Expert Bartonella Author and Doctor
Advanced Diagnosis and Treatments
Bartonella Bacilliformis — A Unique Species of Bartonella
Dr. Schaller has written four Bartonella books and as a physician has been researching vast ways to diagnosis Bartonella and what actually works. Everything does not work. And it is very hard to diagnosis Bartonella with antibodies or DNA [PCR]. It does not mean this is a waste of time but Dr. Schaller's approaches are vastly most advanced, complex, and have been going on longer with full-time study. No one on earth has over one book on Bartonella, and he has many texts of the highest advanced science in Bartonella care, and thirteen books on tick infection medicine.
Int J Antimicrob Agents. 2014 Jul;44(1):16-25. doi:
10.1016/j.ijantimicag.2014.04.006. Epub 2014 May 9.
Pathogenicity and treatment of Bartonella infections.
Angelakis E(1), Raoult D(2).
(1)URMITE UMR 6236, CNRS-IRD, Faculté de Médecine Aix Marseille Universite, 27
Bd. Jean Moulin, 13385 Marseille cedex 05, France. (2)URMITE UMR 6236, CNRS-IRD,
Faculté de Médecine Aix Marseille Universite, 27 Bd. Jean Moulin, 13385 Marseille
cedex 05, France. Electronic address: Didier.email@example.com.
Bartonella spp. are responsible for emerging and re-emerging diseases around the
world. The majority of human infections are caused by Bartonella henselae,
Bartonella quintana and Bartonella bacilliformis, although other Bartonella spp.
have also been associated with clinical manifestations in humans. The severity of
Bartonella infection correlates with the patient's immune status. Clinical
manifestations can range from benign and self-limited to severe and
life-threatening disease. Clinical conditions associated with Bartonella spp.
include local lymphadenopathy, bacteraemia, endocarditis, and tissue colonisation
resulting in bacillary angiomatosis and peliosis hepatis. Without treatment,
Bartonella infection can cause high mortality. To date, no single treatment is
effective for all Bartonella-associated diseases. In the absence of systematic
reviews, treatment decisions for Bartonella infections are based on case reports
that test a limited number of patients. Antibiotics do not significantly affect
the cure rate in patients with Bartonella lymphadenopathy. Patients with
Bartonella spp. bacteraemia should be treated with gentamicin and doxycycline,
but chloramphenicol has been proposed for the treatment of B. bacilliformis
bacteraemia. Gentamicin in combination with doxycycline is considered the best
treatment regimen for endocarditis, and erythromycin is the first-line antibiotic
therapy for the treatment of angioproliferative lesions. Rifampicin or
streptomycin can be used to treat verruga peruana. In this review, we present
recent data and recommendations related to the treatment of Bartonella infections
based on the pathogenicity of Bartonella spp.
Copyright © 2014 Elsevier B.V. and the International Society of Chemotherapy. All
PMID: 24933445 [PubMed - indexed for MEDLINE]
PLoS One. 2014 Mar 20;9(3):e92283. doi: 10.1371/journal.pone.0092283. eCollection
Diagnosis of Carrion's disease by direct blood PCR in thin blood smear negative
del Valle Mendoza J(1), Silva Caso W(2), Tinco Valdez C(3), Pons MJ(4), del Valle
LJ(5), Oré VC(1), Michelena DC(2), Mayra JB(6), Gavidea VZ(6), Vargas M(7), Ruiz
(1)Facultad de Ciencias de la Salud. Universidad Peruana de Ciencias Aplicadas -
UPC, Lima, Peru; Instituto de Investigación Nutricional, Lima, Peru. (2)Facultad
de Ciencias de la Salud. Universidad Peruana de Ciencias Aplicadas - UPC, Lima,
Peru. (3)Instituto de Investigación Nutricional, Lima, Peru. (4)Barcelona Centre
for International Health Research (CRESIB, Hospital Clínic - Universitat de
Barcelona), Barcelona, Spain. (5)Universidad Politécnica de Catalunya (UPC),
Barcelona, Spain. (6)Dirección Regional de Salud de Cajamarca (DIRESA-Cajamarca),
Cajamarca, Peru. (7)Fundación Clinic, IDIBAPS, Hospital Clinic i Provincial de
Barcelona, Barcelona, Spain.
Bartonella bacilliformis is the etiologic agent of Carrion's disease. This
disease has two well established phases, the most relevant being the so called
Oroya Fever, in which B. bacilliformis infect the erythrocytes resulting in
severe anemia and transient immunosuppression, with a high lethality in the
absence of adequate antibiotic treatment. The presence of B. bacilliformis was
studied in 113 blood samples suspected of Carrion's disease based on clinical
criteria, despite the absence of a positive thin blood smear, by two different
PCR techniques (using Bartonella-specific and universal 16S rRNA gene primers),
and by bacterial culture. The specific 16S rRNA gene primers revealed the
presence of 21 B. bacilliformis and 1 Bartonella elizabethae, while universal
primers showed both the presence of 3 coinfections in which a concomitant
pathogen was detected plus Bartonella, in addition to the presence of infections
by other microorganisms such as Agrobacterium or Bacillus firmus. These data
support the need to implement molecular tools to diagnose Carrion's disease.
PMID: 24651298 [PubMed - indexed for MEDLINE]
Int J Infect Dis. 2013 Oct;17(10):e811-9. doi: 10.1016/j.ijid.2013.02.016. Epub
2013 Apr 18.
Treatment outcomes of human bartonellosis: a systematic review and meta-analysis.
Prutsky G(1), Domecq JP, Mori L, Bebko S, Matzumura M, Sabouni A, Shahrour A,
Erwin PJ, Boyce TG, Montori VM, Malaga G, Murad MH.
(1)Knowledge and Evaluation Research Unit (KER), Mayo Clinic, 200 First Street
SW, Rochester, MN 55905, USA; Unidad de Conocimiento y Evidencia (CONEVID),
Universidad Peruana Cayetano Heredia, Lima, Peru. Electronic address:
BACKGROUND: Bartonella henselae, Bartonella quintana, and Bartonella
bacilliformis are responsible for the majority of cases of bartonellosis in
humans. These species have various unique epidemiologic characteristics, clinical
manifestations, and treatment approaches. The objective of this study was to
summarize the evidence on the treatment for the three most common species of
Bartonella in humans.
METHODS: We searched electronic databases through August 2011 for randomized
controlled trials and observational studies designed to evaluate the efficacy and
safety of the regimens used to treat diseases produced by B. henselae, B.
quintana, and B. bacilliformis. Study selection and appraisal were done in
RESULTS: We found two randomized and seven non-randomized studies at high risk of
bias. For cat scratch disease, antibiotics did not significantly affect the cure
rate or time to achieve cure. In chronic bacteremia, gentamicin and doxycycline
significantly increased the resolution rate. The recommended treatment was not
better than other regimens for infectious endocarditis and bacillary
CONCLUSIONS: Current clinical practice for the treatment of bartonellosis relies
mostly on expert opinion and antimicrobial susceptibility data. Randomized
controlled trials are needed in the field to compare different treatment options.
Copyright © 2013 International Society for Infectious Diseases. Published by
Elsevier Ltd. All rights reserved.
PMID: 23602630 [PubMed - indexed for MEDLINE]
PLoS Negl Trop Dis. 2012;6(10):e1819. doi: 10.1371/journal.pntd.0001819. Epub
2012 Oct 25.
Bartonella bacilliformis: a systematic review of the literature to guide the
research agenda for elimination.
Sanchez Clemente N(1), Ugarte-Gil CA, Solórzano N, Maguiña C, Pachas P, Blazes D,
Bailey R, Mabey D, Moore D.
(1)London School of Hygiene and Tropical Medicine, London, United Kingdom.
BACKGROUND: Carrion's disease affects small Andean communities in Peru, Colombia
and Ecuador and is characterized by two distinct disease manifestations: an
abrupt acute bacteraemic illness (Oroya fever) and an indolent cutaneous eruptive
condition (verruga Peruana). Case fatality rates of untreated acute disease can
exceed 80% during outbreaks. Despite being an ancient disease that has affected
populations since pre-Inca times, research in this area has been limited and
diagnostic and treatment guidelines are based on very low evidence reports. The
apparently limited geographical distribution and ecology of Bartonella
bacilliformis may present an opportunity for disease elimination if a clear
understanding of the epidemiology and optimal case and outbreak management can be
METHODS: All available databases were searched for English and Spanish language
articles on Carrion's disease. In addition, experts in the field were consulted
for recent un-published work and conference papers. The highest level evidence
studies in the fields of diagnostics, treatment, vector control and epidemiology
were critically reviewed and allocated a level of evidence, using the Oxford
Centre for Evidence-Based Medicine (CEBM) guidelines.
RESULTS: A total of 44 studies were considered to be of sufficient quality to be
included in the analysis. The majority of these were level 4 or 5 (low quality)
evidence and based on small sample sizes. Few studies had been carried out in
CONCLUSIONS: Current approaches to the diagnosis and management of Carrion's
disease are based on small retrospective or observational studies and expert
opinion. Few studies take a public health perspective or examine vector control
and prevention. High quality studies performed in endemic areas are required to
define optimal diagnostic and treatment strategies.
PMID: 23145188 [PubMed - indexed for MEDLINE]
Blood Transfus. 2012 Oct;10(4):563-4. doi: 10.2450/2012.0152-11. Epub 2012 Mar
Long time survival of Bartonella bacilliformis in blood stored at 4 °C. A risk
for blood transfusions.
Ruiz J, Silva W, Pons MJ, Del Valle LJ, Tinco CR, Casabona VD, Gomes C, Bazan J,
Zavaleta V, Cornejo H, Champin D, del Valle J.
PMID: 22507863 [PubMed - indexed for MEDLINE]
Am J Trop Med Hyg. 2012 Mar;86(3):381. doi: 10.4269/ajtmh.2012.11-0540.
A 60-year-old man from the highlands of Peru with fever and hemolysis.
Seas C(1), Villaverde H, Maguiña C.
(1)Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana
Cayetano Heredia, Lima, Peru. firstname.lastname@example.org
PMID: 22403303 [PubMed - indexed for MEDLINE]
Rev Inst Med Trop Sao Paulo. 2011 May-Jun;53(3):149-54.
Cytokines and T-Lymphocute count in patients in the acute and chronic phases of
Bartonella bacilliformis infection in an endemic area in peru: a pilot study.
Huarcaya E(1), Best I, Rodriguez-Tafur J, Maguiña C, Solórzano N, Menacho J,
Lopez De Guimaraes D, Chauca J, Ventosilla P.
(1)Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana
Cayetano Heredia, Lima, Peru.
Human Bartonellosis has an acute phase characterized by fever and hemolytic
anemia, and a chronic phase with bacillary angiomatosis-like lesions. This
cross-sectional pilot study evaluated the immunology patterns using pre- and
post-treatment samples in patients with Human Bartonellosis. Patients between
five and 60 years of age, from endemic areas in Peru, in the acute or chronic
phases were included. In patients in the acute phase of Bartonellosis a state of
immune peripheral tolerance should be established for persistence of the
infection. Our findings were that elevation of the anti-inflammatory cytokine
IL-10 and numeric abnormalities of CD4(+) and CD8(+) T-Lymphocyte counts
correlated significantly with an unfavorable immune state. During the chronic
phase, the elevated levels of IFN-γ and IL-4 observed in our series correlated
with previous findings of endothelial invasion of B. henselae in animal models.
PMID: 21755237 [PubMed - indexed for MEDLINE]
J Vet Emerg Crit Care (San Antonio). 2010 Feb;20(1):62-9. doi:
Feline hemotropic mycoplasmas.
(1)Department of Medicine & Epidemiology, University of California - Davis,
Davis, CA 95618, USA. email@example.com
OBJECTIVE: To describe the current understanding of the etiology, pathogenesis,
diagnosis, and treatment of feline hemotropic mycoplasmosis (feline infectious
DATA SOURCES: Manuscripts published on hemotropic mycoplasmosis in cats and other
animal species, based on a search of PubMed using the search terms
'hemoplasmas,''haemoplasmas,''hemotropic,''haemotropic,' and 'Haemobartonella,'
as well as references published within manuscripts accessed.
HUMAN DATA SYNTHESIS: Although hemotropic bacteria such as Bartonella
bacilliformis have been recognized in humans for over 100 years, it has only been
in recent years that some of these have been identified as hemotropic
VETERINARY DATA SYNTHESIS: Three species of hemotropic mycoplasmas have been
documented in cats worldwide, Mycoplasma haemofelis, 'Candidatus Mycoplasma
turicensis,' and 'Candidatus Mycoplasma haemominutum.' These organisms were
previously known as Haemobartonella felis, but are now known to be mycoplasmas.
M. haemofelis is the most pathogenic species, and causes anemia in
immunocompetent cats. Although 'Candidatus Mycoplasma turicensis' and 'Candidatus
Mycoplasma haemominutum' may be more capable of causing anemia in
immunosuppressed cats, their pathogenicity remains controversial. Assays based on
polymerase chain reaction technology are the most sensitive and specific
diagnostic tests available for these organisms, because they remain uncultivable
in the laboratory setting. Blood smears are unreliable for diagnosis of
hemoplasmosis because of their lack of sensitivity and specificity.
CONCLUSIONS: Cats presenting to emergency/critical care specialists with
hemolytic anemia should be tested using polymerase chain reaction assays for
hemotropic mycoplasmas before instituting antimicrobial therapy. Positive test
results for M. haemofelis suggest involvement of this organism in hemolytic
anemia. Other differential diagnoses for hemolytic anemia should be considered in
cats testing positive for 'Candidatus Mycoplasma turicensis' and 'Candidatus
Mycoplasma haemominutum,' because the presence of these organisms is not always
associated with anemia. Blood from infected cats should be handled with care
because of the potential zoonotic nature of this infection.
PMID: 20230435 [PubMed - indexed for MEDLINE]
Med Hypotheses. 2010 Jan;74(1):45-9. doi: 10.1016/j.mehy.2009.06.054. Epub 2009
The pathophysiology of the acute phase of human bartonellosis resembles AIDS.
Ticona E(1), Huaroto L, Garcia Y, Vargas L, Madariaga MG.
(1)Servicio de Enfermedades Infecciosas, Hospital Nacional Dos de Mayo, Parque
Historia de la Medicina Peruana s/n, Lima 01, Peru. firstname.lastname@example.org
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
PMID: 19665314 [PubMed - indexed for MEDLINE]
Mikrobiyol Bul. 2008 Jan;42(1):163-75.
[Bartonella henselae and its infections].
[Article in Turkish]
(1)Refik Saydam Hifzissihha Merkezi Başkanliği, Salgin Hastaliklar Araştirma
Müdürlüğü, Bakteriyel Zoonozlar Araştirma Laboratuvari, Ankara.
In recent years the number of identified Bartonella species has increased rapidly
and several species in Bartonella genus isolated from various mammalian
reservoirs were recognized as zoonotic agents in humans. Three Bartonella species
are considered to be pathogenic for humans; B. henselae, B. quintana and B.
bacilliformis. B. henselae causes asymptomatic intraerythrocytic bacteraemia in
the feline reservoir host and is the most important zoonotic species as the cause
of human diseases including cat scratch disease, bacillary angiomatosis,
bacillary peliosis, bacteraemia, endocarditis and neurological disorders. In this
review article general characteristics of B. henselae, infection types and
clinical features, laboratory diagnosis, treatment and preventive measures have
PMID: 18444576 [PubMed - indexed for MEDLINE]
J Antimicrob Chemother. 2007 Jun;59(6):1065-70. Epub 2007 Apr 21.
Molecular mechanisms of resistance to antibiotics in Bartonella bacilliformis.
Biswas S(1), Raoult D, Rolain JM.
(1)Unité des Rickettsies, CNRS UMR 6020, IFR 48, Faculté de Médecine et de
Pharmacie, Université de la Méditerranée, 27 Bd Jean Moulin, 13385 Marseille
Cedex 05, France.
OBJECTIVES: Bartonella bacilliformis is the aetiological agent of Carrion's
disease. Although ciprofloxacin, rifampicin and erythromycin have been
successfully used in the treatment of the disease, failures and relapses have
been reported. The objective of our study was to select in vitro mutants
resistant to antibiotics in order to determine the frequency of mutations and to
characterize the mechanism of resistance at the molecular level.
METHODS: Antibiotic-resistant mutants were selected by serial passages of
bacteria on blood agar plates containing antibiotics. Candidate genes involved in
resistance were amplified and sequenced and compared in order to look at
mutations associated with antibiotic resistance.
RESULTS: Ciprofloxacin-, rifampicin- and erythromycin-resistant mutants were
obtained after five, three and four passages, respectively. Conversely, no mutant
was obtained with either gentamicin or doxycycline even after 16 passages. The
ciprofloxacin mutant contained an amino acid change at position 87 (Asp --> Asn)
in its quinolone resistance-determining region of the DNA gyrase protein, whereas
the rifampicin-resistant strain had an amino acid change at position 531 (Ser -->
Phe) in the rifampicin resistance-determining region of the rpoB gene. Similarly,
the erythromycin-resistant mutant showed an A2058G mutation in the 23S rRNA gene.
CONCLUSIONS: According with the current knowledge on the treatment of human
bartonellosis, we believe that doxycycline in association with gentamicin may be
the preferred regimen for the treatment of the acute and eruptive stages of
Carrion's disease, but clinical trials are warranted to support our findings.
PMID: 17449882 [PubMed - indexed for MEDLINE]
Vaccine. 2007 Jan 2;25(1):43-54. Epub 2006 Aug 4.
The identification of two protective DNA vaccines from a panel of five plasmid
constructs encoding Brucella melitensis 16M genes.
Commander NJ(1), Spencer SA, Wren BW, MacMillan AP.
(1)Department of Statutory and Exotic Bacterial Diseases, Veterinary Laboratories
Agency, Woodham Lane, New Haw, Addlestone, Surrey KT15 3NB, UK.
Five candidate genes from the Brucella melitensis 16M genome were selected.
Eukaryotic expression plasmids encoding these antigens were constructed and
expression was verified in vitro from transfected Cos7 cells. Each vaccine was
assessed for protective efficacy in a BALB/c mouse brucellosis infection model.
>From these experiments two protective DNA vaccines were identified: p-omp25 and
p-ialB. The Omp25 antigen (BMEI1249) has previously been studied in terms of
Brucella virulence, serodiagnosis and as a protective antigen. However, this
study represents the first report of a significant protective effect achieved
against B. melitensis 16M challenge using the Omp25 antigen in a DNA vaccine
approach. The other protective vaccine identified in this study was p-ialB. The
ialB candidate (BMEI1584) was selected based upon its' putative function as an
invasion protein which was assigned due to shared identity with the invasion
protein B (ialB) of Bartonella bacilliformis. This candidate has not previously
been investigated with regard to Brucella virulence or pathogenesis. This study
is the first report to identify the Brucella invasion protein B (BMEI1584) as a
novel protective antigen for brucellosis.
PMID: 17049676 [PubMed - indexed for MEDLINE]
Rev Inst Med Trop Sao Paulo. 2004 May-Jun;46(3):171-4. Epub 2004 Jul 20.
Carrion's disease (Bartonellosis bacilliformis) confirmed by histopathology in
the High Forest of Peru.
Maco V(1), Maguiña C, Tirado A, Maco V, Vidal JE.
(1)Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana
Cayetano Heredia, Lima, Peru.
Bartonellosis or Carrion's disease is endemic in some regions of Peru,
classically found in the inter-Andean valleys located between 500 and 3200 meters
above sea level. We report the case of a 43 year-old male patient, farmer, who
was born in the Pichanaki district (Chanchamayo, Junin), located in the High
Forest of Peru. He presented with disseminated, raised, erythematous cutaneous
lesions, some of which bled. The distribution of these lesions included the nasal
mucosa and penile region. Additionally subcutaneous nodules were distributed over
the trunk and extremities. Hematologic exams showed a moderate anemia. Serologic
studies for HIV and Treponema pallidum were negative. The histopathologic results
of two biopsies were compatible with Peruvian wart. Oral treatment with
ciprofloxacin (500 mg BID) was begun. Over 10 days, the patient showed clinical
improvement. This is the first report of a confirmed case of bartonellosis in the
eruptive phase originating from the Peruvian High Forest, showing the
geographical expansion of the Carrion's disease.
PMID: 15286824 [PubMed - indexed for MEDLINE]
Am J Trop Med Hyg. 2004 Jul;71(1):53-5.
Report of an unusual case of persistent bacteremia by Bartonella bacilliformis in
a splenectomized patient.
Henríquez C(1), Hinojosa JC, Ventosilla P, Infante B, Merello J, Mallqui V,
Verastegui M, Maguiña C.
(1)Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana
Cayetano Heredia, AP 4314, Lima 100, Peru. email@example.com
We report a case of a 56-year-old man with a history of splenectomy for
idiopathic thrombocytopenic purpura who developed persistent bacteremia in the
acute phase of human bartonellosis. This patient did not develop hemolytic
anemia. Only after several courses of antibiotic treatment was the infection
eradicated. This is an unusual case of overwhelming post-splenectomy infection by
Bartonella bacilliformis, which provides clinical evidence that the spleen is a
critical effector organ of clearance of this infection as well as the effector
organ of bartonellosis-associated hemolytic anemia.
PMID: 15238689 [PubMed - indexed for MEDLINE]
Recenti Prog Med. 2003 Apr;94(4):177-85.
[Article in Italian]
Mansueto P(1), Di Lorenzo G, Rizzo M, Mazzola G, Affronti M, Battista Rini G,
(1)Dipartimento di Medicina Clinica e delle Patologie Emergenti, Università degli
Studi di Palermo. firstname.lastname@example.org
In the last years the number of Bartonella species significantly raised, often
with an epidemiological profile of emergent disease. B. bacilliformis is the
etiological agent of Carrion's disease. B. clarridgeiae has been associated,
together with B. henselae, to Cat-Scratch Disease (CSD), whereas B. elizabethae
to endocarditis and B. grahamii to neuroretinitis. B. henselae has been
associated to CSD and, in patients with immunodeficiency, together with B.
quintana, to bacillary angiomatosis, to peliosis and to endocarditis. B. quintana
is the etiological agent of "trench fever", in its "classical" and "urban" form.
B. vinsonii subsp. arupensis and subsp. berkhoffii have been associated to
bacteremia and endocarditis. The diagnosis foresees pathological examination of
the lesions, germ isolation and use of specific serological test and of
polymerase chain reaction. Prognosis is, generally, favourable. Therapy foresees
the use of numerous antibacterial agents, like: penicillins, cephalosporins,
aminoglycosides, tetracyclines, macrolides, quinolones,
trimethoprim-sulfomethoxazole and rifampicin.
PMID: 12677790 [PubMed - indexed for MEDLINE]
FEMS Microbiol Lett. 2000 Jan 1;182(1):119-24.
Contact-dependent hemolytic activity distinct from deforming activity of
(1)Department of Medical Microbiology and Immunology, Texas A&M University System
Health Science Center, College Station, TX 77843-1114, USA. email@example.com
Although Bartonella bacilliformis causes a severe anemia in humans, this study
presents the first report of hemolytic activity by B. bacilliformis. The activity
was not apparent in culture supernatants but was reliably detected when B.
bacilliformis cells were centrifuged onto erythrocytes prior to incubation.
Abrogation of hemolytic activity by proteinase K treatment suggested the
hemolysin was a Bartonella protein. Even though hemolysis required relatively
long incubation times, de novo protein synthesis was not required to produce the
protein. A preparation containing factors released by B. bacilliformis, including
deformin, a B. bacilliformis protein able to induce pits and invaginations in
erythrocyte membranes, had some ability to lyse erythrocytes. However,
pre-deformed erythrocytes did not lyse faster or to a greater extent than control
erythrocytes after the addition of B. bacilliformis cells. Inhibition of
deformation caused by B. bacilliformis cells with the erythrocyte ATPase
inhibitor, vanadate, did not affect hemolytic activity. This study suggests
hemolytic activity and deforming activity are attributable to different B.
PMID: 10612742 [PubMed - indexed for MEDLINE]
Ann Biol Clin (Paris). 1999 Jan-Feb;57(1):29-36.
[Bartonellosis. II. Other Bartonella responsible for human diseases].
[Article in French]
Piémont Y(1), Heller R.
(1)Institut de bactériologie, Faculté de Médecine et Hôpitaux universitaires de
Strasbourg, 3, rue Koeberlé, 67000 Strasbourg.
In addition to Bartonella henselae, five other Bartonella species were involved
in human pathology. As for B. henselae, ectoparasites seem to be responsible for
the transmission of most or all these bacterial species. B. bacilliformis is
responsible for Carrion's disease that occurs in some valleys of Colombia,
Ecuador and Peru. This disease is transmitted by biting of infected sandflies.
The bacterial reservoir is constituted by humans only. That disease occurs either
as an acute form with severe infectious hemolytic anemia (or Oroya fever), or as
benign cutaneous tumors, also called verruga peruana. Healthy blood carriers of
the bacterium exist. Trench fever was described during the First World War. This
non-lethal disease is constituted of recurrent febrile attacks associated
particularly with osseous pains. The causative agent of the disease is B.
quintana, transmitted by the body louse. Humans seem to be the reservoir of that
bacterium. In some patients, B. quintana can be responsible for endocarditis,
bacillary angiomatosis and chronic or recurrent bacteremia. Other human
infections due to Bartonella sp. have been described: B. vinsonii, isolated from
blood of small rodents, and B. elizabethae, the reservoir of which is currently
unknown, can be responsible for endocardites. B. clarridgeiae (isolated from
blood of 5% of pet cats and 17% of stray cats) may be responsible for human cat
scratch disease. All these bartonelloses are diagnosed by non-standard blood
culture or by in vitro DNA amplification or by serological testing. Their
treatment requires tetracyclines or chloramphenicol or macrolides.
PMID: 9920964 [PubMed - indexed for MEDLINE]
Trans R Soc Trop Med Hyg. 1997 Sep-Oct;91(5):544-6.
An outbreak of bartonellosis in Zamora Chinchipe Province in Ecuador.
Cooper P(1), Guderian R, Orellana P, Sandoval C, Olalla H, Valdez M, Calvopiña M,
Guevara A, Griffin G.
(1)Department of Clinical Investigations, Hospital Vozandes, Quito, Ecuador.
We report an outbreak of human bartonellosis in Zamora Chinchipe Province in
Ecuador, which occurred in 1995-1996. Nineteen cases were seen, of which 18
presented with classical oroya fever (fever and profound anaemia) and one with
verruga peruana; 11 of the cases (58%) had positive blood films containing
Bartonella bacilliformis. The houses of cases and neighbouring controls were
visited; blood samples for thin films and cultures were collected from members of
each house and a questionnaire was administered to investigate possible risk
factors for disease transmission. In none of those sampled was B. bacilliformis
bacteriologically demonstrable. All case houses were located in isolated areas at
the margin of forest and the presence of dead rodents was reported only in case
houses (P < 0.05). We suggest that human bartonellosis is a zoonosis with a
natural rodent reservoir and that migrant humans infected in this way may become
a temporary reservoir host in populated areas.
PMID: 9463663 [PubMed - indexed for MEDLINE]
19. Med Hypotheses. 1997 Jun;48(6):511-5.
Bartonellosis and human immunodeficiency disease (AIDS): L-forms as persisters,
activating factors, and mechanism of disease.
Sood FH, Phatak VD, Chaudhari MS.
Bartonella, genus Proteus, can cause immunodepressive disease. The organisms, in
parasitized red blood cells, may invade the brain and every other system and
space in the human body. Bartonella henselae is proposed to have a role in the
pathogenesis of acquired immunodeficiency syndrome (AIDS) encephalopathy.
Bartonella bacilliformis produces two known toxins that can induce spasm and
angiomatosis, respectively, and manifest as diseases associated with symptomatic
AIDS. The skin lesions of bartonellosis may be mistaken clinically and
histologically for Kaposi's sarcoma. Bacteria of the genus Proteus produce
L-forms: their elementary bodies may be mistaken for what are called the 'human
immunodeficiency viruses' (HIV). Antibiotics, especially penicillin, induce
bacteria to produce L-forms. Air pollution and high sugar, salt and fat diets are
factors that may increase the lipid content of microbes that produce toxins and
L-forms that may persist or revert to bacterial form.
PMID: 9247895 [PubMed - indexed for MEDLINE]
Pediatr Infect Dis J. 1997 Feb;16(2):163-79.
The expanding spectrum of Bartonella infections: II. Cat-scratch disease.
Bass JW(1), Vincent JM, Person DA.
(1)Department of Pediatrics, Tripler Army Medical Center, Honolulu, HI
96859-5000, USA. firstname.lastname@example.org
Recent advancements and developments in molecular biotechnology have allowed more
precise reclassification of many microorganisms. With the use of these new
taxonomy tools, several organisms previously thought to belong to other genera
have been recently described as bartonellae. Of the 11 organisms now described as
Bartonella spp., only four have been shown to be pathogenic for humans. Table 1
lists the four Bartonella human pathogens along with the their known epidemiology
and the scope and range of disease associated with each. All are now considered
to be bacteria and can be grown on blood-enriched agar although primary isolation
in some may best be achieved in cell tissue culture. B. bacilliformis infection
is limited to certain geographic regions in South America where the only human
reservoir and the sandfly vector(s) that spreads the disease reside together.
Specific antibiotic treatment is dramatically effective in treating the highly
fatal, acute intraerythrocytic hemolytic form of the disease, but their
effectiveness in treating the vascular proliferative forms (verruga peruana) or
the chronic asymptomatic, bacteremic, carrier state of the disease has not been
effective. This disease should remain confined to its present endemic geographic
areas in South American unless asymptomatic bacteremic persons from these areas
migrate to areas where sandflies and humans exist that are capable of
establishing this infection in new endemic areas. B. quintana and B. henselae
cause a wide range of clinical diseases in humans, the type and extent of which
varies significantly with the immune status of the host. In immunocompetent hosts
the pathologic response is granulomatous, suppurative, extracellular and
intracellular, generally self-limited and usually unresponsive to antibiotic
treatment, even to those drugs to which the organism is shown to be sensitive in
vitro. In contrast, in immunocompromised hosts the pathologic response is
vasculoproliferative, organisms may be seen intracellularly but they are often
seen in abundance in extracellular clumps and infection is usually progressive
and fatal unless treated. In these patients clinical response to treatment with
drugs that are effective in vitro against these organisms has usually been
dramatic. Of these agents those that penetrate cells and are found in high
concentrations intracellularly, such as erythromycin, clarithromycin,
azithromycin, rifampin, doxycycline and gentamicin, appear to be most effective.
These agents not only appear to provide the most dramatic treatment response in
patients with BA, BP and PRFB and other manifestations of B. henselae (and B.
quintana as well) in immunocompromised persons, they appear to be the most
promising agents for treatment of persons with both typical and atypical CSD.
Further studies will be necessary to more clearly elucidated the mechanisms
responsible for the diverse clinical presentations of infection with these
organisms in human hosts relative to their immune status. In addition
clarification of the epidemiology of B. elizabethae infections in humans may be
helpful in understanding the nature of infection with Bartonella organisms.
PMID: 9041596 [PubMed - indexed for MEDLINE]