Archive for the ‘Bartonella’ Category

Bartonella Found in Ticks, Biting Midges, and Moose

https://pubmed.ncbi.nlm.nih.gov/32757355/

. 2020 Aug 5.

doi: 10.1111/tbed.13762. Online ahead of print.

Bartonella spp. detection in ticks, Culicoides biting midges and wild cervids from Norway

Carlos Sacristán 1, Carlos G das Neves 1, Faisal Suhel 1, Irene Sacristán 2, Torstein Tengs 3, Inger S Hamnes 1, Knut Madslien 1
Affiliations expand

Abstract

Bartonella spp. are fastidious, gram-negative, aerobic, facultative intracellular bacteria that infect humans, and domestic and wild animals. In Norway, Bartonella spp. have been detected in cervids, mainly within the distribution area of the arthropod vector deer ked (Lipoptena cervi). We used PCR to survey the prevalence of Bartonella spp. in blood samples from 141 cervids living outside the deer ked distribution area (moose [Alces alces, n = 65], red deer [Cervus elaphus, n = 41] and reindeer [Rangifer tarandus, n = 35]), in 44 pool samples of sheep tick (Ixodes ricinus, 27 pools collected from 74 red deer and 17 from 45 moose) and in biting midges of the genus Culicoides (Diptera: Ceratopogonidae, 120 pools of 6,710 specimens). Bartonella DNA was amplified in moose (75.4%, 49/65) and in red deer (4.9%, 2/41) blood samples. All reindeer were negative. There were significant differences in Bartonella prevalence among the cervid species.

Additionally, Bartonella was amplified in two of 17 tick pools collected from moose and in 3 of 120 biting midge pool samples. The Bartonella sequences amplified in moose, red deer and ticks were highly similar to B. bovis, previously identified in cervids. The sequence obtained from biting midges was only 81.7% similar to the closest Bartonella spp.

We demonstrate that Bartonella is present in moose across Norway and present the first data on northern Norway specimens. The high prevalence of Bartonella infection suggests that moose could be the reservoir for this bacterium.

This is the first report of bacteria from the Bartonella genus in ticks from Fennoscandia and in Culicoides biting midges worldwide.

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**Comment**

Many Lyme patients also have Bartonella.  It is an under-appreciated pathogen:  https://madisonarealymesupportgroup.com/2019/04/24/human-bartonellosis-an-underappreciated-public-health-problem/

It can cause schizophrenia-like symptoms:  https://madisonarealymesupportgroup.com/2019/03/21/bartonella-sudden-onset-adolescent-schizophrenia-a-case-study/

Again, our ‘authorities’ have pigeon-holed Lyme into a singular illness when for many there are numerous pathogens at play, not to mention other important issues like MCAS and mold that need to be dealt with. Also, most doctors are taught that Bartonella is not a big deal and the immune system will just deal with it.  I’ve lost count of how many articles have crossed my desk showing just the opposite to be true.  Bartonella can kill.

Category:

Bartonella, research, Uncategorized

New Case Report: Neuropsychiatric Symptoms and Bartonella-Associated Skin Lesions

https://www.galaxydx.com/bartonella-skin-lesions-and-neuro-symptoms-new-cases/

written on

New Case Report: Neuropsychiatric Symptoms and Bartonella-Associated Skin Lesions

A new case report co-authored by Galaxy Diagnostics scientists highlights the importance of bartonellosis being considered as a differential diagnosis when patients present with neuropsychiatric symptoms and skin lesions.

History

Bartonellosis is an emerging multi-system vector-borne disease caused by one or more bacteria belonging to the Bartonellagenus. Common Bartonella species infections such as cat scratch disease (CSD) or trench fever are often described as acute and, in the case of CSD, self-limiting in the medical literature. However, chronic symptoms and severe disease related to the heart, joints, and central nervous system (CNS) are increasingly described by researchers.

A 2019 publication by Dr. Breitschwerdt, chief scientific officer and co-founder of Galaxy Diagnostics, his team at NC State University, and a group of collaborating physicians described a boy diagnosed with PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) who was found to have Bartonella henselae in his bloodstream. The boy’s severe neuropsychiatric symptoms and skin lesions resolved in association with antibiotic treatment directed at B. henselae.

Bartonella species primarily occupy two niches in their host: the skin and the vascular endothelium (lining of the blood vessels). Vectors such as fleas, ticks, lice, and biting flies give Bartonella a vehicle to enter the skin and then the local blood and lymphatic vessels. The bacteria then travel through the bloodstream, in association with a relapsing bacteremia, to other areas of the body, potentially causing a wide variety of symptoms that can span months, years and possibly decades.

Newly Published Research

A new set of cases described by Dr. Breitschwerdt and a multi-institution collaborative team provide further evidence for neuropsychiatric and dermatological manifestations of bartonellosis in pediatric (< 18 years old) patients.

Dr. Breitschwerdt explained,

“Based upon the limited case reports and this case series, it is imperative to design studies that will determine if, or to what extent, Bartonella species might contribute to concurrent cutaneous [skin] lesions in patients with neuropsychiatric symptoms.”

At the same time as the team at NCSU has been advancing this symptom research, a team from Fujita Health University School of Medicine in Japan has been advancing the signaling work. They found a protein secreted by Bartonella species that activates the vascular endothelial growth factor (VEGF) pathway.

Where Do We Go From Here?

The pathophysiology of Bartonella species infections in people is complex. While the past 30 years of research has helped elucidate how persistent infections may occur, understanding why the host response differs and “atypical” symptoms develop in certain patient populations requires further research. Furthermore, research on these “atypical” manifestations may lead to the development of more accurate tools for Bartonella testing.

More research is needed to document both if Bartonella species might contribute to skin lesions in patients with neuropsychiatric symptoms and the mechanisms by which this might occur. We speculate that long-standing microvascular injury induced by these bacteria may result in chronic inflammation, local mast cell activation and collagen injury.

We encourage dermatologists and veterinarians to consider vector and animal exposures in patients with unusual or unexplained cutaneous lesions and consider testing these patients for Bartonella species infection.

We have found that advances in the understanding of skin lesions so far has been serendipitous, such as when a veterinarian’s own animal develops skin lesions and there are enhanced opportunities to collect samples. The more scientific inquiry is systemized across human and animal health (One Health), the faster our understanding of any potential association between Bartonella species infections and skin lesions will grow.

References

Breitschwerdt, E. B. et al. (2019). Bartonella henselae bloodstream infection in a boy with pediatric acute-onset neuropsychiatric syndrome. Journal of Central Nervous System Disease, 11. doi:10.1177/1179573519832014 https://journals.sagepub.com/doi/10.1177/1179573519832014

Maluki, A. et al. (2020). Imaging analysis of Bartonella species in the skin using single‐photon and multi‐photon (second harmonic generation) laser scanning microscopy. Clinical Case Reports, 2020, 1-7. doi:10.1002/ccr3.2939 https://onlinelibrary.wiley.com/doi/full/10.1002/ccr3.2939

Tsukamoto, K. et al. (2020). The Bartonella autotransporter BafA activates the host VEGF pathway to drive angiogenesis. Nature Communications, 11, 3571. doi:10.1038/s41467-020-17391-2 https://www.nature.com/articles/s41467-020-17391-2

Category:

Bartonella, research

Bartonella Endocarditis in Elderly Patient

https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0008376

Bartonella henselae endocarditis in an elderly patient

Published: July 30, 2020

https://doi.org/10.1371/journal.pntd.000837

Citation: Drummond MR, de Almeida AR, Valandro L, Pavan MHP, Stucchi RSB, Aoki FH, et al. (2020) Bartonella henselae endocarditis in an elderly patient. PLoS Negl Trop Dis 14(7): e0008376. https://doi.org/10.1371/journal.pntd.0008376

Editor: Joseph M. Vinetz, Yale University School of Medicine, UNITED STATES

Published: July 30, 2020

Copyright: © 2020 Drummond et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Funding: This work was supported by Brazilian National Council for Scientific and Technological Development (CNPq) grant #159717/2013-2 (MRD) and #301900/2015-9 (PENFV). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Summary

We report an 85-year-old white man admitted to the emergency department of the University of Campinas with fever of undetermined origin (FUO) who received antibiotics previously. Initially, the hypothesis was pneumonia. He presented a drug reaction misdiagnosed as staphylococcal desquamation. The follow-up confirmed that prolonged fever was caused by bacterial endocarditis by transthoracic echocardiogram that showed vegetation in the aortic valve. Bartonella henselae etiology was confirmed by PCR.

This case reinforces the difficulty of diagnosing Bartonella sp. infection; this etiology must be considered even in patients with negative serology. The criteria for the diagnosis of bacterial endocarditis should contemplate a molecular positivity investigation for Bartonella spp, such as PCR in blood or serum samples as a major Duke criterion, even if with titers lower than 1 to 800.

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For more:  https://madisonarealymesupportgroup.com/2020/01/05/bartonella-endocarditis-masquerading-as-systemic-vasculitis-with-rapidly-progressive-glomerulonephritis/

https://madisonarealymesupportgroup.com/2019/09/05/rare-presentation-of-endocarditis-mycotic-brain-aneurysm/

https://madisonarealymesupportgroup.com/2019/08/12/tick-borne-pathogens-bartonella-spp-borrelia-burgdorferi-sensu-lato-coxiella-burnetii-rickettsia-spp-may-trigger-endocarditis/

https://madisonarealymesupportgroup.com/2019/08/16/endocarditis-caused-by-bartonella-quintana-a-rare-case-in-the-u-s/

https://madisonarealymesupportgroup.com/2017/01/04/endocarditis-consider-bartonella/

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

https://madisonarealymesupportgroup.com/2018/07/10/infective-endocarditis-associated-with-bartonella-henselae-a-case-series/

https://madisonarealymesupportgroup.com/2019/04/25/case-of-endocarditis-caused-by-bartonella-after-mitral-valve-repair/

https://madisonarealymesupportgroup.com/2019/04/24/human-bartonellosis-an-underappreciated-public-health-problem/

It doesn’t appear to me that endocarditis caused by Bartonella is rare.

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

https://madisonarealymesupportgroup.com/2019/05/05/good-news-for-bartonella-patients-identification-of-fda-approved-drugs-with-higher-activity-than-current-front-line-drugs/

Category:

Bartonella, Heart Issues, research

Bartonella: American Academy of Pediatrics

https://pedsinreview.aappublications.org/content/41/8/434

In Briefs

Bartonella

Beth Goodman and Patricia Whitley-Williams
Pediatrics in Review August 2020, 41 (8) 434-436; DOI: https://doi.org/10.1542/pir.2019-0198

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

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  1. Beth Goodman, MD*
  2. Patricia Whitley-Williams, MD†
  1. *Department of Pediatrics, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ
  2. †Department of Pediatrics and Division of Allergy, Immunology, and Infectious Disease, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ

  • AUTHOR DISCLOSURE

    Drs Goodman and Whitley-Williams have disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.

Pediatricians are often familiar with cat-scratch disease (CSD), but many are not familiar with the other manifestations of Bartonella infection. The Bartonella genus of bacteria are fastidious and slow-growing gram-negative bacilli. From 1889 to the present, 8 different Bartonella species have been identified, with differing manifestations. This In Brief reviews the illnesses caused by 3 of the more common Bartonella strains: henselae, quintana, and bacilliformis.

CSD, caused by Bartonella henselae, is the most common Bartonella infection, but it is also a “newer” manifestation. CSD was first reported clinically in 1950, yet B henselae was not identified as the etiologic agent until 1983.

In immunocompetent patients, typical (uncomplicated) CSD is characterized by regional lymphadenopathy, the most common manifestation of B henselae infection, along with a history of cat exposure. For most patients with CSD, regional lymphadenopathy is the only symptom. In approximately 30% of patients with CSD, mild systemic symptoms are also present, including low-grade fever, fatigue, and headache. A skin papule, vesicle, or pustule may be present at the presumed site of inoculation, which is often a bite or scratch from an infected cat. Regional lymphadenopathy develops approximately 1 to 2 weeks after the inoculation. The affected nodes are most frequently in the axillary, cervical, and inguinal areas, and the skin overlying the affected lymph nodes is often tender, warm, erythematous, and indurated, consistent with a bacterial lymphadenitis. Approximately 10% of affected nodes suppurate spontaneously.

Atypical (complicated) CSD is a disseminated infection that develops in 5% to 14% of immunocompetent patients and may involve almost any organ system. Ocular manifestations of B henselae occur in 5% to 10% …

(See link for article you can purchase)

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**Comment**

Due to the increasing prevalence of Bartonella, I hope doctors are utilizing articles like this one and learning what to look for.

Here’s 18 pediatric cases of Bartonella in a singular Hawaiian facility:  https://madisonarealymesupportgroup.com/2020/06/20/disseminated-cat-scratch-disease-in-pediatric-patients-in-hawaii/

https://madisonarealymesupportgroup.com/2019/02/06/uh-study-shows-hawaii-kids-more-vulnerable-to-bartonella/  University of Hawaii study shows Hawaii keiki are more than three times more likely to get severe forms of cat scratch disease than mainland kids.

This adolescent had sudden onset schizophrenia caused by Bartonella:  https://madisonarealymesupportgroup.com/2019/03/21/bartonella-sudden-onset-adolescent-schizophrenia-a-case-study/

For more:  https://madisonarealymesupportgroup.com/2020/07/16/5-questions-to-discuss-with-your-physician-when-bartonellosis-is-suspected/

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

https://madisonarealymesupportgroup.com/2019/04/24/human-bartonellosis-an-underappreciated-public-health-problem/

 

 

 

 

 

Category:

Bartonella, Uncategorized

Bartonella Causing Encephalitis

https://pubmed.ncbi.nlm.nih.gov/32675979/

. 2020 Apr 24;33(3):440-441.

doi: 10.1080/08998280.2020.1756141. eCollection 2020 Jul.

Cat scratch disease causing encephalitis

Jerry Fan 1, Hameed Ali 1

Free PMC article

Abstract

Cat scratch disease is often a benign infection caused by Bartonella henselae, which is transmitted from scratches or bites from kittens. Presentations can vary from localized lymphadenopathy to neurologic manifestations. We present a case of a 22-year-old man with a 3-week history of an enlarged inguinal lymph node who presented with status epilepticus.

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**Comment**

Unfortunately, many still consider Bartonella “benign” when for many it is extremely severe and tenacious.  I would consider it as bad if not worse than Lyme in many respects.  Many also do not have lymph node involvement. Some patient’s only manifestation is psychological.

For more:  https://madisonarealymesupportgroup.com/category/bartonella-treatment/  There is a checklist within this link of symptoms.

https://madisonarealymesupportgroup.com/2019/05/05/good-news-for-bartonella-patients-identification-of-fda-approved-drugs-with-higher-activity-than-current-front-line-drugs/  My husband and I use Berberine for Bartonella maintenance successfully.

https://madisonarealymesupportgroup.com/2019/04/24/human-bartonellosis-an-underappreciated-public-health-problem/

https://madisonarealymesupportgroup.com/2020/07/16/5-questions-to-discuss-with-your-physician-when-bartonellosis-is-suspected/

https://madisonarealymesupportgroup.com/2019/02/27/advanced-imaging-found-bartonella-around-pic-line/

 

Category:

Bartonella, research