGE)), mycoplasma (parasitic bacteria), and Powassan-like virus also are spread by ticks.(2) More recently, bartonella, an intracellular organism transmitted via the tick, has also been found to infect humans.(3)(4)(5)

The organisms in the genus bartonella have emerged in importance as opportunistic pathogenic infections in humans. Seven species, with a possibility of an eighth, exist in the genus bartonella and are known to cause illness in humans: Bartonella bacilliformis, B. elizabethae, B. henselae, B. quintana, B. washoensis, B. vinsonii subsp. Berkhoffii, B. vinsonii subsp. Arupensis. (Table 1) A widening spectrum in the bartonella species and subspecies of organisms causes infections in mammals as well. Birds, which carry lice and ticks, no doubt play a major role in transporting and disseminating these infected vectors, resulting in widespread disease. Numerous animals, both domestic and wild, act as reservoirs for the bartonella species. With the apparent ability of insects also to act as bartonella reservoirs, a much higher prevalence of this infectious disease is becoming evident.

Another possibility is that many of the infectious diseases mentioned above could have the potential to be sexually transmitted. Research into transmission of some of the above diseases through other vectors, such as the mosquito,(6) flea, sand fly, and louse, as well as via blood transfusions,(8 )(9(10) mother to fetus transmission,(13)(14), and transmission through breast-feeding, has been documented. A few early studies looked at direct contact as a mode of transmission of spirochetes. (15) (19) It is possible that bartonella infections or the other pathogenic organisms found in Lyme disease patients may also be transmitted between species by other mechanisms than those known or suspected. (6) (12) Clearly, the growth in the numbers of ticks in the United States and worldwide is alarming. (11) Increasing tick populations, along with other vectors capable of transmitting Lyme disease and other infectious illnesses to humans, has reached a level that no prudent public or private healthcare professional should ignore.

The bartonella species are not free-living organisms and require a reservoir host that is transferred by vectors such as body lice, flies, and ticks. Fleas have been found infected with Bartonella henselae in both dogs and cats, indicating that Bartonella henselae may be transmitted to humans and pets via the flea vector. (15) (16) While researchers still dispute this, there is a growing number of reports of patients proving positive for bartonella infection having no history of contact with cats. Scratches from a cat and exposure to the saliva were thought to be the only means of transmission of bartonella infection for a very long period. It has since been established that fleas carry the organism in their midgut, and bartonella has also been found in the feces of fleas.(16) (21)(39) Other small and large animals that carry fleas and ticks may undoubtedly act as hosts as well. (Table 1)

Table 1 - The genus bartonella with species and subspecies listed. As research is ongoing, undoubtedly more strains will be discovered and more information will be forthcoming on the specific illnesses these organisms are capable of causing in humans.


Bartonella bacilliformis (also called Bartonellesis)
Flies in South America Oroyo fever (acute hemolytic anemia), Carrion?s disease (chronic ? verruga peruana) (3)(15)(20)
B. Elizabethae Tick and Rodent Endocarditis (26)
B. henselae (11 strains)* Fleas, ticks, animals Cat scratch disease, endocarditis, (3)(19) bacillary angiomatosis (24)
B. quintana (7 strains)* Body louse, tick Trench fever, endocarditis, (3)(23) bacillary angiomatosis (46)
B. clarridgeiae Fleas, cats. Isolated from a patient Found in cat scratch disease. Found in a patient with endocarditis
B. alsatica sp. nov. Isolated from the blood of wild rabbits Unknown if disease in humans
B. birtlesii Isolated from small mammals Unknown if disease in humans
B. bovis Isolated from European & American ruminants Unknown if disease in humans
B. capreoli Isolated from European ruminants Unknown if disease in humans
B. doshiae Isolated from the blood of animals and man Unknown if disease in humans
B. grahamii (5 strains)* Isolated from the blood of animals Neuroretinitis(54)
B. koehlerae Isolated from the blood of animals Unknown if disease in humans
B. peromysci Isolated from the blood of animals Unknown if disease in humans
B. schoenbuchii sp. nov. Isolated from the blood of wild roe deer (45)
B. talpae Isolated from the blood of animals Unknown if disease in humans
B. taylorii (6 strains)* Isolated from the blood of animals Unknown if disease in humans
B. tribocorum Isolated from the blood of animals Unknown if disease in humans
B. vinsonii subsp. arupensis Isolated from the blood of animals and man Valvular disease, heart, fever, and neurological signs(3)
B. vinsonii subsp. berkhoffii Isolated from the blood of the canine, rodents, and ticks Endocarditis(3)(19)(26)
B. vinsonii subsp. vinsonii Isolated from the blood of animals, transmission via tick Unknown if disease in humans
B. washoensis
Rodents, I. pacificus ticks

Myocarditis (3)

(1) (26) (27) (37) (43)*
Relationship of Bartonella Species
Similar protein profiles have been established and a dendrogram (comparison of relationships based on immunoreactive bands) demonstrated that the Bartonella species can be divided into three groups:
? Bartonella bacilliformis is distinct from the other bartonella species
? Bartonella grahamii, Bartonella taylorii, Bartonella doshiae, and Bartonella Vinsonii are related and form a cluster
? Bartonella henselae, Bartonella quintana, Bartonella elizabethae and Bartonella clarridgeiae also form a cluster
. (Bartonella henselae is related closely to Bartonella quintana, Bartonella clarridgeiae is closely related to Bartonella henselae, and Bartonella elizabethae is closely related to Bartonella quintana and Bartonella henselae)

ITS, or intergenic spacer sequencing, may be an effective method for the further sub-typing and identification of the Bartonella spp. For instance, B. henselae has further been found to have 11 strains of the organism.(43)(56)
Western blotting appears to be an effective method to identify the phenotype of the bartonella group down to the species.(43)

? Bartonella bacilliformes: Oroyo fever, or Carrion?s disease, is transmitted from the sand fly in South America and can cause severe progressive anemia and high fevers with muscle, tendon, and joint pain. Skin eruptions or internal lesions that bleed profusely may be present, and the result can be fatal. The organism attaches to red blood cells and destroys them. If disseminated into the brain, neurological problems may develop causing seizures, paralysis, and death. In 1926 research by H. Noguchi, the tick Dermacentor andersoni was experimentally infected with Bartonella bacilliformis, which then transmitted the organism to a non-human primate.(20)

The term ?bartonellosis? has been used to describe the frequently fatal syndrome caused by B. bacilliformis. It has only been reported in South America, although with the emergence and increase in illness due to vector-borne disease worldwide, it may someday have no boundaries. One treatment and another consideration worth noting is that chloramphenicol is effective against Salmonella, and this organism has been found as a secondary infection along with B. bacilliformis.(25)

? Trench fever due to Bartonella quinata (formerly Rickettsia, Rochalimaea) can be contracted after exposure to the body louse and may cause prolonged or recurrent fevers. Transmission commonly occurs when infected lice feces are rubbed into an open area on the skin or in the eyes. The organism can persist in humans for months after recovery and relapses have been reported as many as ten years later. This illness was seen in military personnel during World War I and World War II. The incubation period is 14-30 days, but problems may appear sooner. Onset is sudden, with fever, weakness, dizziness, and headache. There may be severe back and leg pains, bone pain, and an enlarged spleen. Fever may reach 40.5° C (105° F) and persist for five to six days. Fever has been reported to reoccur at intervals. Rash is possible. The liver and the spleen may enlarge, and recently endocarditis, an infection involving the heart, has been documented.(19)(22)(25) Recommendations for treatment are chloramphenicol and the tetracyclines, although currently there have been no studies to prove that this disease can be overcome completely.(18 )(19)(24)

? Bacillary angiomatosis (BA), due specifically to B. henselae and B. quintana, was the name used when first recognized in immunocompromised AIDS patients. These patients either developed nodules under the skin or vascular lesions, meaning bartonella infection had entered the blood vessels or lymph system. The nodules included papular, nodular, or polypoid lesions. (23) BA may also occur as a septicemia, infection that has disseminated into the blood, which if left untreated may lead to death. A patient with BA may have an increase in lesions, rashes, abscesses, chills, fever, sweats, lack of appetite, nausea, and vomiting as well as weight loss. BA is now reported to be an illness found in immunocompetent patients as well (32)

? B. elizabethae can cause endocarditis. B. vinsonii has been reported recently to be another cause of human endocarditis. Two Bartonella species, B. henselae and B. clarridgeiae, have been isolated from the blood of cats. B. henselae DNA has been amplified from fleas isolated from bacteremic cats. Transmission of B. henselae by the cat flea, or Ctenocephalides felis, has been demonstrated. Recently, B. clarridgeiae was isolated from the blood of a cat. It was present in the bloodstream of a healthy cat involved in a human case of cat-scratch disease (CSD) caused by B. henselae. It is not known whether B. clarridgeiae can be transmitted to man via cat or whether it actually does induce disease in humans.(26)(27) However, it is highly suspect since B. clarridgeiae antibodies recently have been found in a chest wall abscess.(35)

? Bartonella henselae, or cat -scratch disease (CSD), originally named Rochalimaea henselae in 1992, was renamed Bartonella henselae after the entire genus of Rochalimaea was merged with the genus of Bartonella in 1993. This organism is a gram-negative rod-like bacillus. Cat-scratch disease was described in 1950, but not until some 43 years later was a primary pathogen found. In the 1990s, it was determined that this infectious agent could be widespread in humans after AIDS patients were observed exhibiting symptoms that affected virtually every organ system in the body, including the brain, heart, lymph, bone, bone marrow, muscle, soft tissue, liver, and spleen. (20)(21)(25) The same organism has been identified as a cause of encephalitis following dissemination of Bartonella henselae into the central nervous system.

CSD can be transmitted by kittens and cats and, most likely, by fleas and ticks. This illness is closely related to Bacillary angiomatosis, which has mainly been seen in AIDS and other immunocompromised patients.(20)(27) It should be noted that the saliva of the cat might also contain the organism. Therefore, if an open area on the body is exposed to the Bartonella organism, transmission can also occur in that fashion.

Earlier papers discussed the idea that immunocompromised individuals would be the most susceptible population at risk for contracting cat-scratch fever if exposed to the organism Bartonella. First recognized in AIDS patients and later in individuals with chronic illnesses such as cancer, it has most recently been detected in patients with chronic infections including Lyme disease. This population of patients most likely would have more complications in fighting this infection. Still some physicians continue to insist that infection with a Bartonella species is a self-limiting illness in an otherwise healthy individual.

After a superficial scratch from cat or kitten, a raised lesion or papule may form near the point of injury, reportedly, in about half of the CSD patients. The lesion becomes red and crusty. One to two weeks later, swollen painful lymph glands, along with fever, may appear. Conjunctivitis, meningitis, or pneumonia, all serious complications, may develop.(24)

Patients complain of fatigue, headache, sore throat, swollen and painful lymph glands and, sometimes, loss of appetite, with weight loss due to nausea and vomiting occurring in some individuals. Reddish, berry-like lesions on the skin can bleed very easily if the skin is injured. In other patients, no rashes or lesions develop. Infections occur in bone, liver, and brain. Abscesses may form. Endocarditis may develop in AIDS patients or the immunocompromised patient infected with Bartonella henselae and Bartonella quinata. As this pathogenic organism may not be well recognized, it could present as a very serious illness in the immunocompetent person as well.(33)(34)

Other symptoms include inflammation of the optic nerve and the retina, myelitis leading to paraplegia, and cerebral arteritis, an inflammation of an artery in the brain. Cranial or peripheral nerve involvement may be present. Facial palsy or peripheral facial nerve paralysis, known as Bell?s palsy, has been commonly reported in patients with Lyme disease and is also reported in Cat Scratch Disease.(22)(24)(36))(37)(38 )(49)

Cats can be infected with Bartonella henselae but remain without symptoms. With the latest findings that a flea or tick may carry the disease and transmit it to humans, potential infection with this disease should not be overlooked. This is an important fact for all clinicians to take into account. Families that have pets or may have contact with small animals that carry lice and ticks need to take action to eliminate these parasites from their pets.

Testing and Diagnosing

?For many years, CSD has been clinically diagnosed when three of the following four criteria are met in a patient: 1) history of traumatic cat contact; 2) positive skin-test response to CSD skin-test antigen; 3) characteristic lymph node lesions; and 4) negative laboratory investigation for unexplained lymphadenopathy.? (32) Quoted from Russell Regnery, Ph.D., and Jordan Tappero, M.D., 1995

Blood serology has commonly been used to look for the antibodies to both Bartonella henselae and Bartonella quintana. It was not until fairly recently that testing for antibodies in other species was undertaken. Bartonella henselae can be cultured from lymph nodes or the papule area of a scratch. Positive antibody titers can help confirm the diagnosis, but may or may not be present. CT scans may be normal or EEG?s may show some slowing, but the all-important medical history and physical exam are essential in determining the diagnosis of cat-scratch disease. An antibody titer test may be ordered to see if the person is producing antibodies to Bartonella henselae. A polymerase chain reaction test (PCR) can be performed but it still may not reflect with absolute certainty an infection with the Bartonella organism unless histology and serology testing is also done. Using special techniques, the bacteria can sometimes be seen in a biopsy specimen from the affected body part.

Still, it is possible to have routine laboratory cultures reported as ?negative.? Bartonella organisms from the many species and strains have not all been differentiated, and so the exact infecting species or strain may not be known in patients. Enhanced methodologies in the future may help answer these questions and decrease confusion. Coxiella or Chlamydia are two infections that are difficult to differentiate from bartonella even with testing. All can be a cause of endocarditis, but different antibiotics are used in treatment. Development of reliable tests to distinguish between these organisms is very much needed.(44)

Spinal fluid may also show an increase in protein, but minimal pleocytosis (a small increase in the number of lymphocytes in cerebral spinal fluid) may be observed. New testing methods that distinguish between B. henselae and closely related B. quintana cells might be more sensitive in PCR testing. The organism itself can be viewed in tissues.(43)(44) Other illnesses due to Bartonella henselae are bacillary angiomatosis (BA) and Parinaud?s oculoglandular syndrome (eye involvement with red, irritated eye). There may be excessive tears, similar to conjunctivitis. Sometimes swelling of the lymph glands occurs nearby, often in front of the ear. A fever and generalized illness may be present.(3)

Using indirect fluorescence assay (IFA), IgG antibody positive titers in the acute phase of B. henselae infection have been reported to be high after two weeks. IgG antibodies were lower after 25 weeks. IgM antibodies demonstrated less sensitivity using IFA serology testing.(45) PCR sensitivity and specificity from the lesions or nodes, may be even more accurate if fine needle aspiration is employed. (32) Bartonella henselae and Bartonella quinata can be tested in the blood of immunocompromised patients by obtaining blood cultures and using special stains that are allowed to grow for 21 days or longer. This may delay much needed treatment. In summary, this infection can be present in the immunocompetent patient and not easily identified by a lab test alone.

It cannot be stressed enough how often misdiagnoses of Bartonella infections have occurred due to atypical onset and non-recognition of the widespread symptoms. A case study revealed that a four-year-old girl died even though treated aggressively for fevers and seizure. At autopsy, the little girl?s brain revealed marked cerebral edema and multiple granulomatous lesions as well as meningitis and encephalitis. Testing using PCR and Southern Blot was positive for Bartonella DNA.(40)

The pathogenic course of a bartonella infection can be very difficult to distinguish from the signs and symptoms of many bacteria, viruses, fungi, and protozoan infections. Gaubitz et al., reported a young woman who had been diagnosed with systemic lupus erythematosus and treated with increasing doses of steroids, but yet did not respond. Scratches on her arms from her cat led to suspicion of cat-scratch disease, and the illness was ultimately confirmed with additional blood tests. Treatment with clarithromycin was given and a rapid, favorable response resulted.(29)

Brain involvement may not be recognized as due to an infectious organism. A careful history, including potential exposure to cats or other animals, fleas, ticks, or other vectors may determine if serological testing for one of the bartonella species is necessary. Whole families can develop CSD. Multiple cases of encephalitis may raise the question if differing virulence among the strains of Bartonella henselae is a possibility. If antibodies to Bartonella henselae are detected in CSF, the organism may have directly invaded the central nervous system.(48 )

Treatment
An acute bartonella infection may respond to antimicrobial treatment even in immunocompromised individuals. Doxycycline, erythromycin, and rifampin are recommended antibiotics. Penicillin, gentamicin, ceftriaxone, ciprofloxacin, and azithromycin have been used and patients have responded favorably. Treatment for two weeks in immunocompetent individuals and six weeks in immunocompromised people is generally recommended. Relapses, associated with bacteremia, have been reported in immunocompromised people despite treatment for six weeks. (50)

"Because Bartonella species are highly susceptible to aminoglycosides, the usual recommendation of penicillin or ampicillin plus an aminoglycoside to treat blood culture-negative endocarditis will effectively treat Bartonella endocarditis. In one patient (patient 19), however, B. henselae was isolated after the completion of a course of aminoglycoside therapy. Some researchers have reported that ciprofloxacin is more effective.? (3) Rauolt, et al, 1996

According to the same sources, treatment is not generally needed except in an immunocompromised population and when neurological or liver involvement develops. CSD might be suspected if it has been previously diagnosed, and the patient has persistent complaints of not feeling well. Recurrence is possible.

When a scratch or a bite from a kitten or cat or other furred creature has occurred, warm compresses to the scratch and papule area should be applied after first cleaning with an antiseptic, such as peroxide. If the area becomes swollen, irritated, and uncomfortable, a doctor should be called. Purulent drainage may indicate an infection. If lymph nodes become swollen and painful, needle aspiration should be considered, as well as testing for potential infectious agents.

Rifampin, ciprofloxacin, gentamicin, and trimethoprim-sulfamethoxazole have demonstrated good results for CSD in a laboratory setting. Treatment failures, however, have been reported in some patients. In severe cases, gentamicin has shown some effectiveness.(25) Oral doses of erythromycin or doxycycline have been used over at least a three-month period with reported success. Infections involving the heart, liver or, in the case of severe disseminated infection, may require intravenous antibiotics, changed to orals after the infection is under some control. Combination antibiotics may be indicated.(25) There are reports on the varying duration of treatment, ranging from at least six weeks to six months or longer.

Because of the wide variations of antibiotics used against bartonella infections in both lab settings and actual patients, it is unclear which treatment is superior to another. Patient responses in objective and subjective outcomes have to guide the physician. Co-infections must be considered, because once an organism has invaded and produced an illness, a patient?s immune capabilities are at risk. There is no set protocol of treatment for many of the vector-borne diseases, especially if two or three are involved in a specific patients? illness. Treatment has to be individualized and followed closely by a doctor who is experienced in treating the full realm of vector-borne illnesses.

Summary

As more is learned about bartonella infections in patients already infected with Borrelia burgdorferi, the possibility exists that infection with this organism is one explanation for the chronicity of Lyme disease. The idea that short courses of antibiotics may cure the Lyme borreliosis infected victim when, in fact, various spirochetal strains are known to recur and persist, is illogical. With the added knowledge of co-infection, treatments must be individualized and no set protocol can be followed precisely. Being co-infected with a recurring or persistent bartonella infection, or even another infectious agent such as a Babesia spp., may help to explain prolonged illness in some of the Lyme borreliosis-infected population.(55)

We can no longer ignore some of the questions regarding bartonella infections and what role they may be playing in Lyme disease victims. There are many unknowns about bartonella infections as well as its various species and strains.

Does borreliosis play a role, due to the Borrelia spp. spirochetes and other vector-borne infections, in people diagnosed with chronic fatigue syndrome, fibromyalgia, or Gulf War Syndrome? Ticks, fleas, sand flies, and other insects, as well as household pets and the above mentioned illnesses and syndromes, may all be involved when the immune system becomes compromised and a person has had exposure to a pathogenic organism. Testing is not conclusive in many of the vector-borne diseases. Signs and symptoms can overlap or be misdiagnosed without thought being given to a chronic infection, let alone the full spectrum of infections.

A major problem exists - physicians in the United States and around the world do not adequately recognize the issue of the seriousness of tick-borne or other vector-borne illnesses. The vast majority of mainstream medical providers do not acknowledge that local ticks and other vectors that transmit pathogenic organisms can cause severe illness. The appropriate recognition of Lyme borreliosis and other opportunistic infections causing a host of continuing problems, manifested as chronic persistent disease, is essential for meaningful progress to be made.

Signs & Symptoms Involving Bartonella Infection

Scratches, bites from a cat or animal Nausea, vomiting, weight loss
Rashes and/or lesion ? may or may not be present Liver and/or spleen enlargement
Draining, purulent wound, may or may not be present Headache
Respiratory difficulties, shortness of breath, cough Heart ? chest pain, cough, irregular heart beat
Temperature ? may or may not be elevated Memory loss
Generalized weakness. Limbs, whole body Extreme fatigue
Pain ? muscle, tendons, joints Hearing loss
Swollen lymph glands, may become tender, painful Balance, equilibrium problems
Pain in limbs, disseminated throughout the body Facial palsy
Difficulty with urination, bloody urine Seizures
Retention of fluids, swelling in extremities Vision problems, eye infections, red, runny

References

(1) Schouls LM, Van De Pol I, Rijpkema SG, Schot CS, Detection and identification of Ehrli
chia, Borrelia burgdorferi sensu lato, and Bartonella species in Dutch Ixodes ricinus ticks. J Clin Mi
crobiol 1999. Jul;37(7):2215-22 Research Laboratory for Infectious Diseases, National Institute of
Public Health and the Environment, Bilthoven, The Netherlands. L.M.Schouls@rivm.nl
http://www2.lymenet.org/domino/abstract ... 4c13c50ba4
82591852567d800047ac7?OpenDocument
(2) Burgdorfer, W. A review of Rocky Mountain spotted fever (tick-borne typhus), its agent, and its tick vectors in the United States. Journal of Medical Entomology, (1975). 12, 269-278.
(3) Information on Arboviral Encephalitides CDC, Division of Vector-borne Infectious Diseases,
http://www.cdc.gov/ncidod/dvbid/arbor/arbdet.htm
(4) Chang CC; Chomel BB; Kasten RW; Romano V; Tietze N Molecular evidence of Bartonella spp. in questing adult Ixodes pacificus ticks in California J Clin Microbiol 2001 Apr;39(4):1221-6 (ISSN: 0095-1137) Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, California 95616, USA.
http://jcm.asm.org/cgi/reprint/39/4/1221.pdf
http://jcm.asm.org/cgi/content/full/39/ ... smjournals
(5) Mitchell, Paul D.* Reed, Kurt D. and Hofkes, Jeanie M., Journal Of Clinical Microbiology, 1996 Mar., p. 724?727 Vol. 34, No. 3 0095-1137/96/$04.0010 Copyright q 1996, American Society for Microbiology Immunoserologic Evidence of Coinfection with Borrelia burgdorferi, Babesia microti, and Human Granulocytic Ehrlichia Species in Residents of Wisconsin and Minnesota Microbiology Section, Marshfield Laboratories, Marshfield, Wisconsin 54449
http://jcm.asm.org/cgi/reprint/34/3/724.pdf]
(6) Eskow E; Rao RV; Mordechai E Concurrent infection of the central nervous system by Borrelia burgdorferi and Bartonella henselae: evi-
dence for a novel tick-borne disease complex. Arch Neurol 2001 Sep;58(9):1357-63 (ISSN: 0003-9942) Hunterdon Medical Center,
Flemington, NJ, USA. http://archneur.ama-assn.org/issues/v58 ... 10093.html
(7) Halouzka J; Wilske B; Stunzner D; Sanogo YO; Hubalek Z Isolation of Borrelia afzelli from overwintering Culex pipiens biotype molestus mosquitoes Infection 1999;27(4-5):275-7 (ISSN:0300-8126) Institute od Vertebrate Biology, Academy of Sciences of the Czech Republic,
Brno. http://www.ncbi.nlm.nih.gov/entrez/quer ... t=Abstract
(8 ) Isolation of the spirochaete Borrelia afzelii from the mosquito Aedes vexans in the Czech Repub lic. Med Vet Entomol. 1998
Jan;12(1):103-5.PMID: 9513946 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/quer ... t=Abstract
(9) Pantanowitz L, Telford SR, Cannon ME. Tick-borne diseases in transfusion medicine. Department of Pathology (LP, MEC), Beth Israel Deaconess Medical Center, Harvard Medical School and Har vard School of Public Health (SRT), Boston, MA 02215, USA lpantanowitz@hotmail.com
http://www.blackwellsynergy.com/servlet ... 02.00358.x
(10) Geralyn Willan RN, Blood Products, Centre Universitaire de Santé McGill / McGill University Health Centre Hôpital Général de Montréal/ Montreal General Hospital 5.Infectious Disease Transmission ? Blood transfusions by http://www.mmi.mcgill.ca/sicu/files/bloodproduct.pdf
(11) Arguin PM, Singleton J, Rotz LD, Marston E, Treadwell TA, Slater K, et al. An investigation into the possibility of transmission of tick-borne pathogens via blood transfusion. Transfusion.
(12) LT Charmagne Goodman, MC, USNR; CAPT Angeline A. Lazarus, MC, USN; CDR Gregory mJ. Martin, MC, USN Manifestations of tick-borne illness Incidence and variety are increasing worldwideVOL 109 / NO 6 / JUNE 2001 / POSTGRADUATE MEDICINE http://www.postgradmed.com/issues/2001/ ... oodman.htm
(13) Agustín Estrada-Peña, Environmental Health Perspectives Volume 110, Number 7, July 2002 In creasing Habitat Suitability in the United States for the Tick that Transmits Lyme Disease: A Remot Sensing Approach Department of Parasitology, Faculty of Veterinary Medicine, Miguel Servet, Zaragoza, Spain http://ehpnet1.niehs.nih.gov/docs/2002/ ... tract.html
(14) Lavoie PE; Lattner BP; Duray PH; Barbour AG; Johnson HC. Culture positive seronegative transplacental Lyme borreliosis infantmortality. Arthritis Rheum 1987; Volume 30, Number 4, 3(Suppl):S50
(15) J. Elliott,1 Stephen C. Eppes,2 A and Joel D. Klein 2* Teratogen Update: Lyme Disease Daniel 1Department of Pediatrics, Thomas Jefferson University, Philadelphia, Pennsylvania 19107 Department of Pediatrics, Division of Infectious Disease, A I duPont Hospital for Children, Wilmington, Delaware 19899 TERATOLOGY 64:276?281 (2001) http://www.teratology.org/updates/64pg276.pdf
(16) Burgess EC, Amundson TE, Davis JP, Kaslow RA, Edelman R Am J Trop Med Hyg Volume 35 Issue 2 British Library Experimental
inoculation of Peromyscus spp. with Borrelia burgdorferi: evidence of contact transmission. Am J Trop Med Hyg 1986 Mar 35:2 355-9
http://www.ncbi.nlm.nih.gov:80/entrez/q ... t=Abstract
(17) Welch, D. F., Carroll, K. C., Hofmeister, E. K., Persing, D. H., Robison, D. A., Steigerwalt, A. G., Brenner, D. J. Isolation of a New
Subspecies, Bartonella vinsonii subsp. arupensis, from a Cattle Rancher: Identity with Isolates Found in Conjunction with Borrelia burgdor
feri and Babesia microti among Naturally Infected Mice. J. Clin. Microbiol. 37: 2598-2601 (1999).
http://jcm.asm.org/cgi/content/full/37/8/2598
(18 ) Hofmeister EK, Kolbert CP, Abdulkarim AS, Magera JM, Hopkins MK, Uhl JR, Ambyaye A, Telford SR 3rd, Cockerill FR 3rd,
Persing DH.JInfect Dis 1998 Feb;177(2):409-16 Cosegregation of a novel Bartonella species with Borrelia burgdorferi and Babesia microti
in Peromyscus leucopus, Department of Laboratory Medicine and Pathology, Mayo Foundation, Rochester, Minnesot 55905,
USA.Hofmeister.Erik@Mayo.edu http://www.ncbi.nlm.nih.gov/entrez/quer ... t=Abstract
(19) Anderson JF, Johnson RC, Magnarelli LA, Hyde FW, Myers JE.J Clin Microbiol 1986 Jan;
23(1):135-7 Peromyscus leucopus and Microtus pennsylvanicus
simultaneously infected with Borrelia burgdorferi and Babesia microti.
(20) Ha giwara MK, de Souza Zanutto M, Mamizuka EM, et al Experimental Infection And Hori
zontal Transmission Of Bartonella Henselae In Domestic Cats 26th WSAVA Congress Proceedings
August 8 - 11, 2001 Vancouver, British Columbia, Canada
http://www.vin.com/VINDBPub/SearchPB/Pr ... R00252.htm
(21) Noguchi, H. 1926. Etiology of Oroya fever. V. The experimental transmission of Bartonella
bacilliformis by ticks (Dermacentor andersoni). J. Exp. Med. 44:729-734.
(22) Higgins JA; Radulovic S; Jaworski DC; Azad AF Acquisition of the cat scratch disease agent
Bartonella henselae by cat fleas (Siphonaptera:Pulicidae). J Med Entomol 1996 May;33(3):490-5
(ISSN: 0022-2585) Department of Microbiology and Immunology, University of
Maryland Medical School, Baltimore 21201, USA.
(23) Ishida C; Tsuneoka H; Iino H; Murakami K; Inokuma H; Ohnishi T; Tsukahara M Bartonella
henselae infection in domestic cat and dog fleas Kansenshogaku Zasshi 2001
Feb;75(2):133-6 (ISSN: 0387-5911) Faculty of Health Sciences, Yamaguchi University School of
Medicine.
http://intapp.medscape.com/px/medlineap ... dings_file
=1&local_journals_only=0&searchstring=Bartonella+%2B+fleas
(24) Nair,* Tim G. Harrison,? Ian Hunt,* Norman K. Fry,? and Jon S. Friedland*? Prosthetic Valve
Endocarditis Caused by Bartonella quintana, Vol. 8, No. 2 February 2002
*Hammersmith Hospital, London, United Kingdom; ?PHLS Central Public Health Laboratory, Lon
don, United Kingdom; and ?Imperial College, London, United Kingdom
http://www.cdc.gov/ncidod/eid/vol8no2/01-0206.htm
(25) Karem KL. Immune aspects of Bartonella. Crit Rev Microbiol 2000;26(3):133-45 (ISSN: 1040-
841X) Viral and Rickettsial Zoonoses Branch, Division of Viral and Rickettsial Diseases, National
Center for Infectious Diseases, Centers for Disease Control and Prevention, Public Health Service,
U.S. Department of Health and Human Ser.
(26) The Merck Manual of Diagnostics and Therapy, Sec. 13; Ch 159, Rickettsial Diseases.
http://www.merck.com/pubs/mmanual/secti ... 9/159j.htm
(27) Burt E. Anderson*1 and Mark A. Neuman2 Bartonella spp. as Emerging Human Pathogens
Department of Medical Microbiology and Immunology, College of Medicine, University of South
Florida, Tampa, Florida 33612,1 and Department of Pathology and Laboratory Medicine, Naples
Community Hospital, Inc., Naples, Florida 33940,2
http://cmr.asm.org/cgi/reprint/10/2/203 ... lOJlpOjh9I
(28 ) Jensen WA; Fall MZ; Rooney J; Kordick DL; Breitschwerdt EB Rapid identification and differ-
entiation of Bartonella species using a single-step PCR assay. J Clin Microbiol 2000
May;38(5):1717-22 (ISSN: 0095-1137) Heska Corporation, Fort Collins, Colorado 80525, USA.
http://jcm.asm.org/cgi/reprint/38/5/1717.pdf
(29) Massei F, Messina F, Talini I, Massimetti M, Palla G, Macchia P, Maggiore G., Widening of the
clinical spectrum of Bartonella henselae infection as recognized through serodiagnostics. Diparti
mento di Medicina della Procreazione e della Eta Evolutiva, Universita di Pisa, Italy
(30) Gaubitz M, Herrmann M, Shahin M, Schotte H, Willeke P, Domschke W. Lupus
2001;10(12):883-5 Cat scratch disease (bartonellosis) mimicking an SLE flare.
Department of Medicine, University of Munster, Germany. gaubitz@uni-muenster.de
http://www.ncbi.nlm.nih.gov/entrez/quer ... s=11787880
&dopt=Abstract
(31) Raoult D, Fournier PE, Drancourt M, Marrie TJ, Etienne J, Cosserat J, et al. Diagnosis of 22
new cases of Bartonella endocarditis. Ann Intern Med 1996;125:646-52.
http://www.acponline.org/shell-cgi/prin ... rtonel.htm
(32) La Scola B; Raoult D Culture of Bartonella quintana and Bartonella henselae from human samples:
a 5-year experience (1993 to 1998). J Clin Microbiol 1999 Jun;37(6):1899-905 (ISSN: 0095-1137)
Unite des Rickettsies, CNRS UPRESA 6020, Faculte de Medecine, 13385 Marseille Cedex 05, France.
http://intapp.medscape.com/px/medlineap ... dings_file
=1&local_journals_only=0&searchstring=Bartonellosisagnosis
(33) Russell Regnery, Ph.D., and Jordan Tappero, M.D EID Volume 1 * Number 1 January-March
1995 Unraveling Mysteries Associated with Cat-Scratch Disease, Bacillary Angiomatosis, and Re-
lated Syndromes National Center for Infectious Diseases, Centers for Disease Control and Preven-
tion, Atlanta, Georgia, USA http://www.cdc.gov/ncidod/eid/vol1no1/regnery.htm
(34) Bacillary Angiomatosis Authored by Robert A Schwartz, MD, MPH, Professor and Head,
Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and
Community Health, UMDNJ-New Jersey Medical School Coauthored by W Clark Lambert,
MD, PhD, Professor and Head, Dermatopathology, Departments of Pathology and Dermatol
ogy, UMDNJ-New Jersey Medical School, Newark, New Jersey eMedicine Journal, November
2 2001, Volume 2, Number 11
http://www.emedicine.com/derm/topic44.htm
(35) Modi SP, Eppes SC, Klein JD Cat-scratch disease presenting as multifocal osteomyelitis with
thoracic abscess Pediatr Infect Dis J 2001 Oct;20(10):1006-7 (ISSN: 0891-3668)
http://intapp.Medscape.com/px/medlineap ... l_holdings
_file=1&local_journals _only=0&searchstring=Catscratch+disease+presenting+as+multifocal+
osteomyelitis
(36) Margileth AM, Baehren DF. Chest-wall abscess due to cat-scratch disease (CSD) in an
adult with antibodies to Bartonella clarridgeiae: case report and review of the thoracopulmonary
manifestations of CSD. Department of Pediatrics, Mercer University School of Medicine, Macon,
Georgia, USA Therapy Clin Infec Dis 1998 Aug;27(2):353-7
(37) Maurin M; Birtles R; Raoult D Current knowledge of Bartonella species. Eur J Clin Microbiol
Infect Dis 1997 Jul;16(7):487-506 (ISSN: 0934-9723) Unite des Rickettsies, CNRS UPRESA
6020, Universite de la Mediterrance, Faculte de Medecine, Marseille, France.
http://intapp.medscape.com/px/medlineap ... oldings_fi
le=1&local_journals_only=0&searchstring=Bartonella+%2B+fleas
(38 ) PEDIATRICS Vol. 101 No. 5 May 1998, p. e13 ELECTRONIC ARTICLE: Cat Scratch Disease
Presenting With Peripheral Facial Nerve Paralysis Robert S. Walter Division of General Pediat-
rics Department of Pediatrics Thomas Jefferson University duPont Hospital for Children Wil
mington, DE 19899 Stephen C. Eppes Division of Infectious Diseases Department of Pediatrics
Thomas Jefferson University duPont Hospital for Children Wilmington, DE 19899
http://www.pediatrics.org/cgi/content/full/101/5/e13
(39) Arisoy ES, Correa AG, Wagner ML, Kaplan SL. Clin Infect Dis 1999 Apr;28(4):778-84 Hepato-
splenic cat-scratch disease in children: selected clinical features and treatment. Department of
Pediatrics, Baylor College of Medicine, Texas Children?s Hospital, Houston, USA
http://www.journals.uchicago.edu/CID/jo ... 78.web.pdf
(40) Jared M. Frandson, MPH, Julie Rawlings, MPH, Christine R. Burgess, MPH, Kate A. Hen
dricks, MD, MPH&TM; Texas Department of Health, Austin. Cat-Scratch Disease in Texas.
2000. Infect Med 17(10):690-694.
http://id.medscape.com/SCP/IIM/2000/v17 ... .fran.html
(41) Gerber JE, Johnson JE, Scott MA, Madhusudhan KT., Fatal meningitis and encephalitis due to
Bartonella henselae bacteria Journal of Forensic Sciences, Volume: 47 Issue: 3 Year: 2002
Pages: 640-644
(42) Abbott et al. (1997) Experimental and natural infection with Bartonella henselae in cats. Comp.
Immunol. Microbiol. Infect. Dis. 20:41-51.
(43) Kordick et al. (1995) Prolonged Bartonella bacteremia in cats associated with cat-scratch dis-
ease patients. J. Clin. Microbiol. 33:3245-3251.
(44) Pierre Houpikian and Didier Raoult* Journal of Clinical Microbiology, August 2001, p. 2768-
2778, Vol. 39, No. 80095-1137/01/$04.00+0 DOI: 10.1128/JCM.39.8.2768-2778.2001 Copyright ©
2001, American Society for Microbiology. All rights reserved. 16S/23S rRNA Intergenic Spacer Re-
gions for Phylogenetic Analysis, Identification, and Subtyping of Bartonella Species Unité des Rick
ettsies, CNRS-UPRES-A 6020, Faculté de Médecine de Marseille, 13385 Marseille Cedex, France
Corresponding author.Mailing address: Unité des Rickettsies, Faculté de Médecine, 27 boulevard
Jean Moulin, 13006 Marseille, France. Phone: 33 4 91 38 55 17. Fax: 33 4 91 38 77 72.
E-mail: Didier.Raoult@medecine.univ-mrs.fr.
http://jcm.asm.org/cgi/content/full/39/8/2768#FN150
(45) Zhongxing Liang, Bernard La Scola, Hubert Lepidi, and Didier Raoult* Clinical and Diagnostic
Laboratory Immunology, 1071-412X/01/$04.0010 DOI: 10.1128/CDLI.8.4.847?849.2001 July 2001,
p. 847?849 Vol. 8, No. 4 Copyright © 2001, American Society for Microbiology. All Rights Re-
served. Production of Bartonella Genus-Specific Monoclonal Antibodies Unite´ des Rickettsies,
CNRS UPRES-A 6020, Faculte´ de Me´decine, Universite´ de la Mediterrane´e, 13385 Marseille
Ce´dex, France Received 26 October 2000/Returned for modification 22 January 2001/Accepted 3
April 2001
http://cdli.asm.org/cgi/reprint/8/4/847.pdf
(46) KUSABA1), Hiroshi YOSHIDA1), Michihiro SUMINO1) & Michio SATA2) 1) Longitudinal Study
of Serological Response to Bartonella henselae by Indirect Fluorescence Assay in Cat Scratch Dis-
ease Nobuhide Department of Medicine, Yame General Hospital 2)Second Department of
Medicine, Kurume University School of Medicine, Kurume Language JA Page 557-561 Received
JAN 9, 2001 Accepted APR 13, 2001
http://www.kansensho.or.jp/journal/2001/075070557e.html
(47) The Beth Israel Deconess Medical Housestaff Manual,
http://home-dev.caregroup.org/UGmanual/ ... ctions.htm
(48 ) Ralf Schüleina,b, Anja Seuberta,b, Christian Gilleb, Christa Lanzb, Yves Hansmannc, Yves Piémontc, and
Christoph Dehioa,b Invasion and persistent intracellular colonization of erythrocytes. A unique para-
sitic strategy of the emerging pathogen Bartonella. a Biozentrum of the University of Basel, Department
of Molecular Microbiology, CH-4056 Basel, Switzerland b Max Planck Institute for Biology, Department of
Infection Biology, D-72076 Tübingen, Germany c Institute of Bacteriology, Faculty of Medicine, University
Louis Pasteur, F-67000 Strasbourg, France Correspondence to: Christoph Dehio, Biozentrum of the University
of Basel, Dept. of Molecular Microbiology, Klingelbergstrasse 70, CH-4056 Basel, Switzerland. Tel:41-61-
267-2140 Fax:41-61-267-2118 E-mail:christoph.dehio@unibas.ch. J Exp Med. 2001 May 7;193(9):1077-
86. PMID: 11342592 [PubMed - indexed for MEDLINE]
http://www.jem.org/cgi/content/full/193/9/1077
(49) Hercik K, Melter O, Janecek J, Branny P. Mol Cell Probes 2002 Feb;16(1):49-56 In situ detection
of Bartonella henselae cells.Division of Cell and Molecular Microbiology, Institute of Microbiology,
Czech Academy of Sciences, Prague, Czech Republic.
http://www.ncbi.nlm.nih.gov/entrez/quer ... list_uids=
12005447&dopt=Abstract
(50) Cassandra D. Salgado and Martin E. Weisse Transverse Myelitis Associated with Probable Cat-
Scratch Disease in a Previously Healthy Pediatric Patient Clinical Infectious Diseases 2000;31:609-
611 Department of Pediatrics, West Virginia University, Morgantown
http://www.journals.uchicago.edu/CID/jo ... 94179.html
(51) Brigid Kane 41st Interscience Conference on Antimicrobial Agents and Chemotherapy Daily Ses-
sion Coverage: Clueless in Chicago: When Diagnosis is Difficult, Chicago, Tuesday, December 18,
2001 http://www.medscape.com/viewarticle/420053
(52) Authors: Hubalek Z, Halouzka J, Juricova Z Title: Investigation of haematophagous arthropods
for borreliae--summarized data, 1988-1996. Source: Folia Parasitol (Praha) 1998;45(1):67-72
Organization: Institute of Landscape Ecology, Academy of Sciences of the Czech Republic, Brno,
Czech Republic.
(53) Characterization of Bartonella Strains from Russia and the USA Leading Institute: Gamalei
Institute of Epidemiology and Microbiology, Moscow, Russia Supporting institutes: Moscow Medi-
cine Academy, Moscow, Russia Collaborators: US Department of Health & Human Services /
Centers for Disease Control and Prevention, Atlanta, GA, USA
http://www.tech-db.ru/istc/db/projects.nsf/prjn/2223
(54) van Tooren RM, van Leusen R, Bosch FH. Neth J Med 2001 Nov;59(5):218-24 Culture negative
endocarditis combined with glomerulonephritis caused by Bartonella species in two immunocompe-
tent adults. St. Lucas/Andreas Ziekenhuis, Amsterdam, The Netherlands.
http://www.ncbi.nlm.nih.gov/entrez/quer ... list_uids=
11705641 &dopt=Abstract
(55) Kerkhoff, F. T., A. M. C. Bergmans, A. van der Zee, and A. Rothova. 1999. Demonstration of
Bartonella grahamii DNA in ocular fluids of a patient with neuroretinitis. J. Clin. Microbiol.
37:4034-4038 http://jcm.asm.org/cgi/reprint/37/12/4034.pdf
(56) Breitschwerdt, E. B., and D. L. Kordick. 2000. Bartonella infection in animals: carriership,
reservoir potential, pathogenicity, and zoonotic potential for human infection. Clin. Microbiol.
Rev. 13:428-438 http://cmr.asm.org/cgi/content/full/13/ ... epYWsJvnMo
(57) Zhongxing Liang and Didier Raoult* Clinical and Diagnostic Laboratory Immunology, July 2000,
p. 617-64, Vol. 7, No. 41071-412X/00/$04.00+0. Differentiation of Bartonella Species by a
Microimmunofluorescence Assay, Sodium Dodecyl Sulfate-Polyacrylamide Gel Electrophoresis,
and Western Immunoblotting Unité des Rickettsies, CNRS UPRES-A 6020, Faculté de Médecine,
Université de la Mediterranée, 13385 Marseille Cédex, France Received 3 December 1999/Returned
for modification 4 April 2000/Accepted 8 May 2000
http://cdli.asm.org/cgi/content/full/7/4/617
(58 ) Aguirrebengoa K, Benito JR, Montejo M, Bereciartua E, Perez-Irezabal J, Gonzalez-Zarate P.
Cat-scratch disease: series of 14 cases. The diagnostic usefulness of serology [Article in
Spanish] Enferm Infecc Microbiol Clin 1999 Jan;17(1):15-8 Unidad de Enfermedades
Infecciosas-Servicio de Medicina Interna, Hospital de Cruces, Baracaldo, Vizcaya.
http://www.ncbi.nlm.nih.gov/entrez/quer ... list_uids=
10069107 &dopt=Abstract






soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Ma Loka 26, 2009 10:49

BARTONELLAN HOITO

Bartonellasta ja sen hoidosta on olemassa erittäin vähän tietoa. Tri James Schallerin kirjassa, Bartonella: Diagnosis and Treatment, kerrotaan laajasti bartonellasta ja jonkin verran sen hoidosta. Olen keskustellut tri Schallerin kanssa. Hän kertoi, että on käynyt läpi kaikki bartonellatutkimukset. Synteettisistä antibiooteista ei ole ollut mainittavaa pitkäaikaista hyötyä koska näyttää siltä että bartonellabakteeri suojautuu biofilmin suojaan. Tällöin antibiooteista ei ole juurikaan hyötyä. Schaller mainitsee kirjassaan antibioottiyhdistelmän sekä luonnon antibiootteja joista on ollut potilaille hyötyä.

Antibiooteista Zithromax ja Biaxin 1250 mg/vrk yhdessä Augmentinin kanssa on auttanut joitakin. Kiinalaisessa lääketieteessä tunnettu yrtti Houttuynia kykenee mahdollisesti tuhoamaan punasolujen ulko-ja sisäpuolella olevia bartonellabakteereja.

Eteerisistä öljyistä neilikkaöljy on Schallerin mukaan osoittautunut tehokkaaksi. Neilikkäöljyä sekoitetaan esim. ruokalusikalliseen oliivi- tai kookosöljyä. Schaller ei mainitse kirjassaan annostusta.
(Suom. huom. Yleensä eteerisiä öljyjä käytetään korkeintaan 2 viikkoa yhteen menoon ja sen jälkeen pidetään vähintään yhtä pitkä tauko. Annostus on ollut 1 - 5 tippaa x 3.)

Schallerin kokemuksen mukaan suurin osa antibiooteista ja myös Rife-hoito ovat osoittautuneet enemmän tai vähemmän tehottomiksi bartonellan hoidossa.


New Remedies For Bartonella
http://www.wellsphere.com/lyme-disease- ... ella/98824

So little is known about how to treat bartonella, but fortunately, Dr. J. Schaller, MD, in his book, Bartonella: Diagnosis and Treatment , has come to the rescue with some new ideas for treating this pernicious, but little-understood infection that almost always accompanies Lyme disease.

After explaining the various ways that this infection can be trasmitted (from flea feces to cat paws), and how the multitude of ever-increasing strains affects humans, Dr. Schaller details the remedies currently in use in traditional medicine to treat bartonella, and then offers hope by suggesting new, and perhaps improved, remedies.

I was at first dismayed when I started to read his evaluation of current strategies: Penicillin doesn't work...neither oral nor IM form has been shown to be beneficial...Doxycycline and minocycline haven't had any effect that was clear at high and prolonged doses....IV Rocephin is useless...Zithromax and Biaxin are considered top treatments, but..."we" (referring to Dr. Schaller's practice) have not seen IV or oral dosing up to 1,000 mg per day significantly decrease bartonella, even after months of use...

Okay? Well, what DOES kill this nasty infection?

But as I kept reading, I was encouraged.

....Zithromax and biaxin at 1250/mg per day with augmentin XR have helped some.

And guess why this might be? Dr. Schaller speculates that bartonella might make biofilms, and that one of these antibiotics functions to get rid of the biofilm, leaving the bugs vulnerable to the other antibiotic. Not all antibiotics can destroy biofilm, and those that can't, basically are useless without another agent to remove the biofilm.

I know, back up. What is biofilm? Well, it's the in-vogue science topic of 2008...basically, plastic wrap that bugs make to protect themselves. Why haven't we studied biofilm as it applies to Lyme and co-infections before? (BTW, I'm going to call it plastic wrap for now...you can do a Wikipedia search if you really want to understand how the goo is made). Suffice it to say, biofilm keeps the rascals safe, and this may be another reason why certain antibiotics, when combined, are more effective at combating bartonella.

As I continued to read, my spirits lifted a little more when I came across Houttuynia, or HH. (No, HH is not Human Growth Hormone!).

This Chinese herb, apparently well-known amongst those who practice Modern Chinese Medicine, has been found to be quite effective for treating bartonella. Formulated for bartonella sufferers in the United States by Dr. C. Zhang, a Harvard-educated MD,

Zhang has found that HH is good at killing bartonella attached to, or inside of, red blood cells. Dr. Schaller does not mention, however, how much of this stuff is needed to eradicate the infection, if in fact, it can do that.

Offering further hope was Dr. Schaller's discussion of clove bud essential oil, which he contends has been effective for ridding bartonella in a handful of his patients (who had tried it on their own). He advocates high doses of 75% diluted clove bud oil with olive, coconut or grape seed oil, although again, did not comment on what constitutes a "high dose." So you'll have to jump on some rabbit trails if you want the answer to that one.

Dr. Schaller's evaluation of treatments finished with others that have not worked, according to his experience...Ceftin, Omnicef, Levaquin, and Cipro. Shucks. Rife machines were also given a thumbs-down. Come to think of it, Rifing didn't seem to help me with my bartonella, either. If it has helped others, however, I would like to know!

So we know what really doesn't work--according to one physician's experience and research. But alas, Dr. Schaller has presented a few new, and potentially marvelous strategies for treating bartonella...Houyttunia, clove bud essential oil, and perhaps the antibiotic combination of zithromax and biaxin, at high doses. If any of these appeal to you, consult a licensed practitioner versed in the use of these for the treatment of your bartonella. In the meantime, check out Dr. Schaller's book, which presents some fascinating facts about bartonella, as well as more detailed information regarding treatments.
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Ma Marras 16, 2009 11:28

Bartonellalajeja tunnetaan jo 24 - niistä kymmenen tiedetään aiheuttavan sairauden ihmisille. Bartonella infektoi mm. punasolut ja aiheuttaa angiogeneesiä.

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]
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Pe Marras 20, 2009 09:18

Telegraph (UK) 24. marraskuuta 2009.

"Tutkijat ovat löytäneet tämän vuosituhannen uuden mahdollisen 'ruton'.

Euroopassa yleiset ruskeat rotat saattavat välittää uuden bakteeripandemian. Kyseessä on bartonellabakteeri joka leviää rotissa olevien kirppujen välityksellä. Bakteeri aiheuttaa mm. vakavia sydäntauteja. Tutkimus julkaistiin Journal of Medical Microbiology -julkaisussa.

Bartonellabakteerista on löydetty jo yli 20 eri alalajia 1990-luvun alusta lähtien. Bakteerien katsotaan olevan ihmisille tauteja aiheuttavia kaikkialla maailmassa. Bakteeri voi aiheuttaa oireita esim. sydämessä, pernassa, keskushermostossa jne.

Viimeisin bartonellan alalaji nimitettiin B. rochalimaeksi. Se löydettiin henkilöstä joka oli ollut matkoilla Etelä-Amerikassa. Potilaan perna oli suurentunut. Tutkijat ovat löytäneet jyrsijöistä useita patogeenisiä bartonellalajeja. Esim. B. grahamii aiheuttaa silmien retiniittiä.

Aikoinaan 'musta surma' oli yksi tuhoisimmista pandemioista ihmiskunnan historiassa. Taudinaiheuttajana oli Yersinia pestis -bakteeri. Tauti levisi jyrsijöiden välityksellä ja tappoi arviolta 75 miljoonaa ihmistä."

http://www.telegraph.co.uk/science/scie ... tists.html


21st century plague discovered by scientists

A new disease that is passed from rats to humans via fleas, much like the Black Death, has been discovered by scientists.

By Richard Alleyne, Science Correspondent
Published: 7:29PM GMT 24 Nov 2008

Research suggests that brown rats, the biggest and most common rats in Europe, may now be carrying the bacteria Photo: Alamy
The bacteria can cause serious heart disease in humans are being spread by rat fleas, sparking concern that the infections could become a bigger problem in humans.

Research published in the Journal of Medical Microbiology suggests that brown rats, the biggest and most common rats in Europe, may now be carrying the bacteria.

Since the early 1990s, more than 20 species of Bartonella bacteria have been discovered. They are considered to be emerging pathogens, because they can cause serious illness in humans worldwide from heart disease to infection of the spleen and nervous system.

"A new species called Bartonella rochalimae was recently discovered in a patient with an enlarged spleen who had travelled to South America," said Professor Chao-Chin Chang from the National Chung Hsing University in Taiwan.

"This event raised concern that it could be a newly emerged pathogens. Therefore, we decided to investigate further to understand if rodents living close to human environment could carry this bacteria."

Scientists have found that rodents carry several pathogenic species of Bartonella, such as B. elizabethae, which can cause endocarditis and B. grahamii, which was found to cause neuroretinitis in humans. Although scientists are unsure about the main route of transmission, these infections are most likely to be spread by fleas.

Ctenophthalmus nobilis, a flea that lives on bank voles, was shown to transmit different species of Bartonella bacteria. These pathogens have also been found in fleas that live on gerbils, cotton rats and brown rats.

The researchers took samples from 58 rodents, including 53 brown rats, two mice (Mus musculus) and three black rats (Rattus rattus).

Six of the rodents were found to be carrying Bartonella bacteria; 5 of these were brown rats. Four of the rodents were carrying B. elizabethae, which can cause heart disease in humans, and one of the black rats was found to be harbouring B. tribocorum.

The Black Death was one of the deadliest pandemics in human history, widely thought to have been caused by a bacterium named Yersinia pestis, or Bubonic plague.

It was spread by rodents in the 14th century and centuries after that, killing an estimated 75 million people worldwide.
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Ke Joulu 09, 2009 14:17

Espanjan Andalusian kirpuista löydettiin (13,5 %) neljää eri bartonellalajia.


Detection and identification of Bartonella sp. in fleas from carnivorous mammals in Andalusia, Spain.

Med Vet Entomol. 2009 Dec;23 (4):393-8.

Márquez FJ, Millán J, Rodríguez-Liébana JJ, García-Egea I, Muniain MA.

Departamento Biología Animal, Biología Vegetal y Ecología, Universidad de Jaén, 23071 Jaén, Spain. jmarquez@ujaen.es


A total of 559 fleas representing four species (Pulex irritans, Ctenocephalides felis, Ctenocephalides canis and Spilopsyllus cuniculi) collected on carnivores (five Iberian lynx Lynx pardinus, six European wildcat Felis silvestris, 10 common genet Genetta genetta, three Eurasian badger Meles meles, 22 red fox Vulpes vulpes, 87 dogs and 23 cats) in Andalusia, southern Spain, were distributed in 156 pools of monospecific flea from each carnivore, and tested for Bartonella infection in an assay based on polymerase chain reaction (PCR) amplification of the 16 S-23 S rRNA intergenic spacer region.

Twenty-one samples (13.5%) were positive and the sequence data showed the presence of four different Bartonella species. Bartonella henselae was detected in nine pools of Ctenocephalides felis from cats and dogs and in three pools of Ctenocephalides canis from cats; Bartonella clarridgeiae in Ctenocephalides felis from a cat, and Bartonella alsatica in Spilopsyllus cuniculi from a wildcat. DNA of Bartonella sp., closely related to Bartonella rochalimae, was found in seven pools of Pulex irritans from foxes.

This is the first detection of B. alsatica and Bartonella sp. in the Iberian Peninsula. All of these Bartonella species have been implicated as agents of human diseases. The present survey confirms that carnivores are major reservoirs for Bartonella spp.
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » La Joulu 19, 2009 11:24

15-vuotias leukemiaa sairastava tyttö menetti äkillisesti näkökyvyn oikeasta silmästään. Silmässä havaittiin makulan turvotusta. Aiheuttajaksi paljastui Bartonella henselae.


J AAPOS. 2009 Dec;13(6):602-4.

Bartonella henselae neuroretinitis in a 15-year-old girl with chronic
myelogenous leukemia.

Irshad FA, Gordon RA.

Tulane University School of Medicine, Department of Ophthalmology, New
Orleans, Louisiana.

A 15-year-old girl being treated with imatinib for chronic myelogenous
leukemia (CML) presented with acute vision loss in her right eye
accompanied by swelling of the right side of her neck. On examination,
she was found to have disk and macular edema of the right eye.
Fine-needle aspiration and excisional biopsies of an enlarged
submandibular lymph node were negative for malignancy. Although initial
serologies were equivocal for Bartonella henselae, repeat serologies
performed 1 week later upon the appearance of a macular star were
positive. This is the first reported case of B. henselae in a patient
with CML.

PMID: 20006827 [PubMed - in process]
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Ti Tammi 05, 2010 12:04

14 tutkimusta bartonellasta ja sen aiheuttamista oireista. Tutkimukset on tehty v. 1999 - 2005.


1. Infect Immun. 2006 Sep;74(9):5003-13.

Bartonella quintana variably expressed outer membrane proteins mediate vascular

endothelial growth factor secretion but not host cell adherence.

Schulte B, Linke D, Klumpp S, Schaller M, Riess T, Autenrieth IB, Kempf VA.



Institut für Medizinische Mikrobiologie und Hygiene, Elfriede-Aulhorn-Strasse 6,

D-72076 Tübingen, Germany.



Bartonella quintana causes trench fever, endocarditis, and the

vasculoproliferative disorders bacillary angiomatosis and peliosis hepatis in

humans. Little is known about the interaction of this pathogen with host cells.

We attempted to elucidate the interaction of B. quintana with human macrophages

(THP-1) and epithelial cells (HeLa 229). Remarkably, only B. quintana strain

JK-31 induced secretion of vascular endothelial growth factor (VEGF) from THP-1

and HeLa 229 cells upon infection similar to the secretion induced by B. henselae

Marseille, whereas other strains (B. quintana 2-D70, B. quintana Toulouse, and B.

quintana Munich) did not induce such secretion. Immunofluorescence testing and

electron microscopy revealed that the B. quintana strains unable to induce VEGF

secretion did not express the variable outer membrane proteins (Vomps) on their

surfaces. Surprisingly, the increase in VEGF secretion mediated by B. quintana

JK-31 was not paralleled by elevated host cell adherence rates compared with the

rates for Vomp-negative B. quintana strains. Our results suggest that the Vomps

play a leading role in the angiogenic reprogramming of host cells by B. quintana

but not in the adherence to host cells.



PMCID: PMC1594870

PMID: 16926391 [PubMed - indexed for MEDLINE]





2. Infect Immun. 2005 Sep;73(9):5735-42.

Interaction of Bartonella henselae with endothelial cells promotes
monocyte/macrophage chemoattractant protein 1 gene expression and protein production and triggers monocyte migration.

McCord AM, Burgess AW, Whaley MJ, Anderson BE.

Department of Medical Microbiology and Immunology, College of Medicine,

University of South Florida, MDC10, 12901 Bruce B. Downs Blvd., Tampa, FL 33612,

USA.



Bacillary angiomatosis (BA), one of the many clinical manifestations resulting

from infection with the facultative intracellular bacterium Bartonella henselae,

is characterized by angiogenic lesions. Macrophages have been identified as

important effector cells contributing to the angiogenic process during B.

henselae infection by infiltrating BA lesions and secreting vascular endothelial

growth factor. Monocyte-macrophage chemoattractant protein 1 (MCP-1) recruits

macrophages to sites of inflammation. In this study, we investigated the ability

of B. henselae to upregulate MCP-1 gene expression and protein production in the

human microvascular endothelial cell line HMEC-1. MCP-1 mRNA was induced at 6 and

24 h after treatment with bacteria, whereas protein production was elevated at 6,

24, and 48 h. This induction was not dependent on the presence of bacterial

lipopolysaccharide or endothelial cell toll-like receptor 4. However, MCP-1

production was dependent on NF-kappaB activity. Outer membrane proteins of low

molecular weight were able to upregulate MCP-1 production. Furthermore,

supernatants from B. henselae-infected HMEC-1 were able to induce chemotaxis of

THP-1 monocytes. These data suggest a mechanism by which the macrophage effector

cell is recruited to the endothelium during B. henselae infection and then

contributes to bacterial-induced angiogenesis.



PMCID: PMC1231114

PMID: 16113290 [PubMed - indexed for MEDLINE]





3. Cell Microbiol. 2005 Jul;7(7):1019-34.



Unusual trafficking pattern of Bartonella henselae -containing vacuoles in

macrophages and endothelial cells.



Kyme PA, Haas A, Schaller M, Peschel A, Iredell J, Kempf VA.



Institut für Medizinische Mikrobiologie und Hygiene, Eberhard-Karls-Universität,

Elfriede-Aulhorn-Str. 6, D-72076 Tübingen, Germany.



Bartonella henselae, the agent of cat-scratch disease and vasculoproliferative

disorders in humans, is a fastidious facultative intracellular pathogen, whose

interaction with macrophages and endothelial cells (ECs) is crucial in the

pathogenesis of these diseases. However, little is known about the subcellular

compartment in which B. henselae resides. Two hours after infection of murine

macrophages and human ECs, the majority of B. henselae-containing vacuoles (BCVs)

lack typical endocytic marker proteins, fail to acidify, and do not fuse with

lysosomes, suggesting that B. henselae resides in a non-endocytic compartment. In

contrast to human umbilical vein endothelial cells, bacterial death and lysosomal

fusion with BCVs is apparent in J774A.1 macrophages at 24 h. This phenomenon of

delayed lysosomal fusion requires bacterial viability, and is confined to the BCV

itself. Using magnetic selection, we enriched for transposon-mutagenized B.

henselae trapped in lysosomes of macrophages 2 h after infection. Genes affected

appear to be relevant to the intracellular lifestyle in macrophages and ECs and

include some previously implicated in Bartonella pathogenicity. We conclude that

B. henselae has a specific capacity to actively avoid the host endocytic pathway

after entry of macrophages and ECs, from within a specialized non-endocytic

membrane-bound vacuole.



PMID: 15953033 [PubMed - indexed for MEDLINE]





4. Circulation. 2005 Mar 1;111(8 ):1054-62. Epub 2005 Feb 21.



Activation of hypoxia-inducible factor-1 in bacillary angiomatosis: evidence for

a role of hypoxia-inducible factor-1 in bacterial infections.



Kempf VA, Lebiedziejewski M, Alitalo K, Wälzlein JH, Ehehalt U, Fiebig J, Huber

S, Schütt B, Sander CA, Müller S, Grassl G, Yazdi AS, Brehm B, Autenrieth IB.



Institut für Medizinische Mikrobiologie und Hygiene, Eberhard-Karls Universität,

Tübingen, Germany. volkhard.kempf@med.uni-tuebingen.de



BACKGROUND: Bartonella species are the only known bacterial pathogens causing

vasculoproliferative disorders in humans (bacillary angiomatosis [BA]). Cellular

and bacterial pathogenetic mechanisms underlying the induction of BA are largely

unknown. METHODS AND RESULTS: Activation of hypoxia-inducible factor-1 (HIF-1),

the key transcription factor involved in angiogenesis, was detected in Bartonella

henselae-infected host cells in vitro by immunofluorescence, Western blotting,

electrophoretic mobility shift, and reporter gene assays and by

immunohistochemistry in BA tissue lesions in vivo. Gene microarray analysis

revealed that a B henselae infection resulted in the activation of genes typical

for the cellular response to hypoxia. HIF-1 was essential for B henselae-induced

expression of vascular endothelial growth factor as shown by inhibition with the

use of HIF-1-specific short-interfering RNA. Moreover, infection with B henselae

resulted in increased oxygen consumption, cellular hypoxia, and decreased ATP

levels in host cells. Infection with a pilus-negative variant of B henselae did

not lead to cellular hypoxia or activation of HIF-1 or vascular endothelial

growth factor secretion, suggesting a crucial role of this bacterial surface

protein in the angiogenic reprogramming of the host cells. CONCLUSIONS: B

henselae induces a proangiogenic host cell response via HIF-1. Our data provide

for the first time evidence that HIF-1 may play a role in bacterial infections.



PMID: 15723970 [PubMed - indexed for MEDLINE]





5. Cell Microbiol. 2005 Jan;7(1):91-104.



Bartonella henselae inhibits apoptosis in Mono Mac 6 cells.



Kempf VA, Schairer A, Neumann D, Grassl GA, Lauber K, Lebiedziejewski M, Schaller

M, Kyme P, Wesselborg S, Autenrieth IB.



Institut für Medizinische Mikrobiologie und Hygiene, Eberhard-Karls-Universität,

Tübingen, Germany. volkhard.kempf@med.uni-tuebingen.de



Bartonella henselae causes the vasculoproliferative disorders bacillary

angiomatosis and peliosis probably resulting from the release of

vasculoendothelial growth factor (VEGF) from infected epithelial or monocytic

host cells. Here we demonstrate that B. henselae in addition to VEGF induction

was also capable of inhibiting the endogenous sucide programme of monocytic host

cells. Our results show that B. henselae inhibits pyrrolidine dithiocarbamate

(PDTC)-induced apoptosis in Mono Mac 6 cells. B. henselae was observed to be

present in a vacuolic compartment of Mono Mac 6 cells. Direct contact of B.

henselae with Mono Mac 6 cells was crucial for inhibition of apoptosis as shown

by the use of a two-chamber model. Inhibition of apoptosis was paralleled by

diminished caspase-3 activity which was significantly reduced in PDTC-stimulated

and B. henselae-infected cells. The anti-apoptotic effect of B. henselae was

accompanied by (i) the activation of the transcription factor NF-kappaB and (ii)

the induction of cellular inhibitor of apoptosis proteins-1 and -2 (cIAP-1, -2).

Our results suggest a new synergistic mechanism in B. henselae pathogenicity by

(i) inhibition of host cell apoptosis via activation of NF-kappaB and (ii)

induction of host cell VEGF secretion.



PMID: 15617526 [PubMed - indexed for MEDLINE]





6. Infect Immun. 2004 Dec;72(12):7315-7.



In vitro model of Bartonella henselae-induced angiogenesis.



Kirby JE.



Department of Pathology, Division of Cancer Biology and Angiogenesis, Beth Israel

Deaconess Medical Center, 330 Brookline Ave., Yamins 309, Boston, MA 02215, USA.

jekirby@bidmc.harvard.edu



Bartonella henselae is a gram-negative pathogen that causes angiogenesis. Here, I

establish in vitro models to study Bartonella-induced blood vessel formation. I

found that B. henselae induces long-term endothelial survival and tubular

differentiation within type I collagen matrix.



PMCID: PMC529148

PMID: 15557658 [PubMed - indexed for MEDLINE]





7. J Exp Med. 2004 Nov 15;200(10):1267-78. Epub 2004 Nov 8.



Bartonella adhesin a mediates a proangiogenic host cell response.



Riess T, Andersson SG, Lupas A, Schaller M, Schäfer A, Kyme P, Martin J, Wälzlein

JH, Ehehalt U, Lindroos H, Schirle M, Nordheim A, Autenrieth IB, Kempf VA.



Institut für Medizinische Mikrobiologie und Hygiene, Eberhard-Karls-Universität,

Elfriede-Aulhorn-Strasse 6, 72076 Tübingen, Germany.



Bartonella henselae causes vasculoproliferative disorders in humans. We

identified a nonfimbrial adhesin of B. henselae designated as Bartonella adhesin

A (BadA). BadA is a 340-kD outer membrane protein encoded by the 9.3-kb badA

gene. It has a modular structure and contains domains homologous to the Yersinia

enterocolitica nonfimbrial adhesin (Yersinia adhesin A). Expression of BadA was

restored in a BadA-deficient transposon mutant by complementation in trans. BadA

mediates the binding of B. henselae to extracellular matrix proteins and to

endothelial cells, possibly via beta1 integrins, but prevents phagocytosis.

Expression of BadA is crucial for activation of hypoxia-inducible factor 1 in

host cells by B. henselae and secretion of proangiogenic cytokines (e.g.,

vascular endothelial growth factor). BadA is immunodominant in B.

henselae-infected patients and rodents, indicating that it is expressed during

Bartonella infections. Our results suggest that BadA, the largest characterized

bacterial protein thus far, is a major pathogenicity factor of B. henselae with a

potential role in the induction of vasculoproliferative disorders.



PMCID: PMC2211922

PMID: 15534369 [PubMed - indexed for MEDLINE]





8. Mol Microbiol. 2004 Apr;52(1):81-92.



The VirB type IV secretion system of Bartonella henselae mediates invasion,

proinflammatory activation and antiapoptotic protection of endothelial cells.



Schmid MC, Schulein R, Dehio M, Denecker G, Carena I, Dehio C.



Division of Molecular Microbiology, Biozentrum, University of Basel,

Klingelbergstrasse 70, 4056 Basel, Switzerland.



Bartonella henselae is an arthropod-borne zoonotic pathogen causing

intraerythrocytic bacteraemia in the feline reservoir host and a broad range of

clinical manifestations in incidentally infected humans. Remarkably, B. henselae

can specifically colonize the human vascular endothelium, resulting in

inflammation and the formation of vasoproliferative lesions known as bacillary

angiomatosis and bacillary peliosis. Cultured human endothelial cells provide an

in vitro system to study this intimate interaction of B. henselae with the

vascular endothelium. However, little is known about the bacterial virulence

factors required for this pathogenic process. Recently, we identified the type IV

secretion system (T4SS) VirB as an essential pathogenicity factor in Bartonella,

required to establish intraerythrocytic infection in the mammalian reservoir.

Here, we demonstrate that the VirB T4SS also mediates most of the virulence

attributes associated with the interaction of B. henselae during the interaction

with human endothelial cells. These include: (i) massive rearrangements of the

actin cytoskeleton, resulting in the formation of bacterial aggregates and their

internalization by the invasome structure; (ii) nuclear factor kappaB-dependent

proinflammatory activation, leading to cell adhesion molecule expression and

chemokine secretion, and (iii) inhibition of apoptotic cell death, resulting in

enhanced endothelial cell survival. Moreover, we show that the VirB system

mediates cytostatic and cytotoxic effects at high bacterial titres, which

interfere with a potent VirB-independent mitogenic activity. We conclude that the

VirB T4SS is a major virulence determinant of B. henselae, required for targeting

multiple endothelial cell functions exploited by this vasculotropic pathogen.



PMID: 15049812 [PubMed - indexed for MEDLINE]





9. Am J Pathol. 2003 Oct;163(4):1321-7.



Infectious angiogenesis: Bartonella bacilliformis infection results in

endothelial production of angiopoetin-2 and epidermal production of vascular

endothelial growth factor.



Cerimele F, Brown LF, Bravo F, Ihler GM, Kouadio P, Arbiser JL.



Emory Skin Disease Research Core Center, Department of Dermatology, Emory

University School of Medicine, Boston, Massachusetts, USA.



Pathological angiogenesis, the development of a microvasculature by neoplastic

processes, is a critical component of the development of tumors. The role of

oncogenes in the induction of angiogenesis has been extensively studied in benign

and malignant tumors. However, the role of infection in inducing angiogenesis is

not well understood. Verruga peruana is a clinical syndrome caused by the

bacterium Bartonella bacilliformis, and is characterized by the development of

hemangioma-like lesions, in which bacteria colonize endothelial cells. To gain

insight into how this bacteria induces angiogenesis in vivo, we performed in situ

hybridization of clinical specimens of verruga peruana for the angiogenesis

factors vascular endothelial growth factor (VEGF), its receptors VEGFR1 and

VEGFR2, and angiopoietin-2. High-level expression of angiopoietin-2 and VEGF

receptors was observed in the endothelium of verruga peruana. Surprisingly, the

major source of VEGF production in verruga peruana is the overlying epidermis.

Infection of cultured endothelium with B. bacilliformis also resulted in

induction of angiopoetin-2 in vitro. These findings imply a collaboration between

infected endothelium and overlying epidermis to induce angiogenesis.



PMCID: PMC1868281

PMID: 14507641 [PubMed - indexed for MEDLINE]





10. Curr Opin Microbiol. 2003 Feb;6(1):61-5.



Recent progress in understanding Bartonella-induced vascular proliferation.



Dehio C.



Division of Molecular Microbiology, Biozentrum of the University of Basel,

Klingelbergstrasse 70, CH-4056 Basel, Switzerland. christoph.dehio@unibas.ch



The ability to induce endothelial cell proliferation is a common feature of human

pathogenic Bartonella species. Recent data have indicated that bartonellae can

provoke angioproliferation by at least two independent mechanisms: directly, by

triggering proliferation and inhibiting apoptosis of endothelial cells; and

indirectly, by stimulating a paracrine angiogenic loop of vascular endothelial

growth factor production by infected macrophages. A NF-kappaB-mediated acute

inflammatory reaction of the Bartonella-infected endothelium appears to be

critical for the recruitment of monocytes/macrophages and the initiation and

maintenance of a paracrine angiogenic loop. Given that bartonellae effectively

adhere to and invade endothelial cells, their ability to trigger

angioproliferation might represent a dedicated pathogenic strategy for expanding

the bacterial host cell habitat.



PMID: 12615221 [PubMed - indexed for MEDLINE]





11. Infect Immun. 2002 Aug;70(8 ):4564-70.



Induction of a potential paracrine angiogenic loop between human THP-1

macrophages and human microvascular endothelial cells during Bartonella henselae

infection.



Resto-Ruiz SI, Schmiederer M, Sweger D, Newton C, Klein TW, Friedman H, Anderson

BE.



University of South Florida, College of Medicine, Department of Medical

Microbiology and Immunology, Tampa 33612, USA.



Bartonella henselae is responsible for various disease syndromes that loosely

correlate with the immune status of the host. In the immunocompromised

individual, B. henselae-induced angiogenesis, or bacillary angiomatosis, is

characterized by vascular proliferative lesions similar to those in Kaposi's

sarcoma. We hypothesize that B. henselae-mediated interaction with immune cells,

namely, macrophages, induces potential angiogenic growth factors and cytokines

which contribute in a paracrine manner to the proliferation of endothelial cells.

Vascular endothelial growth factor (VEGF), a direct inducer of angiogenesis, and

interleukin-1beta (IL-1beta), a potentiator of VEGF, were detected within 12 and

6 h, respectively, in supernatants from phorbol 12-myristate

13-acetate-differentiated human THP-1 macrophages exposed to live B. henselae.

Pretreatment of macrophages with cytochalasin D, a phagocytosis inhibitor,

yielded comparable results, suggesting that bacterium-cell attachment is

sufficient for VEGF and IL-1beta induction. IL-8, an angiogenic cytokine with

chemotactic properties, was induced in human microvascular endothelial cells

(HMEC-1) within 6 h of infection, whereas no IL-8 induction was observed in

infected THP-1 cells. In addition, conditioned medium from infected macrophages

induced the proliferation of HMEC-1, thus demonstrating angiogenic potential.

These data suggest that Bartonella modulation of host or target cell cytokines

and growth factors, rather than a direct role of the bacterium as an endothelial

cell mitogen, is the predominant mechanism responsible for angiogenesis. B.

henselae induction of VEGF, IL-1beta, and IL-8 outlines a broader potential

paracrine angiogenic loop whereby macrophages play the predominant role as the

effector cell and endothelial cells are the final target cell, resulting in their

proliferation.



PMCID: PMC128175

PMID: 12117969 [PubMed - indexed for MEDLINE]





12. Cell Microbiol. 2001 Sep;3(9):623-32.



Evidence of a leading role for VEGF in Bartonella henselae-induced endothelial

cell proliferations.



Kempf VA, Volkmann B, Schaller M, Sander CA, Alitalo K, Riess T, Autenrieth IB.



Institut für Medizinische Mikrobiologie, Eberhard- Karls-Universität,

Elfriede-Aulhorn-Str. 6, D-72076 Tübingen, Germany.

volkhard.kempf@med.uni-tuebingen.de



Bartonella henselae causes the vasculoproliferative disorders bacillary

angiomatosis (BA) and bacillary peliosis (BP). The pathomechanisms of these

tumorous proliferations are unknown. Our results suggest a novel bacterial

two-step pathogenicity strategy, in which the pathogen triggers growth factor

production for subsequent proliferation of its own host cells. In fact, B.

henselae induces host cell production of the angiogenic factor vascular

endothelial growth factor (VEGF), leading to proliferation of endothelial cells.

The presence of B. henselae pili was associated with host cell VEGF production,

as a Pil- mutant of B. henselae was unable to induce VEGF production. In turn,

VEGF-stimulated endothelial cells promoted the growth of B. henselae.

Immunohistochemistry for VEGF in specimens from patients with BA or BP revealed

increased VEGF expression in vivo. These findings suggest a novel

bacteria-dependent mechanism of tumour growth.



PMID: 11553014 [PubMed - indexed for MEDLINE]





13. Proc Natl Acad Sci U S A. 2001 Jun 19;98(13):7481-6. Epub 2001 Jun 12.



Excessive tumor-elaborated VEGF and its neutralization define a lethal

paraneoplastic syndrome.



Wong AK, Alfert M, Castrillon DH, Shen Q, Holash J, Yancopoulos GD, Chin L.



Department of Adult Oncology, Dana-Farber Cancer Institute, Boston, MA 02115,

USA.



Vascular endothelial growth factor (VEGF) is a potent endothelial cell mitogen

and key regulator of both physiologic and pathologic (e.g., tumor) angiogenesis.

In the course of studies designed to assess the ability of constitutive VEGF to

block tumor regression in an inducible RAS melanoma model, mice implanted with

VEGF-expressing tumors sustained high morbidity and mortality that were out of

proportion to the tumor burden. Documented elevated serum levels of VEGF were

associated with a lethal hepatic syndrome characterized by massive sinusoidal

dilation and endothelial cell proliferation and apoptosis. Systemic levels of

VEGF correlated with the severity of liver pathology and overall clinical

compromise. A striking reversal of VEGF-induced liver pathology and prolonged

survival were achieved by surgical excision of VEGF-secreting tumor or by

systemic administration of a potent VEGF antagonist (VEGF-TRAP(R1R2)), thus

defining a paraneoplastic syndrome caused by excessive VEGF activity. Moreover,

this VEGF-induced syndrome resembles peliosis hepatis, a rare human condition

that is encountered in the setting of advanced malignancies, high-dose androgen

therapy, and Bartonella henselae infection. Thus, our findings in the mouse have

suggested an etiologic role for VEGF in this disease and may lead to diagnostic

and therapeutic options for this debilitating condition in humans.



PMCID: PMC34694

PMID: 11404464 [PubMed - indexed for MEDLINE]





14. Microb Pathog. 1999 Dec;27(6):419-27.



Live Bartonella henselae enhances endothelial cell proliferation without direct

contact.



Maeno N, Oda H, Yoshiie K, Wahid MR, Fujimura T, Matayoshi S.



Department of Bacteriology, Faculty of Medicine, Kagoshima University, 8-35-1

Sakuragaoka, Kagoshima, 890-8520, Japan.



The proliferation of human umbilical vein endothelial cells (HUVECs) cocultivated

with live B. henselae was enhanced in a bacterial dose-dependent manner, and the

stimulatory effect was specific to vascular endothelial cells. The inactivation

of B. henselae by UV or heat treatment abolished its stimulatory activity,

suggesting that live bacteria is necessary for the growth stimulation effect. To

investigate the role of direct contact, live B. henselae were separated from

HUVECs by a filter membrane (Millicell-CM insert). Even under this condition, an

enhanced proliferation of HUVECs was observed. However, no morphological changes

in the HUVECs were apparent compared to the B. henselae -infected cells.

Furthermore, we isolated a nonpiliated strain of B. henselae that is unable to

attach to and enter into endothelial cells. The nonpiliated strain possessed the

ability to stimulate the proliferation of cocultivated HUVECs the same as the

piliated strain. Moreover, the culture supernatants of B. henselae were also able

to induce HUVEC proliferation. Our results indicate that the stimulation of HUVEC

proliferation by B. henselae is mediated by soluble factor(s) secreted from the

bacteria. Copyright 1999 Academic Press.



PMID: 10588914 [PubMed - indexed for MEDLINE]
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Ke Tammi 13, 2010 20:38

"Akuuttivaiheen bartonelloosi muistuttaa AIDSia immuunipuolustuksen heikentymisineen. Kliiniset oireet ilmenevät myöhemmin."

Toisessa tutkimuksessa kerrotaan bartonellan tarttumisesta maksansiirron välityksellä.



Med Hypotheses. 2010 Jan;74(1):45-9. Epub 2009 Aug 7.
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. eticonacrg@gmail.com

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.

.....................................................................................................

Liver Int. 2007 Feb;27(1):145-8.
Cat scratch disease causing hepatic masses after liver transplant.

Thudi KR, Kreikemeier JT, Phillips NJ, Salvalaggio PR, Kennedy DJ, Hayashi PH.

Gastroenterology and Hepatology Division, Department of Internal Medicine, Saint Louis University Hospital, St Louis, MO, USA.

Hepatic cat scratch disease is rarely reported in liver transplant recipients and has never been reported with discrete liver lesions in the graft. A 52-year-old woman was transplanted for hepatitis C cirrhosis and hepatocellular carcinoma. Her posttransplant course was uneventful. She presented 2.7 years after transplantation with fever of unknown origin and went on to develop multiple and diffuse discrete liver lesions. Despite an extensive work-up including percutaneous and laparoscopic biopsies, a subsegmental resection that included one of these masses was required to make the diagnosis of Bartonella henselae infection. Serologic tests were equivocal. Histology was consistent with cat scratch disease of the liver, and polymerase chain reaction (PCR) testing of the resected tissue confirmed the diagnosis. Response to doxycycline was rapid. Fevers resolved within 7 days. Repeat abdominal CT scan showed reduction of the liver masses. Cat scratch disease should be considered in postliver transplant patients presenting with fever and liver lesions, especially if close contact with cats has occurred. Diagnosis by PCR testing of involved tissue is preferred when serologies are equivocal due to immunosuppression.

PMID: 17241393 [PubMed - indexed for MEDLINE]
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Ti Tammi 19, 2010 21:36

Bartonellan voi saada verensiirron välityksellä. Maksansiirron saanut lapsi sairastui bartonellaan.


Transpl Infect Dis. 2009 Oct;11(5):474.
Blood transfusion as an alternative bartonellosis transmission in a pediatric liver transplant.

Velho PE.

Publication Types:
Comment
Letter

http://eutils.ncbi.nlm.nih.gov/entrez/e ... md=prlinks
PMID: 19804481 [PubMed - indexed for MEDLINE]
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Ti Helmi 16, 2010 14:39

"Bartonellan saa useimmiten kissojen kirppujen välityksellä, mutta myös vertaimevien hyönteisten, punkkien ja mahdollisesti koirien välityksellä." (2010)


J Appl Microbiol. 2010 Jan 22; [Epub ahead of print]
Bartonellosis, an increasingly recognized zoonosis.

Chomel BB, Kasten RW.

Department of population Health and reproduction, School of Veterinary Medicine, University of California, Davis CA, USA.

Summary Cat scratch disease is the most common zoonotic infection caused by Bartonella bacteria. Among the many mammals infected with Bartonella spp., cats represent a large reservoir for human infection, as they are the main reservoir for Bartonella henselae, Bartonella clarridgeiae and Bartonella koehlerae.

Bartonella spp. are vector-borne bacteria, and transmission of B. henselae by cat fleas occurs mainly through infected flea faeces, although new potential vectors (ticks and biting flies) have been identified. Dogs are also infected with various Bartonella species and share with humans many of the clinical signs induced by these infections. Although the role of dogs as source of human infection is not yet clearly established, they represent epidemiological sentinels for human exposure. Present knowledge on the aetiology, clinical features and epidemiological characteristics of bartonellosis is presented.

http://eutils.ncbi.nlm.nih.gov/entrez/e ... md=prlinks

PMID: 20148999 [PubMed - as supplied by publisher]
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Ma Maalis 29, 2010 16:25

Nuori mies kuoli saatuaan sairaalassa useita pussillisia punasoluja. Miehen verestä löytyi bartonellabakteeri. Ei tiedetä oliko miehellä bakteeri jo ennen tiputusta vai saiko hän sen verivalmisteesta.


http://informahealthcare.com/doi/abs/10 ... 0902785567

Bartonellosis as Cause of Death After Red Blood Cell Unit Transfusion

ABSTRACT

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.
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Ma Maalis 29, 2010 16:27

Bartonelloosi on vaarallinen ja vähän tunnettu infektiotauti:

http://veterinarymedicine.dvm360.com/ve ... ryId=46382


Bartonellosis: An emerging and potentially hidden epidemic?
Bartonella species, their animal hosts, potential vectors, and sequelae of infection are being identified at a snowballing rate. A new diagnostic test may help DVMs and MDs come together to better understand these infections in their patients.
Mar 1, 2010
By: Edward B. Breitschwerdt, DVM, DACVIM
VETERINARY MEDICINE


12345
Next »

Veterinarians and physicians should talk to each other more frequently than we have in the past. Of all known organisms, 61% are zoonotic,1,2 and of the emerging pathogens, the vast majority are zoonotic organisms. My research at the Intracellular Pathogens Research Laboratory at the North Carolina State University College of Veterinary Medicine focuses on vector-transmitted organisms, of which 22% are zoonotic.1,3 In recent years, the genus Bartonella has been the major focus of our vector-borne research efforts.

BARTONELLA SPECIES COMPLEXITIES

The organism that causes cat scratch disease in people was identified as a Bartonella species in 1992. As researchers have continued to study these bacteria, we've learned that the intraerythrocytic component of the infection with a Bartonella species has been somewhat overemphasized. My research laboratory and others have demonstrated that Bartonella species are endotheliotropic bacteria that use a specialized invasion process to enter endothelial cells and can move about the body by infecting macrophages, with localization in a variety of tissues.3

Knowing more about Agrobacterium species and the pathogenic mechanisms it uses to induce tumors in plants will probably benefit physicians and veterinarians in better understanding what Bartonella species are doing to promote vasculoproliferative disorders in our patients.4

Researchers have learned that Bartonella species are the first bacteria identified to have an ability to invade CD34+ progenitor cells in bone marrow.5 This may be why we find Bartonella organisms in cats in only a low percentage (3%) of their erythrocytes.

The genus Bartonella is also unusual because it appears that no other infectious agent is transmitted by more vectors. We now know that sand flies, human body lice, cat fleas, rodent fleas, and probably many other flea species are capable of transmitting certain Bartonella species. And cattle, deer, elk, and sheep all have their own Bartonella species that appear to be transmitted by biting flies or keds (wingless flies).6

Our laboratory wondered whether ticks could transmit Bartonella species. Currently, the answers appear to be yes and maybe.7 Good case-based evidence exists in the human and veterinary medical literature that suggests ticks may transmit Bartonella species. And in many laboratories around the world, PCR testing reveals Bartonella species DNA in ticks, particularly in Ixodes species ticks. Researchers in France have nearly demonstrated Ixodes ricinus transmission of Bartonella henselae.8 Interestingly, Bartonella henselae is prevalent in I. ricinus ticks in southern Germany and in France.9 However, although tick transmission of Bartonella species is possible, it hasn't yet been definitively proven for ticks in North America.

IS A HIDDEN EPIDEMIC POSSIBLE?

In my opinion, a hidden epidemic is possible if several conditions are met.

* First, you start with an unknown bacterial genus, which was the situation for Bartonella in North America and much of the world until the human immunodeficiency virus (HIV) epidemic of the late 1980s and 1990s.
* Second, the organism must behave as a stealth pathogen that is capable of hiding in the host, as is true for Bartonella species.10
* Third, a large number of diverse animal reservoir hosts for the organism are maintained in nature?and that too is the case for the genus Bartonella. Several mammals?grey squirrels, flying squirrels, groundhogs?have their own genetically distinct Bartonella species that have coevolved in those animals and have a high prevalence in their respective hosts in nature.
* Finally, the organism creatively facilitates its transmission, not only through vectors, but by direct transmission through bites and scratches, which has been reasonably well-established for dogs and cats and for rabbits in Europe.11
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Ti Huhti 13, 2010 21:02

Bartonellan voi saada esim. kärpästen, kirppujen, punkkien jne välityksellä. Bartonellaa löydetään usein sekä ihmisistä että eläimistä. Bakteerin häätäminen on vaikeaa.


Parasit Vectors. 2010 Apr 8;3(1):29 [Epub ahead of print]
Bartonella vinsonii subsp. berkhoffii and Bartonella henselae bacteremia in a
father and daughter with neurological disease.

Breitschwerdt EB, Maggi RG, Lantos PM, Woods CW, Hegarty BC, Bradley JM.

ABSTRACT: BACKGROUND: Bartonella vinsonii subsp. berkhoffii is an important,
emerging, intravascular bacterial pathogen that has been recently isolated from
immunocompetent patients with endocarditis, arthritis, neurological disease and
vasoproliferative neoplasia. Vector transmission is suspected among dogs and
wild canines, which are the primary reservoir hosts. This investigation was
initiated to determine if pets and family members were infected with one or more
Bartonella species. METHODS: PCR and enrichment blood culture in Bartonella
alpha Proteobacteria growth medium (BAPGM) was used to determine infection
status. Antibody titers to B. vinsonii subsp. berkhoffii genotypes I-III and B.
henselae were determined using a previously described indirect fluorescent
antibody test. Two patients were tested sequentially for over a year to assess
the response to antibiotic treatment. RESULTS: Intravascular infection with B.
vinsonii subsp. berkhoffii genotype II and Bartonella henselae (Houston 1
strain) were confirmed in a veterinarian and his daughter by enrichment blood
culture, followed by PCR and DNA sequencing. Symptoms included progressive
weight loss, muscle weakness, lack of coordination (the father) and headaches,
muscle pain and insomnia (the daughter). B. vinsonii subsp. berkhoffii genotype
II was also sequenced from a cerebrospinal fluid BAPGM enrichment culture and
from a periodontal swab sample. After repeated courses of antibiotics,
post-treatment blood cultures were negative, there was a decremental decrease in
antibody titers to non-detectable levels and symptoms resolved in both patients.
CONCLUSIONS: B. vinsonii subsp. berkhoffii and B. henselae are zoonotic
pathogens that can be isolated from the blood of immunocompetent family members
with arthralgias, fatigue and neurological symptoms. Therapeutic elimination of
Bartonella spp. infections can be challenging, and follow-up testing is
recommended. An increasing number of arthropod vectors, including biting flies,
fleas, keds, lice, sandflies and ticks have been confirmed or are suspected as
the primary mode of transmission of Bartonella species among animal populations
and may also pose a risk to human beings.


http://eutils.ncbi.nlm.nih.gov/entrez/e ... md=prlinks
PMID: 20377863 [PubMed - as supplied by publisher]
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Su Huhti 18, 2010 08:15

Isällä ja tyttärellä on bartonellan aiheuttamia neurologisia oireita.
Bartonella voi aiheuttaa sydän- ja niveltulehduksia, neurologisia oireita uupumusta jne. Bakteerin häätö elimistöstä voi olla vaikeaa. Yhä lisääntyvässä määrin erilaisten vertaimevien hyönteisten kuten kärpästen, kirppujen, täiden jne. on todettu levittävän bakteeria.


http://www.parasitesandvectors.com/content/3/1/29

Bartonella vinsonii subsp. berkhoffii and Bartonella henselae bacteremia in a father and daughter with neurological disease

Edward B Breitschwerdt email, Ricardo G Maggi email, Paul M Lantos email, Christopher W Woods email, Barbara C Hegarty email and Julie M Bradley email

Parasites & Vectors 2010, 3:29doi:10.1186/1756-3305-3-29
Published: 8 April 2010
Abstract (provisional)

Background

Bartonella vinsonii subsp. berkhoffii is an important, emerging, intravascular bacterial pathogen that has been recently isolated from immunocompetent patients with endocarditis, arthritis, neurological disease and vasoproliferative neoplasia. Vector transmission is suspected among dogs and wild canines, which are the primary reservoir hosts. This investigation was initiated to determine if pets and family members were infected with one or more Bartonella species.

Methods

PCR and enrichment blood culture in Bartonella alpha Proteobacteria growth medium (BAPGM) was used to determine infection status. Antibody titers to B. vinsonii subsp. berkhoffii genotypes I-III and B. henselae were determined using a previously described indirect fluorescent antibody test. Two patients were tested sequentially for over a year to assess the response to antibiotic treatment.
Results

Intravascular infection with B. vinsonii subsp. berkhoffii genotype II and Bartonella henselae (Houston 1 strain) were confirmed in a veterinarian and his daughter by enrichment blood culture, followed by PCR and DNA sequencing. Symptoms included progressive weight loss, muscle weakness, lack of coordination (the father) and headaches, muscle pain and insomnia (the daughter). B. vinsonii subsp. berkhoffii genotype II was also sequenced from a cerebrospinal fluid BAPGM enrichment culture and from a periodontal swab sample. After repeated courses of antibiotics, post-treatment blood cultures were negative, there was a decremental decrease in antibody titers to non-detectable levels and symptoms resolved in both patients.

Conclusions

B. vinsonii subsp. berkhoffii and B. henselae are zoonotic pathogens that can be isolated from the blood of immunocompetent family members with arthralgias, fatigue and neurological symptoms. Therapeutic elimination of Bartonella spp. infections can be challenging, and follow-up testing is recommended. An increasing number of arthropod vectors, including biting flies, fleas, keds, lice, sandflies and ticks have been confirmed or are suspected as the primary mode of transmission of Bartonella species among animal populations and may also pose a risk to human beings.
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » To Huhti 29, 2010 12:33

Kroonisesta selkäkivusta kärsivältä mieheltä löytyi bartonellabakteeri. Bakteeria ei löydetty millään tavanomaisella testillä. Bakteeri löydettiin PCR/ESI-MS-tutkimuksessa.

Hawaii Med J. 2010 Mar;69(3):68-9.

A "silent culture-negative" abdominal aortic mycotic aneurysm: Rapid detection of Bartonella species using PCR and high-throughput mass spectrometry.

Koo M, Manalili S, Bankowski MJ, Sampath R, Hofstadler SA, Koo J.

University of Hawai'i John A Burns School of Medicine, Honolulu, HI 96813, USA.

A gram-negative, rod-shaped microorganism was detected in a 69-year-old man suffering from chronic back pain but otherwise exhibiting no signs of infection.

The bacterium could not be identified using any routine diagnostic modality.

A research use only application utilizing PCR and Mass Spectrometry was performed on nucleic acid extracted from the tissue sample. These studies resulted in the implication of Bartonella quintana as the underlying cause of the infection.

B. quintana is not a well-known cause of an abdominal aortic mycotic aneurysm. This article will discuss the B. quintana infection, its diagnosis and treatment, and reinforce the potential of B. quintana as a possible etiology in mycotic aneurysms that show no apparent indications of infection. It will also explore the potential use of polymerase chain reaction detected by electrospray ionization mass spectrometry (PCR/ESI-MS) to help identify B. quintana in a situation where other conventional methods prove non-informative.

http://eutils.ncbi.nlm.nih.gov/entrez/e ... md=prlinks
PMID: 20397506 [PubMed - in process]
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » To Touko 13, 2010 11:09

Uusi Bartonellan alalaji löydetty. Nimeksi kaavaillaan "Candidatus Bartonella mayotimonensis". Bakteeri löytyi sydäntulehdusta (sydämen sisäkalvo) sairastavan henkilön aortaläpästä. Tautia ei kyetty toteamaan verikokeista sillä niiden tulokset olivat normaalit!


Candidatus Bartonella mayotimonensis and Endocarditis

http://cdc.gov/eid/content/16/3/500.htm#cit

Abstract
We describe a new Bartonella species for which we propose the name Candidatus Bartonella mayotimonensis. It was isolated from native aortic valve tissue of a person with infective endocarditis. The new species was identified by using PCR amplification and sequencing of 5 genes (16S rRNA gene, ftsZ, rpoB, gltA, and internal transcribed spacer region).

Bartonella species are small, fastidious, gram-negative, intracellular bacteria that cause culture-negative infective endocarditis. Six species have been documented to cause endocarditis in humans: B. quintana (1), B. henselae (2), B. elizabethae (3), B. vinsonii subsp. berkhoffii (4), B. koehlerae (5), and B. alsatica (6).

We report a case of culture-negative endocarditis caused by a new Bartonella species, for which we propose the name Candidatus Bartonella mayotimonensis.
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » To Touko 13, 2010 12:47

Silmän näköhermon tulehduksen voi aiheuttaa useat eri mikrobit esim. bartonella. Tulehdus on yleinen eri keskushermostotaudeissa, esim. neurosyfilis, MS-tauti, lupus, Sjögren, sarkoidoosi jne. (2010)

Suom.huom. Myös borreliabakteeri voi aiheuttaa tulehduksen silmän eri osissa.



Rev Med Interne. 2010 Apr 28; [Epub ahead of print]
[Optic neuritis.]

[Article in French]

Meyniel C, Wiertlewski S.

Centre d'investigation clinique, hopital Laennec, clinique neurologique, CHU de Nantes, 44093 Nantes, France.

Optic neuritis is a common feature of inflammatory diseases of the central nervous system such as multiple sclerosis and neuromyelitis optica. It may also reveal systemic inflammatory disorders including sarcoidosis, lupus, Sjogren's syndrome, Behcet's disease, or infections such as neurosyphilis or with Bartonella. In some patients diagnostic workup remains negative leading to the diagnosis of an idiopathic optic neuritis. A painful loss of vision is the usual clinical presentation. The fundoscopy is normal or shows papilloedema. Brain magnetic resonance imaging is a mandatory in all patients.

Copyright (c) 2010.
Published by Elsevier SAS.

http://eutils.ncbi.nlm.nih.gov/entrez/e ... md=prlinks
PMID: 20434241 [PubMed - as supplied by publisher]
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » To Kesä 03, 2010 21:17

"Erilaisten vertaimevien hyönteisten välityksellä voi saada yllättävänkin usein bakteeritartunnan - bartonellan. Taudinaiheuttaja saattaa tarttua myös äidistä lapseen. Tri E. Breitschwert on maailman johtavia bartonella-tutkijoita ja hän on ensimmäistä kertaa dokumentoinut tapauksen jossa bakteeri näyttäisi siirtyneen perheenjäsenestä toiseen.

Perheen äiti ja isä kärsivät voimakkaasta uupumuksesta ym oireista pian avioitumisensa jälkeen. Pian kaksosten syntymän jälkeen toinen lapsista kuoli 9 päivän ikäisenä sydänongelmiin. Toisella lapsellakin ilmeni kroonisia terveysongelmia.

Breitschwerdt tutki kuolleesta lapsesta otettuja näytteitä sekä elossa olevia perheenjäseniä. Kaikilla oli bartonellan aiheuttama infektio. Bartonellan tiedetään aiheuttavan erilaisia kipuja, tulehduksia joita lääkärit eivät useimmiten kykene diagnosoimaan.

Lisätutkimusten tekeminen on vaikeaa sillä tutkimukselle on vaikea löytää rahoittajia. Bakteerien ei tällä hetkellä ajatella olevan merkittävä terveysongelma ihmisille. Breitschwert uskoo että bakteeri on useimpien kroonisten oireiden todellinen syy - lihaskivut, fatiikki, neurologiset oireet, niveltulehdukset jne. Tavanomaisesti käytössä olevat testit eivät yleensä pysty osoittamaan tartuntaa sillä ne testaavat ainoastaan vasta-aineiden muodostumista."



"A bacterial infection typically spread by fleas, lice and biting flies could be more prevalent than many think, and may have been transmitted from a mother to her children at birth, scientists from N.C. State University say.

Dr. Edward Breitschwerdt, an infectious disease veterinarian and one of the world's leading researchers of bacteria called Bartonella, has for the first time documented evidence that the pathogen may have been passed between family members.

Although more studies are needed to back up his findings, Breitschwerdt and colleagues describe the case of a mother and father who began battling chronic aches, fatigues and other symptoms soon after they were married. When their twins were born in 1998, the daughter died after nine days from a heart defect, and the son developed chronic health problems.

Using tissue from the daughter's autopsy and blood from the surviving family members, Breitschwerdt's team discovered that the entire family was infected with the same species of Bartonella bacteria, despite having no shared exposures to flea or lice infestations. Bartonella is known to causes such illnesses as trench fever and cat scratch disease, and it is increasingly suspected of triggering a variety of aches and inflammations that doctors have been unable to diagnose.

"I think we have stumbled across something that is of monumental medical importance," said Breitschwerdt, whose findings were published recently in the Journal of Clinical Microbiology.

Proving the mother-child transmission could be difficult, however. Little funding is available for such research because the bacteria are still not considered a major source of human disease.

Dr. Michael Kosoy, who heads the Bartonella laboratory for the Centers for Disease Control and Prevention in Fort Collins, Colo., said scientists are only beginning to build evidence that Bartonella infections may be more common than previously thought.

"Bartonella are circulated around the world in many animals, but there are different Bartonella species, and the question is how can they be transmitted to humans?" Kosoy said, noting that most known cases have been transmitted from biting insects. He said the NCSU findings about the potential family transmission are compelling but inconclusive.

Dozens of strains

At least 26 strains of Bartonella have been named worldwide, and the list is growing. The most notorious Bartonella infection is cat scratch disease, a fever illness passed to humans from flea-infected cats. Fleas are the primary hosts, and they spread the bacteria in their feces.

Other Bartonella strains spread more serious diseases. Kosoy is studying how often heart inflammation is caused by a Bartonella that thrives among rat fleas in Thailand. He has already established that about 25 percent of unexplained fever illnesses among a group of patients there was caused by Bartonella .

"This is not limited to cat scratch," Kosoy said. "That's just the tip of the iceberg."

Breitschwerdt said he thinks the bacteria may be the hidden cause behind a host of chronic symptoms - muscle aches, neurological problems, fatigue, arthritis - that defy diagnosis.

About two years ago, Breitschwerdt began testing blood samples from a doctor in Maryland, who was curious whether Bartonella infections might be causing problems for some of his patients.

"There are lab tests showing inflammation," but no discernible cause, said Dr. Robert Mozayeni, a Yale-educated rheumatologist who practices in Rockville, Md.

Mozayeni contacted Breitschwerdt and his NCSU colleague, Ricardo Maggi, who together developed a more sensitive test for Bartonella. Routine blood tests fail to detect Bartonella because they search for antibodies that the body is slow to produce.

Instead, Breitschwerdt and Maggi figured out how to cultivate the bacteria in the laboratory from blood samples of infected people. They founded a company called Galaxy Diagnostics to handle the laboratory volume.

Of Mozayeni's mystery patients tested at the lab, nearly 20 percent had Bartonella infections.

"I suspect this is going to be one of the causes of rheumatoid arthritis and a few other things, but it's too speculative right now to say," Mozayeni said.

Human testing

More studies are needed, and Mozayeni has joined Breitschwerdt and Maggi in the diagnostic company to oversee human testing.

"Certainly, the prevalence of Bartonella infection in people with chronic illness is higher than I would have ever guessed, but we still don't know what that means," Breitschwerdt said.

Among the biggest unknowns is how to treat people who have been infected. The effectiveness of antibiotics depends on which strain of Bartonella is at work, and with so many strains, treatments can be hit or miss.

Breitschwerdt said the family in his most recent study declined to comment about their experience. He said they were having difficulty finding a doctor.

"It is very difficult to find a physician who wants to see someone with a chronic illness that is poorly defined," he said, adding that many such patients often think they have Lyme disease, a tick-borne bacterial infection with similar symptoms - and stigma. "With an unexplained illness, it becomes problematic."



Read more: http://www.newsobserver.com/2010/05/21/ ... z0oqQf0kSj
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » To Kesä 10, 2010 22:50

http://www.ts.fi/online/kotimaa/58419.html

Hirvikärpäset levittävät haitallista bakteeria

TURUN SANOMAT

Julkaistu 3.7 2009

Hirvikärpäset aiheuttavat monelle metsässä kävijälle hankalia ihottumia ja allergisia reaktioita. Tutkijat havaitsivat hiljattain, että kiusallinen hyönteinen levittää myös Bartonella-bakteeria, jonka eräät muodot aiheuttavat sydänlihastulehduksia.

Vielä ei tiedetä, voiko bakteeri tarttua pistoksen kautta myös ihmiseen.

?Tarttuminen on mahdollista, mutta vielä on liian aikaista arvioida tapahtuuko niin. Tutkimukset ovat kesken, toteaa monitieteellisessä hirvikärpästutkimusprojektissa mukana oleva professori Olli Vapalahti Helsingin yliopistosta.

Tutkijoille oli yllätys, että suomalaisilta hirvikärpäsiltä löytyy bakteeria. Asiaa alettiin selvittää, kun Sveitsissä havaittiin hirvikärpäset bakteerien kantajiksi.

Ihottuma bakteeria suurempi riesa

Bartonella-bakteerista kohistiin Ruotsissa 1990-luvun alussa niin sanottujen suunnistajakuolemien yhteydessä.

Vapalahti muistaa kohun, mutta korostaa, ettei bakteerin yhteyttä kuolemiin varmistettu.

Suomalaisten marjastajien, sienestäjien ja muiden metsässä liikkujien ei Olli Vapalahden mukaan kannatakaan huolestua uudesta löydöstä.

?Riski ei ole sen suurempi kuin ennenkään. Todennäköisesti bakteerilöydös olisi ollut aiemmin samanlainen, jos sitä olisi etsitty, Vapalahti toteaa.

Hänen mukaansa bakteeria suurempi riesa on hirvikärpäsen syljen aiheuttama allerginen ihottuma, jonka parantuminen on joissakin tapauksissa kestänyt jopa puoli vuotta.

Yliopistojen, Eviran ja Metlan yhteisessä hirvikärpäsprojektissa tutkitaan hirvikärpästen leviämistä pohjoista kohti sekä kärpäsen vaikutuksia ihmiseen. 1960-luvulla Suomeen lennähtäneen hirvieläinten loisen elämänkaarta ja lisääntymistä tunnetaan yhä heikosti, kertoo projektin vetäjä, professori Hannu Ylönen Jyväskylän yliopistosta.

Lisääntyy aina Utsjoella asti

Mysteeri on esimerkiksi se, miksi hirvikärpäset ovat Suomessa levinneet pohjoisemmaksi kuin naapurissa Ruotsissa, jossa niitä on ollut yli parisataa vuotta.

?Tutkimusten mukaan hirvikärpänen pystyy lisääntymään jopa Utsjoella. Runsaan levinneisyyden raja kulkee poronhoitoalueen etelärajalla, Ruotsissa Tukholman pohjoispuolella, Hannu Ylönen kuvailee.

Lisätietoa odotetaan vireillä olevasta Pohjoismaiden yhteisestä hirvikärpässelvityksestä. DNA-tutkimusten perusteella tiedetään jo, että eurooppalaiset hirvikärpäset ovat samaa kantaa suomalaisten kanssa.

Tutkimuksissa huomio kohdistuu hirvikärpästen koteloihin, joita kerätään hangesta hirvien talvehtimispaikoilta. Yhdellä makuupaikalla saattaa olla kymmenittäin koteloita.

?Yritämme selvittää, miten kotelot selviävät maassa puolikin vuotta niin, että muurahaiset tai myyrät eivät syö niitä, Hannu Ylönen kertoo.

Nopeasti levinneillä hirvikärpäsillä ei Suomessa juuri ole luontaisia vihollisia.

?Ehkä hömötiaiset, joiden on havaittu käyvän makuupaikoilla, Ylönen sanoo.

ELINA MALKAMÄKI
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » To Kesä 10, 2010 22:52

GALAXY DIAGNOSTICS ILMOITTAA KEHITTÄNEENSÄ UUDEN TESTIN BARTONELLAN DIAGNOSTIIKKAAN. Taudinaiheuttajaa on normaalitesteillä vaikea löytää verestä ihmisillä. Kissoilta sitä löydetään sen sijaan helpommin. Tauti diagnosoidaan ihmisillä usein virheellisesti muiksi sairauksiksi esim. MS-taudiksi. Tauti aiheuttaa esim. erilaisia silmäsairauksia (suom. huom. aiheesta lisää aiemmissa artikkeleissa), fatiikkia, päänsärkyä, heikotusta jne.


http://www.techjournalsouth.com/news/ar ... em_id=7497

Galaxy Diagnostics plans to fight bug borne bacteria
May 26, 2009
By Allan Maurer
RALEIGH, NC?A new company plans to develop a diagnostic test for the hard-to-detect Bartonella bacteria that can cause human infections from tick bites or contact with pet cats. Galaxy Diagnostics has raised $40,000 of $100,000 in debt funding targeted and is in the process of setting up a new commercial laboratory.

Galaxy CEO Chris Kelly tells TechJournal South the money raised is a partly a loan from the NC Biotech Center months ago and the company is not actively raising money right now.

Kelly says the company is staying under the radar right now, but that its technology can recognize bacteria that no one else can.

The company revealed the debt funding in a filing with the U.S Securities and Exchange Commission. The filing states the money is from three investors.

Kelly is a serial entrepreneur on his fourth startup. Previously he founded Xlibris Corp., the first on-demand book publisher that became a division of Random House Publishing. He also led Ribonomics, a Duke University biotech spinout.

The company?s technology is based on the proprietary intellectual property from the College of Veterinary Medicine at North Carolina State University.

According to the company?s Web site, its diagnostic for Bartonella involves the use of a patented growth media combined with state-of-the-art molecular-based bacterial DNA detection. The results are highly accurate and significantly more sensitive than any other available method for detecting infection by Bartonella, the company says.

Galaxy?s Chief Scientific Officer, Ed Breitschwerdt, a doctor of veterinary medicine and professor at NC State?s College of Veterinary Medicine, is an internationally recognized leader in the area of Bartonella research, diagnosis, and treatment.

In an earlier interview, Dr. Breitschwerdt told the Raleigh News & Observer that he believes Bartonella infections ?are a silent epidemic.? Many of his own animal patients, cats, dogs, rabbits, cows and other animals, harbor the bacteria, which they picked up from insect bites.

The bacteria are the cause of cat scratch disease, among other ailments. It can be transmitted by infected fleas, lice, sandflies and possibly ticks, but it is difficult to detect in human blood. It can be treated with antibiotics if properly diagnosed.
The symptoms caused by the bacteria, fatigue, headaches, weakness, can easily be misdiagnosed as any number of other diseases, including MS.
Although the bacteria can be found fairly easily in cats, which can have high levels of Bartonella, it requires a more advanced diagnostic test to find it in humans. Galaxy plans to develop that advanced diagnostic.

Galaxy co-founders include Amanda B. Elam, PhD, president, who has had experience with several startups, and Ricardo Maggi, PhD, professor of Medical Microbiology at the College of Veterinary Medicine at North Carolina State.

Dr. Maggi played an integral role in developing the new diagnostic technology and is responsible for transitioning Bartonella testing from the NC State Vector Borne Disease Diagnostics lab to the Galaxy Lab, according to the company.

Online: www.Galaxydx.com
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Pe Kesä 11, 2010 08:26

Kuumeoireiset Thaimaalaiset potilaat olivat ennen Bartonellaan sairastumistaan olleet kontaktissa eläimiin; rotta, kissa, koira jne.

Am J Trop Med Hyg. 2010 Jun;82(6):1140-5.
Identification of bartonella infections in febrile human patients from Thailand
and their potential animal reservoirs.

Kosoy M, Bai Y, Sheff K, Morway C, Baggett H, Maloney SA, Boonmar S, Bhengsri S,
Dowell SF, Sitdhirasdr A, Lerdthusnee K, Richardson J, Peruski LF.

Division of Vector-Borne Infectious Diseases, Centers for Disease Control and
Prevention, Fort Collins, Colorado; International Emerging Infections Program,
Nonthaburi, Thailand; Office of Global Health, Centers for Disease Control and
Prevention, Atlanta, Georgia; Ministry of Public Health, Nonthaburi, Thailand;
Department of Entomology, Armed Forces Research Institute of Medical Sciences,
Bangkok, Thailand.

To determine the role of Bartonella species as causes of acute febrile illness
in humans from Thailand, we used a novel strategy of co-cultivation of blood
with eukaryotic cells and subsequent phylogenetic analysis of
Bartonella-specific DNA products. Bartonella species were identified in 14 blood
clots from febrile patients. Sequence analysis showed that more than one-half of
the genotypes identified in human patients were similar or identical to
homologous sequences identified in rodents from Asia and were closely related to
B. elizabethae, B. rattimassiliensis, and B. tribocorum. The remaining genotypes
belonged to B. henselae, B. vinsonii, and B. tamiae. Among the positive febrile
patients, animal exposure was common: 36% reported owning either dogs or cats
and 71% reported rat exposure during the 2 weeks before illness onset. The
findings suggest that rodents are likely reservoirs for a substantial portion of
cases of human Bartonella infections in Thailand.


http://eutils.ncbi.nlm.nih.gov/entrez/e ... md=prlinks
PMID: 20519614 [PubMed - in process]
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Ma Syys 06, 2010 13:30

Bartonella voi aiheuttaa merkittäviä terveysongelmia useissa elimissä nimenomaan sellaisten henkilöiden kohdalla joiden immuunipuolustus ei toimi kunnolla (2010).

Human isolates of Bartonella tamiae induce pathology in experimentally inoculated immunocompetent mice

Leah Colton email, Nordin Zeidner email, Tarah Lynch email and Michael Y Kosoy email

Bacterial Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA

author email corresponding author email

BMC Infectious Diseases 2010, 10:229doi:10.1186/1471-2334-10-229

The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1471-2334/10/229
Received: 9 February 2010
Accepted: 30 July 2010
Published: 30 July 2010

© 2010 Colton et al; licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background

Bartonella tamiae, a newly described bacterial species, was isolated from the blood of three hospitalized patients in Thailand. These patients presented with headache, myalgia, anemia, and mild liver function abnormalities. Since B. tamiae was presumed to be the cause of their illness, these isolates were inoculated into immunocompetent mice to determine their relative pathogenicity in inducing manifestations of disease and pathology similar to that observed in humans.
Methods

Three groups of four Swiss Webster female mice aged 15-18 months were each inoculated with 106-7 colony forming units of one of three B. tamiae isolates [Th239, Th307, and Th339]. A mouse from each experimental group was sampled at 3, 4, 5 and 6 weeks post-inoculation. Two saline inoculated age-matched controls were included in the study. Samples collected at necropsy were evaluated for the presence of B. tamiae DNA, and tissues were formalin-fixed, stained with hematoxylin and eosin, and examined for histopathology.
Results

Following inoculation with B. tamiae, mice developed ulcerative skin lesions and subcutaneous masses on the lateral thorax, as well as axillary and inguinal lymphadenopathy. B. tamiae DNA was found in subcutaneous masses, lymph node, and liver of inoculated mice. Histopathological changes were observed in tissues of inoculated mice, and severity of lesions correlated with the isolate inoculated, with the most severe pathology induced by B. tamiae Th239. Mice inoculated with Th239 and Th339 demonstrated myocarditis, lymphadenitis with associated vascular necrosis, and granulomatous hepatitis and nephritis with associated hepatocellular and renal necrosis. Mice inoculated with Th307 developed a deep dermatitis and granulomas within the kidneys.
Conclusions

The three isolates of B. tamiae evaluated in this study induce disease in immunocompetent Swiss Webster mice up to 6 weeks after inoculation. The human patients from whom these isolates were obtained had clinical presentations consistent with the multi-organ pathology observed in mice in this study. This mouse model for B. tamiae induced disease not only strengthens the causal link between this pathogen and clinical illness in humans, but provides a model to further study the pathological processes induced by these bacteria.
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » To Syys 16, 2010 08:57

Lääkärien tulee olla tietoisia niveljalkaisten levittämästä yleisestä bartonella-infektiosta. Taudinaiheuttajan voi saada myös pureman tai raapaisun kautta. (2010)

J Am Board Fam Med. 2010 Sep-Oct;23(5):685-6.
Cat Scratch Disease and Arthropod Vectors: More to it than a Scratch?

Mosbacher M, Elliott SP, Shehab Z, Pinnas JL, Klotz JH, Klotz SA.

Third World Veterinary, Fountain Hills, AZ.

Purpose: Cat scratch disease is a common infection, particularly in children,
and clinicians need to be aware of its potential transmission to humans by
arthropod vectors such as fleas and ticks in addition to animal bites and
scratches. The absence of a vertebrate bite or scratch does not preclude
infection with Bartonella henselae.

METHODS: Literature regarding arthropod transmission of B. henselae was reviewed.
RESULTS: B. henselae and related
bacterial species are transmitted among cats and dogs by arthropod vectors. In
the absence of these vectors, disease does not spread amongst the animals. On
the other hand, disease can be spread to humans by bite and scratch as well as
by arthropod vectors. Animals commonly infected with B. henselae and arthropod
vectors are discussed.

CONCLUSIONS: Clinicians should be aware that a common
illness, cat scratch disease, can be transmitted by arthropod vectors and a
history of an animal scratch or bite is not necessary for disease transmission.

http://eutils.ncbi.nlm.nih.gov/entrez/e ... md=prlinks
PMID: 20823366 [PubMed - in process]
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » To Syys 16, 2010 09:00

Kaksi lasta sai kissanraapaisun jälkeen Bartonellan. Oireet: kivuton näön heikkeneminen, kuumetta, imusomukkeiden turvotus. (Puola 2010)

Klin Oczna. 2010;112(4-6):131-4.
[Neuroretinitis in cat scratch disease]

[Article in Polish]

Karolak J, Gotz-Wipckowska A.

Z Katedry i Kliniki Okulistyki Uniwersytetu Medycznego im. K. Marcinkowskiego w
Poznaniu. asia.karolak@gmail.com

PURPOSE: To present two cases of neuroretinitis in cat scratch disease We
present two girls treated in Department of Ophthalmology of Poznai University of
Medical Sciences because of unilateral, painless decrease of vision. Both
patients presented following cat exposure fever and lymph nodes swelling.
Ophthalmoscopic findings was neuroretinitis (optic disc edema with the macular
star). Bartonella henselae antibody titers (IgG) were elevated. CSD is usually
self-limited infection in immunocompetent patients and there is no clear
treatment recommendations. One of our patients received treatment which included
oral antibiotic (macrolides) and steroid. The second patient was left without
treatment. In our case--the duration of visual loss was longer in patient who
was not treated.

Publication Types:
English Abstract

http://eutils.ncbi.nlm.nih.gov/entrez/e ... md=prlinks
PMID: 20825068 [PubMed - in process]
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » La Loka 02, 2010 08:03

RUOTSALAINEN VÄITÖSKIRJA BARTONELLASTA V.2007. Ruotsissa useat huipputason suunistajat kuolivat äkillisesti. Syynä oli bartonellan aiheuttama sydänlihastulehdus.
Sivulta löytyy linkki koko tutkimukseen.


http://cdml.positionett.se/politiken/FM ... QZ2&-find=
Bartonella Infections in Sweden: Clinical Investigations and Molecular Epidemiology

Författare:
Ehrenborg, Christian

Förlag:
Uppsala universitet/Institutionen för medicinska vetenskaper

Datum:
2007-04-26

År:
2007

SAB-kod:
Veba

ISBN:
978-91-554-6886-6

Abstract:
Characteristically, in infections that are caused by the zoonotic pathogen <i>Bartonella</i> naturally infected reservoir hosts are asymptomatic, where infected incidental, non-natural, hosts develop symptomatic disease. Cat-scratch disease (CSD) is a well known example. <i>Bartonella </i>infections in humans may be self-limiting or fulminant and affect different organ systems. The objectives of the present thesis were to (1) identify and characterise <i>Bartonella </i>infection cases in Sweden, (2) to investigate certain human populations regarding <i>Bartonella </i>infections, and (3) compare natural populations of different <i>Bartonella </i>species. Cases with typical and atypical CSD were recognised by using a combination of PCR and serology. Gene sequence comparisons of different genes in <i>B. henselae</i> isolates from the United States and Europe showed that<i> fts</i>Z gene variation is a useful tool for <i>Bartonella</i> genotyping.

Myocarditis was a common finding among Swedish elite orienteers succumbing to sudden unexpected cardiac death (SUCD). The natural cycle of Bartonella, the life style of orienteers, elevated antibody titres to Bartonella antigens,Bartonella DNA amplified from myocardium and the lack of another feasible explanation make Bartonella a plausible aetiological factor.

The first reported case of <i>Bartonella</i> endocarditis (<i>B. quintana</i>) was identified in an immunocompromised patient who underwent heart valve replacement. The patient had been body louse-infested during his childhood. It is hypothesised that a chronic <i>B. quintana</i> infection was activated by the immunosuppression. There was no evidence of an ongoing trench fever (TF) epidemic in a Swedish homeless population, although an increased risk for exposure to <i>Bartonella</i> antigens was demonstrated. The lack of louse infestation might explain the absence of <i>B. quintana</i> bacteremia and low <i>B. quintana</i> antibody titres. Comparisons of genetic loci and the whole genomes of environmental <i>B. grahamii</i> isolates from the Uppsala region, Sweden displayed variants that were not related to specific host species but to geographic locality. Natural boundaries seemed to restrict gene flow.

Länk till fulltext:
Fulltext
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Ke Loka 20, 2010 18:16

Bartonella -infektio voi aiheuttaa erilaisia neurologisia oireita ja esim. hartiapunoksen neuriitin.

http://jnnp.bmj.com/content/early/2010/ ... hort?rss=1>

J Neurol Neurosurg Psychiatry doi:10.1136/jnnp.2009.191940

* Letter

Neuralgic amyotrophy associated with Bartonella henselae infection

1. Cari J Stek1,
2. Jeroen J J van Eijk2,
3. Bart C Jacobs4,
4. Roelien H Enting3,
5. Herman G Sprenger1,
6. Nens van Alfen2,
7. Sander van Assen1

1Department of Internal Medicine, Division of Infectious Diseases, University Medical Centre, Groningen, The Netherlands

2Department of Neurology and Clinical Neurophysiology, Donders Institute for Brain Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

3Department of Neurology, University Medical Centre, Groningen, The Netherlands

4Department of Neurology and Immunology, Erasmus Medical Centre, Rotterdam, The Netherlands

1. Correspondence to Dr J J J van Eijk, 935 Department of Neurology, Donders Institute for Brain Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; j.vaneijk@neuro.umcn.nl

1. Contributors CJS and JJJvE contributed equally.

* Received 17 August 2009
* Revised 8 February 2010
* Accepted 25 February 2010
* Published Online First 14 August 2010

* Bartonella henselae
* neuralgic amyotrophy
* cat scratch disease

We report three patients with a brachial plexus neuropathy diagnosed as neuralgic amyotrophy (NA) preceded by a proven Bartonella henselae infection. Neuralgic amyotrophy is a disabling disease involving the brachial plexus, with attacks of severe shoulder and arm pain followed by weakness and sensory involvement.1 Several observations support the hypothesis of an immune-mediated genesis. First, brachial plexus biopsies of NA patients in the (sub)acute stage show inflammatory changes.2 3 Second, antiganglioside antibodies are reported to be associated with NA.1 4 Third, several immune-triggering events, most frequently infections (50%), are known to precede NA.1?4 Various micro-organisms preceding NA have been reported (see table 1) but not yet B henselae.
View this table:


Table 1

Results of literature search for micro-organisms associated with neuralgic amyotrophy

B henselae is a Gram-negative, intracellular bacterium causing cat-scratch disease (CSD), which usually presents with fever, malaise and regional lymphadenopathy. Occasionally, neurological complications occur, most frequently neuroretinitis and encephalopathy, but also peripheral nervous system disorders.5 These complications occur 1?3 weeks from the onset of lymphadenopathy, without any signs of direct infection of the nervous system, suggesting an immune-mediated genesis.

Infections can induce auto-immune reactions by several mechanisms. Molecular mimicry could be the underlying pathophysiological mechanism in NA, comparable with Guillain?Barré syndrome, for example. Alternatively, NA may ?

[Full text of this article]
.
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » La Loka 23, 2010 08:22

Bartonella - bakteerin aiheuttama infektio on kissoilla yleinen. Bakteeri tarttuu ihmisiin esim. kissojen kirppujen välityksellä. (USA 2010)

Vet Clin North Am Small Anim Pract. 2010 Nov;40(6):1073-90.
Feline bartonellosis.

Guptill L.

Department of Veterinary Clinical Sciences, Purdue University, 625 Harrison
Street, West Lafayette, IN 47907, USA. guptillc@purdue.edu

Bartonella infection is common among domestic cats, but the role of Bartonella
species as feline pathogens requires further study. Most Bartonella species that
infect cats are zoonotic. Cats are the mammalian reservoir and vector for
Bartonella henselae, an important zoonotic agent.

Cat fleas transmit Bartonella
among cats, and cats with fleas are an important source of human B henselae
infections. New information about Bartonella as feline pathogens has recently
been published, and this article summarizes much of that information. Issues
surrounding diagnosis and treatment of feline Bartonella infections are
described, and prevention of zoonotic transmission of Bartonella is discussed.
Copyright (c) 2010 Elsevier Inc. All rights reserved.

http://eutils.ncbi.nlm.nih.gov/entrez/e ... md=prlinks
PMID: 20933137 [PubMed - in process]
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Ti Marras 30, 2010 20:39

Bartonella-bakteeri aiheutti potilaalle silmäkalvon tulehduksen eli uveiitin (2010)


Cornea. 2010 Nov 17; [Epub ahead of print]
Cat-scratch Uveitis Confirmed by Histological, Serological, and Molecular
Diagnoses.

Font RL, Valle MD, Mitchell BM, Boniuk M.

From the *Ophthalmic Pathology Laboratory and daggerDivision of Molecular
Virology and Microbiology, Cullen Eye Institute, Baylor College of Medicine,
Houston, TX.

PURPOSE:: To report a case of a cat-scratch uveitis caused by Bartonella
henselae, which was confirmed by histology, serology, and polymerase chain
reaction (PCR) methodology. METHODS:: An iris nodule was biopsied from a
4-year-old child who was scratched by a kitten on the side of his face and
developed redness of the eye associated with cervical lymphadenopathy. Sections
of the iridectomy specimen were stained with hematoxylin-eosin, periodic
acid-Schiff, and Warthin-Starry technique for histopathologic evaluation.
Additionally, serologic tests and molecular diagnosis using B. henselae-specific
PCR were performed. RESULTS:: Histopathologically, sections of the iridectomy
specimen showed a zonal granulomatous inflammation with a central iris necrotic
abscess surrounded by a mantle of epithelioid histiocytes and more peripherally
by lymphocytes and plasma cells. The Warthin-Starry stain disclosed scattered
short bacilli within the necrotic abscess morphologically compatible with B.
henselae. Report of serologic tests for B. henselae disclosed a negative
immunoglobulin G antibody (negative: less than 12) and a positive immunoglobulin
M antibody of 18 (positive: greater than 15). Other serologic studies including
Toxocara, histoplasmin, blastomycin, coccidioidin, aspergillin, and Chlamydia
were all negative. PCR was positive for B. henselae DNA.

CONCLUSIONS:: Our case
showed a unilateral chronic granulomatous iritis with the histopathologic
features compatible with CSD caused by B. henselae bacillus as demonstrated in
the iris biopsy and confirmed by serology and PCR technique. This case is an
example of a relatively rare uveal manifestation of CSD.


http://eutils.ncbi.nlm.nih.gov/entrez/e ... md=prlinks
PMID: 21099401 [PubMed - as supplied by publisher]
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » To Joulu 09, 2010 19:18

Bartonella voidaan diagnosoida esim. ihonäytteestä (Ranska 2010)


Volume 16, Number 12?December 2010
Dispatch
Bartonella henselae in Skin Biopsy Specimens of Patients with Cat-Scratch Disease

Emmanouil Angelakis, Sophie Edouard, Bernard La Scola, and Didier Raoult Comments to Author
Author affiliation: Université de la Méditerranée, Marseille, France

Suggested citation for this article

Abstract
During the past 2 years, we identified live Bartonella henselae in the primary inoculation sites of 3 patients after a cat scratch. Although our data are preliminary, we report that a cutaneous swab of the skin lesion from a patient in the early stage of cat-scratch disease can be useful for diagnosis of the infection.


free full text: http://www.cdc.gov/eid/content/16/12/1963.htm
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Ke Tammi 12, 2011 16:32

Bartonellan aiheuttama infektio voi olla lieväoireinen mutta joissakin tapauksissa se voi myös olla tappava.

Future Microbiol. 2010 Nov;5:1719-31.
Bartonella infection: treatment and drug resistance.

Biswas S, Rolain JM.

CNRS-IRD, UMR 6236, Unite de Recherche sur les Maladies Infectieuses et
Tropicales Emergentes (URMITE), Faculte de Medecine et de Pharmacie, Universite
de la Mediterranee, 27, boulevard Jean-Moulin, 13385 Marseille cedex 05, France.

Bartonella species, which belong to the alpha-2 subgroup of Proteobacteria, are
fastidious Gram-negative bacteria that are highly adapted to their mammalian
host reservoirs. Bartonella species are responsible for different clinical
conditions affecting humans, including Carrion's disease, cat scratch disease,
trench fever, bacillary angiomatosis, endocarditis and peliosis hepatis. While
some of these diseases can resolve spontaneously without treatment, in other
cases, the disease is fatal without antibiotic treatment. In this article, we
discuss the antibiotic susceptibility patterns of Bartonella species, detected
using several methods. We also provide an overview of Bartonella infection in
humans and animals and discuss the antibiotic treatment recommendations for the
different infections, treatment failure and the molecular mechanism of
antibiotic resistance in these bacteria.

http://eutils.ncbi.nlm.nih.gov/entrez/e ... md=prlinks
PMID: 21133691 [PubMed - in process]
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Ti Helmi 01, 2011 12:58

2 tapausselostusta joissa bartonella-bakteeri aiheutti muutoksia silmien verisuoniin ja sitä kautta näön hämärtymistä ja toisessa tapauksessa vasemman silmän sokeutumisen. 6 -8 päivän antibioottiihoito (atsitromysiini) auttoi kummassakin tapauksessa.

Int Ophthalmol. 2011 Jan 26; [Epub ahead of print]

Unusual retinal manifestations of cat scratch disease.

Pinna A, Puglia E, Dore S.

Institute of Ophthalmology, University of Sassari, Viale San Pietro 43 A, 07100,
Sassari, Italy,apinna@uniss.it.

We report on 2 patients with unusual retinal manifestations of cat scratch
disease (CSD), caused by Bartonella henselae.

Case 1. A 42-year-old farmer
presented with a 5-day history of blurred vision in his right eye. Right visual
acuity was 20/25. Fundus examination of the right eye revealed mild vitreous
hemorrhage and diffuse retinal hemorrhages in the mid-peripheral retina.
Fluorescein angiography showed multiple vasculitic occlusions in the same area.
A blood sample taken on the day of examination revealed the presence of
immunoglobulin (Ig)M and IgG to B. henselae. Oral azithromycin was given for 8
days. One month later, right visual acuity was 20/20, the vitreous and retinal
hemorrhages resolved, and arteriolar attenuation and sclerosis was observed in
the peripheral temporal retina.

Case 2. A 66-year-old craftsman with systemic
hypertension and hypercholesterolemia complained of sudden visual loss (light
perception) in his left eye. Fundus evaluation and fluorescein angiography
revealed central retinal artery occlusion (CRAO) in the affected eye. About 2
weeks earlier, he had been bitten and scratched on his right hand by a stray
cat. Serologic testing detected the presence of IgM to B. henselae. Oral
azithromycin was given for 6 days. One month later, left visual acuity was handmotion.

Ophthalmologists should be aware that unusual ocular complications
associated with CSD include vitreous hemorrhage with retinal vasculitis and
isolated CRAO. Vitreous hemorrhage and retinal vasculitis may be the only
clinical manifestation of CSD.

http://eutils.ncbi.nlm.nih.gov/entrez/e ... md=prlinks
PMID: 21267628 [PubMed - as supplied by publisher]
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

kissanraapima taudista...

ViestiKirjoittaja piiu76 » Ti Syys 13, 2011 14:04

...jokohan sitten tärppäsi; kissoja ollut viimeiset 20 vuotta. osa pelastettuja kulkukissoja ja osa ns. normi oloista. Lisäksi vieraita kissoja olen hoitanut viimeiset 9 vuotta, ja näitä kavereita on ollut likemäs sata eri turilasta vuosien saatossa... sekä koirien kanssa olen myös pelannut lapsesta asti joten raapaisuja ja purema vammojakin on tullut, luonnollisesti , ja joskus jopa pitänyt hakea lääkekuuriakin :cry:
Josko joku taas kehtaisi vääntää tautalangasta, millä tämä pöpö bongataan?? :lol: ja missä ja miten se näkyisi jos näkyisi?
lähes kroonisena vaivana tuo poskiontelontulehdus ollut vuosia ja aiheuttaa siten neurologisia oireita jotka usein helpottavat antibioottikuurin jälkeen...
piiu76
 

ViestiKirjoittaja soijuv » To Syys 22, 2011 19:57

Bartonella on gram negatiivinen bakteeri jota levittävät punkkien lisäksi mm hiekkakärpäset, täit ja kirput (Australia 2011)

Zoonotic Bartonella Species in Fleas and Blood from Red Foxes in Australia.

Kaewmongkol G, Kaewmongkol S, Fleming PA, Adams PJ, Ryan U, Irwin PJ, Fenwick SG

Vector Borne Zoonotic Dis 2011 09 15

Abstract Bartonella are arthropod-borne, fastidious, Gram-negative, and aerobic bacilli distributed by fleas, lice, sand flies, and, possibly, ticks. The zoonotic Bartonella species, Bartonella henselae and Bartonella clarridgeiae, which are the causes of cat scratch disease and endocarditis in humans, have been reported from cats, cat fleas, and humans in Australia. However, to date, there has been no report of B. henselae or B. clarridgeiae in Australian wild animals and their ectoparasites. B. henselae and B. clarridgeiae were detected in fleas (Ctenocephalides felis) from red foxes (Vulpes vulpes), an introduced pest animal species in Australia, and only B. clarridgeiae was detected in blood from one red fox. Phylogenetic analysis of the ribosomal intergenic spacer region revealed that the B. henselae detected in the current study were related to B. henselae strain Houston-1, a major pathogenic strain in humans in Australia, and confirmed the genetic distinctness of B. clarridgeiae. The identification and characterization of Bartonella species in red foxes in the Southwest of Western Australia suggests that red foxes may act as reservoirs of infection for animals and humans in this region.
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » To Syys 22, 2011 20:08

Bartonellan aiheuttama krooninen infektio voi aiheuttaa esim. verisuonikasvaimen (hemangioendothelioma) (2011)

Bartonella species bacteremia in two patients with epitheliod hemangioendothelioma.

Mascarelli PE, Iredell JR, Maggi RG, Weinberg G, Breitschwerdt EB

J Clin Microbiol 2011 09 14

Bartonella henselae and Bartonella koehlerae bacteremia was documented in two epitheliod hemangioendothelioma patients and B. koehlerae bacteremia in a asymptomatic boyfriend. Considering the biology and clinically variable natural history of epitheliod hemangioendothelioma, these results suggest that chronic Bartonella infection could have a role in the development of this vascular neoplasm.
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Ma Loka 10, 2011 11:10

Bartonella bakteerien aiheuttamat infektiot ovat maailmanlaajuinen ongelma. Bakteeria on löydetty myös Nepalista tutkittaessa kuumeilevia potilaita. (2011)

Serological response to Bartonella species in febrile patients from Nepal.

Myint KS, Gibbons RV, Iverson J, Shrestha SK, Pavlin JA, Mongkolsirichaikul D, Kosoy MY

Trans R Soc Trop Med Hyg 2011 09 26

The Bartonella-associated illnesses are spread world-wide and involve a broad spectrum of signs and symptoms in humans. Several Bartonella species have been shown to be responsible for cases of febrile illnesses. Little information exists on distribution of Bartonella species and their role in human diseases in Nepal. Our preliminary study, a retrospective serological survey of archived specimens, suggests that Bartonella antibodies are prevalent among febrile patients in the Kathmandu Valley of Nepal.
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Su Loka 23, 2011 20:22

Saksa 2011. 230 punkkia. n.7%:sta löytyi bartonella-bakteereita. Niistä 25%:sta löytyi sen lisäksi borrelia-bakteereita.

Clin Microbiol Infect. 2011 Jun;17(6):918-20. doi: 10.1111/j.1469-0691.2010.03363.x. Epub 2010 Nov 10.
Occurrence of Bartonella henselae and Borrelia burgdorferi sensu lato co-infections in ticks collected from humans in Germany.
Mietze A, Strube C, Beyerbach M, Schnieder T, Goethe R.
Source
Institute for Microbiology, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany.
Abstract
Bartonella (B.) henselae is the zoonotic agent of cat scratch disease. B. henselae has been associated with therapy-resistant Lyme disease in humans suggesting that B. henselae and Borrelia burgdorferi sensu lato might be transmitted concurrently by ticks.

In the present study we found that 16 (6.9%) of 230 Ixodes ricinus collected from humans harboured DNA of Bartonella spp. Fifteen positive ticks were infected with B. henselae and one tick with B. clarridgeiae. Twenty-five percent of the 16 Bartonella positive ticks were co-infected with Borrelia burgdorferi sensu lato. Our data show that B. henselae is present in Ixodes ricinus and that ticks may serve as source of infection for humans.
2010 The Authors. Clinical Microbiology and Infection; 2010 European Society of Clinical Microbiology and Infectious Diseases.

PMID:
21682805
[PubMed - in process]
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

ViestiKirjoittaja soijuv » Ke Huhti 04, 2012 11:28

http://www.newsobserver.com/2010/05/21/492795/the-pain-of-bartonella.html

Artikkelin mukaan bartonellan voi saada hyönteisten ym lisäksi myös ihmisestä toiseen, esim. äidistä lapseen.
Maailman johtava infektiotautien, erityisesti bartonellan, tutkija tri Breitschwerdt, on dokumentoinut ensimmäistä kertaa bartonella-bakteerin mahdollisen siirtymisen perheenjäseneltä toiselle.

Tutkijaryhmä dokumentoi tapauksen jossa aviopuolisoilla kummallakin alkoivat erilaiset oireet; kipuja, fatiikkia jne, pian naimisiinmenon jälkeen. Pariskunta sai kaksoset v1998. Toinen lapsista kuoli sydänongelmiin 9 päivän ikäisenä. Toisella lapsella todettiin krooninen sydänvika.

Perheen kudoksia tutkittaessa, löydettiin kaikilta perheenjäseniltä samaa bartonella bakteerin alalajia. Löydös on lääketieteellisesti erittäin merkittävä, sanoo Breitschwerdt.

Hänen mukaan bakteeri saattaa olla monien kroonisten oireiden tosiasiallisena syynä esim. lihaskivut, neurologiset oireet, fatiikki, niveltulehdukset jne. Ongelmana on, että normaqllisti käytössä olevat vasta-ainetestit eivät kykene luotettavasti toteamaan bakterin olemassaoloa. Antibioottien tehoon vaikuttaa merkittävästi bakteerin alalaji. Koska alalajeja on monia, on oikean hoidon aloittaminen vaikeata.


BY SARAH AVERY - Staff Writer

A bacterial infection typically spread by fleas, lice and biting flies could be more prevalent than many think, and may have been transmitted from a mother to her children at birth, scientists from N.C. State University say.
Dr. Edward Breitschwerdt, an infectious disease veterinarian and one of the world's leading researchers of bacteria called Bartonella, has for the first time documented evidence that the pathogen may have been passed between family members.

Although more studies are needed to back up his findings, Breitschwerdt and colleagues describe the case of a mother and father who began battling chronic aches, fatigues and other symptoms soon after they were married. When their twins were born in 1998, the daughter died after nine days from a heart defect, and the son developed chronic health problems.

<a target="_new" href="http://ad.doubleclick.net/click%3Bh%3Dv8/3c1f/3/0/%2a/f%3B253296294%3B0-0%3B0%3B18125640%3B4307-300/250%3B46590552/46607210/1%3B%3B%7Esscs%3D%3fhttp://www.sleepys.com/"><img src="http://s0.2mdn.net/3526587/NAO_59833_SleepyMattress_PresidentsDay_300x250_021012.gif" border="0" alt="" ></a> <a href="http://ad.doubleclick.net/jump/mi.nao00/News/Local/Education;atf=N;dcove=d;pl=story;sect=NEducation;pos=1;sz=300x250;tile=3;!c=news;pub=NewsObserver2;ord=239970165744190;gender=;year=;income=?" target="_blank"><img src="http://ad.doubleclick.net/ad/mi.nao00/News/Local/Education;atf=N;dcove=d;pl=story;sect=NEducation;pos=1;sz=300x250;tile=3;!c=news;pub=NewsObserver2;ord=239970165744190;gender=;year=;income=?" border="0" alt="Advertisement"></a>

Using tissue from the daughter's autopsy and blood from the surviving family members, Breitschwerdt's team discovered that the entire family was infected with the same species of Bartonella bacteria, despite having no shared exposures to flea or lice infestations. Bartonella is known to causes such illnesses as trench fever and cat scratch disease, and it is increasingly suspected of triggering a variety of aches and inflammations that doctors have been unable to diagnose.

"I think we have stumbled across something that is of monumental medical importance," said Breitschwerdt, whose findings were published recently in the Journal of Clinical Microbiology.
Proving the mother-child transmission could be difficult, however. Little funding is available for such research because the bacteria are still not considered a major source of human disease.
Dr. Michael Kosoy, who heads the Bartonella laboratory for the Centers for Disease Control and Prevention in Fort Collins, Colo., said scientists are only beginning to build evidence that Bartonella infections may be more common than previously thought.

"Bartonella are circulated around the world in many animals, but there are different Bartonella species, and the question is how can they be transmitted to humans?" Kosoy said, noting that most known cases have been transmitted from biting insects. He said the NCSU findings about the potential family transmission are compelling but inconclusive.
Dozens of strains

At least 26 strains of Bartonella have been named worldwide, and the list is growing. The most notorious Bartonella infection is cat scratch disease, a fever illness passed to humans from flea-infected cats. Fleas are the primary hosts, and they spread the bacteria in their feces.
Other Bartonella strains spread more serious diseases. Kosoy is studying how often heart inflammation is caused by a Bartonella that thrives among rat fleas in Thailand. He has already established that about 25 percent of unexplained fever illnesses among a group of patients there was caused by Bartonella .

"This is not limited to cat scratch," Kosoy said. "That's just the tip of the iceberg."
Breitschwerdt said he thinks the bacteria may be the hidden cause behind a host of chronic symptoms - muscle aches, neurological problems, fatigue, arthritis - that defy diagnosis.

About two years ago, Breitschwerdt began testing blood samples from a doctor in Maryland, who was curious whether Bartonella infections might be causing problems for some of his patients.

"There are lab tests showing inflammation," but no discernible cause, said Dr. Robert Mozayeni, a Yale-educated rheumatologist who practices in Rockville, Md.
Mozayeni contacted Breitschwerdt and his NCSU colleague, Ricardo Maggi, who together developed a more sensitive test for Bartonella.

Routine blood tests fail to detect Bartonella because they search for antibodies that the body is slow to produce.
Instead, Breitschwerdt and Maggi figured out how to cultivate the bacteria in the laboratory from blood samples of infected people. They founded a company called Galaxy Diagnostics to handle the laboratory volume.

Of Mozayeni's mystery patients tested at the lab, nearly 20 percent had Bartonella infections.
"I suspect this is going to be one of the causes of rheumatoid arthritis and a few other things, but it's too speculative right now to say," Mozayeni said.

Human testing
More studies are needed, and Mozayeni has joined Breitschwerdt and Maggi in the diagnostic company to oversee human testing.
"Certainly, the prevalence of Bartonella infection in people with chronic illness is higher than I would have ever guessed, but we still don't know what that means," Breitschwerdt said.

Among the biggest unknowns is how to treat people who have been infected. The effectiveness of antibiotics depends on which strain of Bartonella is at work, and with so many strains, treatments can be hit or miss.

Breitschwerdt said the family in his most recent study declined to comment about their experience. He said they were having difficulty finding a doctor.

"It is very difficult to find a physician who wants to see someone with a chronic illness that is poorly defined," he said, adding that many such patients often think they have Lyme disease, a tick-borne bacterial infection with similar symptoms - and stigma. "With an unexplained illness, it becomes problematic."

sarah.avery@newsobserver.com or 919-829-4882
soijuv
 
Viestit: 3002
Liittynyt: Ke Tammi 21, 2009 14:16

Seuraava

Paluu TUTKIMUSTIETOA LISÄINFEKTIOISTA

Paikallaolijat

Käyttäjiä lukemassa tätä aluetta: Ei rekisteröityneitä käyttäjiä ja 1 vierailijaa