Archive for the ‘Bartonella’ Category

Impact of Pre-operative Antimicrobial Treatment on Microbiological Findings From Endocardial Specimens in Infective Endocarditis

https://www.ncbi.nlm.nih.gov/pubmed/30680557

2019 Jan 24. doi: 10.1007/s10096-018-03451-5. [Epub ahead of print]

Impact of pre-operative antimicrobial treatment on microbiological findings from endocardial specimens in infective endocarditis.

Abstract

Treatment of infective endocarditis (IE) should be initiated promptly. This might hamper the chances to identify the causative organism in blood cultures. Microbiological sampling of infected valve in patients undergoing surgery might identify the causative organism. The impact of pre-operative antimicrobial treatment on the yield of valve samples is not known. This study evaluated the impact of the duration of the pre-operative antibiotic treatment on valve culture and 16S rRNA PCR findings from resected endocardial samples. Patients meeting the modified Duke criteria of definite or possible IE and undergoing valve surgery due to IE during 2011-2016 were included from Southern Finland. Eighty-seven patients were included.

In patients with shorter than 2 weeks of pre-operative antimicrobial treatment, PCR was positive in 91% (n = 42/46) and valve culture in 41% (n = 19/46) of cases. However, in patients who had 2 weeks or longer therapy before operation, PCR was positive in 53% (n = 18/34) and all valve cultures were negative. In 14% of patients, PCR had a diagnostic impact. In blood-culture negative cases (n = 13), PCR could detect the causative organism in ten patients (77%). These included five cases of Bartonella quintana, one Tropheryma whipplei, and one Coxiella burnetii. Long pre-operative antimicrobial treatment was shown to have a negative impact on microbiological tests done on resected endocardial material. After 2 weeks of therapy, all valve cultures were negative, but PCR was positive in half of the cases. PCR aided in diagnostic work-up, especially in blood culture negative cases.

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**Comment**

The dilemma “to treat or not to treat” because of hampered ability to subsequently test for organisms is real; however, the risk for not treating is potentially death.

The big point for Lyme/MSIDS patients; however, is the fact they found Bartonella and Coxiella burnettii, also known as Q-fever in patients with infective carditis.

https://www.columbia-lyme.org/q-fever  Those working with farm animals are at greater risk through inhalation or ingestion of soil or animal waste particles; however, ticks do transmit it.

Signs and Symptoms

Symptoms include high fever, headache, sore throat, malaise, nausea, diarrhea, chest pain, nonproductive cough, pneumonia, and hepatitis. Neurological manifestations occur in about one percent of patients and could develop into meningitis, encephalitis, myelitis and/or peripheral neuropathy. Endocarditis, infection of the heart valves, is the most serious manifestation. However, it is usually found in patients with preexisting valvular disease. Unfortunately, the mortality rate is increasingly high, currently at 65 percent.

Go here for a nifty table with the various coinfections, vectors, causative agent, endemic area, and symptoms: https://www.lymedisease.org/lyme-basics/co-infections/other-co-infections/

You will note that the brown dog tick, Rocky Mountain Wood tick, and the Lone Star Tick are all vectors and Q-fever is endemic throughout the U.S.  Treatment is doxycycline.

https://www.wrair.army.mil/Documents/TropMed/(18)%20Lyme%20and%20Rickettsial%20Disease_LTC%20Waterman.pdf  This document states endocarditis caused by Q fever may be chronic.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC88923/  Interestingly, even as far back as the 30’s, Q fever was noted to have properties of both viruses and rickettsiae. This document states Q fever may occur in patients without any animal contact due to it’s ability to be spread by wind.  The same document states human Q fever cases have occurred in the following:

  • An OB after an abortion on an infected woman
  • transplacental transmission
  • autopsies
  • intradermal inoculation
  • blood transfusion
  • tick bite
  • sexually in infected mice
  • possibly from infected dogs
  • infected cats

The real kicker on that last one was the 1984 report of 13 people who developed febrile respiratory disease by playing poker in a room where a cat had delivered kittens.  Abstract here:

Kosatsky T. Household outbreak of Q-fever pneumonia related to a parturient cat. Lancet. 1984;ii:1447–1449. [PubMed]

Symptoms were:

  • bradycardia (slow heart rate)
  • fever
  • palatal petechiae (red or purple spots on mouth palate)
  • rapidly enlarging bilateral pulmonary infiltrates (fluid in both lungs)

 

 

 

 

 

Study Shows Ticks PCR Positive for Bartonella and Two Strains of Borrelia

https://www.sciencedirect.com/science/article/abs/pii/S1877959X18302942

Regional prevalences of Borrelia burgdorferi, Borrelia bissettiae, and Bartonella henselae in Ixodes affinis, Ixodes pacificus and Ixodes scapularis in the USA

Abstract

The objective of this work was to determine the prevalence of Borrelia and Bartonella species in Ixodes spp. ticks collected from 16 USA states. Genus PCR amplification and sequence analysis of Bartonella and Borrelia16SsRNA-23SsRNA intergenic regions were performed on DNA extracted from 929 questing adult ticks (671 Ixodes scapularis, 155 Ixodes affinis, and 103 Ixodes pacificus).

Overall, 129/929 (13.9%) Ixodes ticks were PCR positive for Borrelia burgdorferi sensu stricto, 48/929 (5.1%) for B. bissettiae whereas 23/929 (2.5%) were PCR positive for a Bartonella henselae. Borrelia bissettiae or B. burgdorferi s.s. and B. henselae co-infections were found in I. affinis from North Carolina at a rate of 4.5%; in a single I. scapularis from Minnesota, but not in I. pacificus. For both bacterial genera, PCR positive rates were highly variable depending on geographic location and tick species, with Ixodes affinis (n = 155) collected from North Carolina, being the tick species with the highest prevalence’s for both Borrelia spp. (63.2%) and B. henselae (10.3%). Based on the results of this and other published studies, improved understanding of the enzootic cycle, transmission dynamics, and vector competence of Ixodes species (especially I. affinis) for transmission of Borrelia spp. and B. henselae should be a public health research priority.

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**Comment**

One of the most understated studies yet.  Research on transmission and vector competence is screaming to be done – especially for Bartonella as mainstream medicine still thinks it’s a simple disease caused by the scratch of a cat that only affects immunocompromised people.  They also insist the black-legged tick is the sole perp for Lyme.  Both of these tenets are being shattered on a daily basis.

https://madisonarealymesupportgroup.com/2018/07/10/bartonella-henselae-neuroretinitis-in-patients-without-cat-scratch/

https://madisonarealymesupportgroup.com/2019/01/23/chest-imaging-of-cat-scratch-disease-in-2-year-old-immunocompetent-baby-with-no-history-of-cat-contact/

https://madisonarealymesupportgroup.com/2018/07/05/cat-scratch-disease-in-a-1-5-year-old-girl-case-report/  A 1.5-year-old girl who was seen in hospital for the sparing use of her left arm when crawling.  Tested positively for Bartonella henselae.

https://madisonarealymesupportgroup.com/2018/04/03/encephalopathy-in-adult-with-cat-scratch-disease/  Case of a 53-year-old healthy man, presenting with confusion.  Serology confirmed Bartonella henselae infection.

https://madisonarealymesupportgroup.com/2019/01/09/transverse-myelitis-guillain-barre-associated-with-bartonella/  Healthy 10 year old girl had coexisting transverse myelitis and Guillain-Barré syndrome (GBS) related to infection with Bartonella henselae.

https://madisonarealymesupportgroup.com/2018/11/05/skull-infection-due-to-bartonella/  A 3-year-old female with a recent history of typical CSD involving lymph nodes who developed osteomyelitis of the skull.

https://madisonarealymesupportgroup.com/2019/01/02/bartonella-langerhans-cell-histiocytosis-cancer/

 

https://madisonarealymesupportgroup.com/2018/11/16/study-shows-lyme-in-15-species-of-canadian-ticks-6-of-which-bite-humans-numerous-new-bird-species-acting-as-hosts/  Overall, 1,265 ticks consisting of 27 tick species belonging to four genera were collected.  Of the 18 tick species tested, 15 species (83%) were positive for Bbsl and, of these infected ticks, 6 species bite humans.

Two ticks species known to be transmitters of disease (I. affinis and I. minor) were transported into Canada and are actually more important vectors of Bbsl in the southeastern U.S. than the blacklegged tick.

THESE FINDINGS UNDERSCORE THE FACT PEOPLE DO NOT HAVE TO GO AN ENDEMIC AREA TO CONTRACT LYME DISEASE AND ASSOCIATED TICK-BORNE DISEASES. 

 

 

 

 

UH Study Shows Hawaii Kids More Vulnerable to Bartonella

http://www.hawaiinewsnow.com/2019/01/17/uh-study-cat-scratch-disease-three-times-more-prevalent-hawaii-keiki-than-mainland-kids/

Cat scratch disease: It’s rare, but a UH study says Hawaii kids are more vulnerable

Cat scratch disease: It’s rare, but a UH study says Hawaii kids are more vulnerable
UH and Kapiolani doctors are warning about cat scratch disease.

Symptoms include fever and swollen lymph nodes. UH and Kapiolani Medical Center doctors studied 18 children who got severe reactions.

“These were children who had infections of their spleen, liver, meningitis, encephalitis. involvement of their eye. Some even developed bone lesions so it was a significant illness in these children,” said Dr. Jessica Kosut, a pediatric hospitalist.

Sarah Pacheco got a mild form of the illness years ago when her new kitten, Kipling, scratched her arm.

“I had just gotten a kitten and they play and you are bound to get scratched, but I noticed I lost my voice completely,” she said.

Cat scratch disease is still rare. Doctors think Hawaii’s humid climate, outdoor lifestyle and higher feral cat population could be partly to blame.

“I don’t think it’s cats that are in people’s homes, but it can be, but a couple of the children that we took care of described playing with cats that were out in the neighborhood and one child was hiding cats in his closet to keep them a secret from his mother,” said Dr. Kosut.

Doctors say cat scratch disease is treatable. Just make sure your cat doesn’t have fleas and doesn’t play with feral cats, and you don’t have to kick out your kitty.

“I’m definitely a fan of cats and I wouldn’t say that this should discourage anyone from getting cats or adopting cats. I just want providers to be aware of it,” said Dr. Johnson.

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**Comment**
Cat Scratch Disease (CSD) or Bartonella IS NOT RARE!  And while some develop fever and swollen lymph nodes, it presents in a million different ways – some purely psychological.
And cats aren’t the only things transmitting it.

http://townsendletter.com/July2015/bartonellosis0715_3.html
Mode of Transmission: Arthropod vectors including fleas and flea feces, biting flies such as sand flies and horn flies, the human body louse, mosquitoes, and ticks; through bites and scratches of reservoir hosts; and potentially from needles and syringes in the drug addicted. Needle stick transmission to veterinarians has been reported. There is documentation that cats have received it through blood transfusion. 3.2% of blood donors in Brazil were found to carry Bartonella in their blood. Bartonella DNA has been found in dust mites. Those with arthropod exposure have an increased risk, as well as those working and living with pets that have arthropod exposure. 28% of veterinarians tested positively for Bartonella compared with 0% of controls. About half of all cats may be infected with Bartonella – as high as 80% in feral cats and near 40% of domestic cats. In various studies dogs have close to a 50% rate as well. Evidence now suggests it may be transmitted congenitally from mother to child – potentially leading to birth defects.

I’m glad they mentioned:
  • infections of their spleen & liver
  • meningitis
  • encephalitis
  • involvement of the eye
  • bone lesions
Because, these are the things crossing my desk on a daily basis.
Bartonella is prolific, tenacious, and can cause severe illness, and many LLMD’s consider it a major coinfection of Lyme.
To read more about the organism and successful treatments:  https://madisonarealymesupportgroup.com/2016/01/03/bartonella-treatment/
For more:  
  • Heart involvement –
  • Eye involvement –
  • Neurological involvement –
https://madisonarealymesupportgroup.com/2019/02/04/from-cat-scratch-disease-to-bartonellosis/  A table within this article states Bart can cause hallucinations.
  • Skull & bone infections
https://www.ncbi.nlm.nih.gov/pubmed/19303175  Besides the case report of a woman with osteomyelitis, the study states a literature review identified 51 other cases of osteomyelitis associated with cat scratch disease, 14 of those confirmed by PCR.
  • Thoracic involvement –
  • Cancer

https://madisonarealymesupportgroup.com/2019/01/02/bartonella-langerhans-cell-histiocytosis-cancer/

  • Chronic abdominal pain, esophageal heartburn, purpuric skin rash, mesenteric adenitis (swollen lymph nodes inside the abdomen)   

https://www.lymediseaseassociation.org/images/NewDirectory/Studies-Papers/Fried_Bartonella-2002.pdf

  • Granulomas & bony lesions

https://madisonarealymesupportgroup.com/2018/07/05/cat-scratch-disease-in-a-1-5-year-old-girl-case-report/

  • Rheumatological involvement –

https://madisonarealymesupportgroup.com/2018/05/09/rheumatological-presentation-of-bartonella-koehlerae-henselae-a-case-report-chiropractors-please-read/   Please note the joint popping with each articulation and continual joint subluxation issue.

  • Can turn off antibodies to Lyme, Babesia, Ehrlichia, Anaplasma, and even itself

http://www.townsendletter.com/July2009/ed_lyme0709.html  Dr. Shaller feels that due to this, Bartonella should be considered in ALL initial consults.

I’m going to stop at this point as I’m growing weary.  The question begs to be asked:
Does this look rare to you?

 

 

From Cat Scratch Disease to Bartonellosis

https://www.galaxydx.com/new-educational-resource-on-human-bartonella-infections/

From Cat Scratch Disease to Bartonellosis

Bartonellosis is a term used to encompass all infections caused by pathogenic Bartonella species. Bartonella are emerging, flea-borne bacteria that are highly adapted to living in mammalian hosts and are implicated in a wide spectrum of diseases in humans and animals.

Pathogenic Bartonella Found For the 1st Time in European Rats

https://www.ncbi.nlm.nih.gov/pubmed/30624020

2019 Jan 9. doi: 10.1002/ps.5323. [Epub ahead of print]

Norway and black rats in Europe: Potential reservoirs for zoonotic arthropod-borne pathogens?

Abstract

BACKGROUND:

Norway rats (Rattus norvegicus) and black rats (R. rattus) are known to be cosmopolitan reservoirs for zoonotic agents. Nevertheless only little is known about prevalence and distribution of arthropod-borne pathogens in rats from Europe. Therefore this survey was focused on the detection of arthropod-borne pathogens. Spleen-derived DNA samples were available from 528 Norway rats and from 74 black rats collected in several European countries. Further, these samples were processed by PCR for the detection of zoonotic pathogens such as Anaplasma phagocytophilum, Candidatus Neoehrlichia mikurensis (CNM), Babesia spp. and Bartonella spp. eventually followed by sequencing.

RESULTS:

Babesia spp. was not detected. Four Norway rat samples were positive for A. phagocytophilum DNA and two for CNM. In 50 rat samples Bartonella spp. DNA was detected (8.1%; 95% CI: 6.2-10.61). Whereas B. tribocorum (n=45) and B. grahamii (n=1) were exclusively carried in Norway rats from Central Europe (Belgium, Germany), B. coopersplainsensis (n=4) was only detected in black rats from southern European countries (Spain, Italy).

CONCLUSIONS:

Pathogenic Bartonella spp. DNA was found in black and Norway rats from Germany, Italy, Spain and Belgium for the first time. Bartonellae were found focally in zoos suggesting Norway rats as possible reservoir for B. tribocorum and black rats for B. coopersplainsensis in Europe. These findings should raise awareness of pathogenic Bartonella spp. in Norway rats especially in terms of pest management control in zoos. Norway and black rats seem not to be predominantly involved in the life cycle of the other examined arthropod-borne pathogens in Europe.

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More on Bartonella:  https://madisonarealymesupportgroup.com/2016/01/03/bartonella-treatment/

https://madisonarealymesupportgroup.com/2019/01/02/bartonella-in-entire-canadian-family/

https://madisonarealymesupportgroup.com/2019/01/09/transverse-myelitis-guillain-barre-associated-with-bartonella/

https://madisonarealymesupportgroup.com/2018/09/20/humana-bartonellosis-perspectives-of-a-veterinary-internist/

https://madisonarealymesupportgroup.com/2018/09/28/bartonella-infective-endocarditis-with-dissemination-a-case-report-literature-review/

https://madisonarealymesupportgroup.com/2018/05/07/fox-news-bartonella-is-the-new-lyme-disease/

 

 

A Brief History of 3 Diseases Caused by Bartonella

https://www.galaxydx.com/a-brief-history-of-bartonella-infections/

A Brief History of Three Diseases Caused by Bartonella

The oldest indication of human Bartonella infection (bartonellosis) was found in a tooth of a person who died about 4,000 years ago.

Chest Imaging of Cat-Scratch Disease in 2-Year Old Immunocompetent Baby With No History of Cat Contact

https://www.ncbi.nlm.nih.gov/pubmed/30657130

2019 Jan 15;89(4):585-588. doi: 10.23750/abm.v89i4.6070.

Chest Imaging of a rare case of cat-scratch disease in a 2-years-old baby.

Abstract

Cat-scratch disease (CSD) is usually a self-limiting infection that in the majority of cases occurs as lymphadenitis in children who have been scratched or bitten by a cat. Rarely, Bartonella henselae is cause of fever of unknown origin (FUO), with dissemination to various organs, mimicking an inflammatory rather than a lymphoproliferative disease. This manuscript will present a case of thoracic manifestations of CSD in an immunocompetent 2-years baby without history of cat contact, with fever of unknown origin, investigated by chest CT and MRI.

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**Comment**

The myths surrounding Bartonella are getting shattered one by one.  More and more cases are showing immunocompetent people contracting Bart as well as folks who have had no exposure to cats.  Time for NEW Research and open minds!  Bartonella, like so many other pathogens needs an entirely new approach.  Nothing about this should be reported as “rare.”  Nobody has a clue on prevalence!

https://madisonarealymesupportgroup.com/2018/07/10/bartonella-henselae-neuroretinitis-in-patients-without-cat-scratch/  All the patients denied a history of a cat or any animal contact, or of having CSD findings.

https://madisonarealymesupportgroup.com/2018/07/05/cat-scratch-disease-in-a-1-5-year-old-girl-case-report/  A 1.5-year-old girl who was seen in hospital for the sparing use of her left arm when crawling.  Tested positively for Bartonella henselae.

https://madisonarealymesupportgroup.com/2018/04/03/encephalopathy-in-adult-with-cat-scratch-disease/  Case of a 53-year-old healthy man, presenting with confusion.  Serology confirmed Bartonella henselae infection.

https://madisonarealymesupportgroup.com/2019/01/09/transverse-myelitis-guillain-barre-associated-with-bartonella/  Healthy 10 year old girl had coexisting transverse myelitis and Guillain-Barré syndrome (GBS) related to infection with Bartonella henselae.

https://madisonarealymesupportgroup.com/2018/11/05/skull-infection-due-to-bartonella/  A 3-year-old female with a recent history of typical CSD involving lymph nodes who developed osteomyelitis of the skull.

https://madisonarealymesupportgroup.com/2019/01/02/bartonella-langerhans-cell-histiocytosis-cancer/