Why is Bartonella Minimized and the Research
So Strongly Filtered by Some Wanting
to Make Bartonella Both Rare and Trivial?

BARTONELLA DAMAGES IN MANY WAYS IN MANY TISSUES AN UNKNOWN PERCENT OF CATS AND HUMANS

NO ONE ALIVE KNOWS THE PERCENT INFECTED OR HARMED,
BUT IT IS A NOT TRIVIAL NUMBER.

I was fairly surprised to see a post from an "expert" group, which seem to rise up monthly like weeds, that proposes that Bartonella is both non-pathological in cats, and is also not a real medical issue in humans. My appeal is Bartonella does cause serious illness, and it does cause detectable illness in cats with diverse testing and careful examinations. Further, I would appeal to you to consider that Bartonella clearly harms tissues in cats or felines and humans.

For example, why do some writers assume the presence of one Bartonella species, means another species or variant cannot be present? With new species found almost monthly, the testing for Bartonella is profoundly new. When you are rapidly finding new species, how can one boast of certainty?

It is very clear that some are bringing huge assumptions with markedly unfounded confidence. Perhaps they want to calm vets, cat owners or physicians and patients. I hope it is not the routine practice of having false competence by easy guidelines with Papal type positions. Mature scientists in biological medicine can live with some grays. People can offer positions, and hold them in a way that allows modification.

I try not to be in love with any position, and it is why I have changed my opinions more often than I care to admit. But this worship of small groups who do the work for you, was an error I made in almost every area of medical science twenty years ago. It was easy. It seemed to help me. But in some areas, not all, it was too simple and wrong. Perhaps the fact some experts are so profoundly correct and useful at times, we get seduced into forgetting that in every culture and in almost every age the mental elite and those with "stature," have been right and wrong when presenting ten positions. Fifty years later some of those ten positions were wrong or too simple.

Below are a small sample of articles to allow you to decide if Bartonella is a safe unimportant bacteria in cats. Or if it can cause damage in any cat, including those with good immune systems. In humans, Bartonella literature reviews that are aggressive, dedicated and take over a year of full time study, show Bartonella damages the human body in excess of 100 ways, and not merely in those with HIV or poor immune systems.

Read this small sample of easy summaries and decide if Bartonella is a harmless infection. And look to see if you sense bias in the researcher to minimize the findings, excess confidence in detection of the organism, or its effects on the entirety of the cat's complex body functions and chemistry.

A REVIEW OF BARTONELLA AND CATS OR FELINES

WHILE BARTONELLA'S IMPACT VARIES AMONG MAMMALS PERHAPS CATS CAN TEACH HUMANS A LITTLE ABOUT HUMANS

1. Ann Trop Med Parasitol. 2011 Oct;105(7):493-8.

Bartonella clarridgeiae, B. henselae and Rickettsia felis in fleas from Morocco.

Boudebouch N, Sarih M, Beaucournu JC, Amarouch H, Hassar M, Raoult D, Parola P.

Laboratoire des Maladies Vectorielles, Institut Pasteur du Maroc 1, Place Louis Pasteur, 20360, Casablanca, Morocco.

A total of 554 fleas were collected in the Moroccan Casablanca and Tiznit regions from domesticated animals and ruminants between August 2007 and October 2008 and were tested for the presence of Rickettsia spp. and Bartonella spp. using molecular methods. For the first time in Morocco, we found Rickettsia felis, the agent of flea-borne spotted fever in Ctenocephalides felis; B. henselae, an agent of cat scratch disease; and Bartonella clarridgeiae, a cat pathogen and potentially a human pathogen.

PMID: 22185943 [PubMed - in process]

2. Clin Dev Immunol. 2012;2012:612809. Epub 2011 Nov 17.

Bartonella infection in immunocompromised hosts: immunology of vascular infection and vasoproliferation.

Mosepele M, Mazo D, Cohn J.

Department of Medicine, Hospital of the University of Pennsylvania, 100 Centrex, Philadelphia, PA 19104, USA.

Most infections by genus Bartonella in immunocompromised patients are caused by B. henselae and B. quintana. Unlike immunocompetent hosts who usually develop milder diseases such as cat scratch disease and trench fever, immunocompromised patients, including those living with HIV/AIDS and posttransplant patients, are more likely to develop different and severe life-threatening disease. This paper will discuss Bartonella's manifestations in immunosuppressed patients and will examine Bartonella's interaction with the immune system including its mechanisms of establishing infection and immune escape. Gaps in current understanding of the immunology of Bartonella infection in immunocompromised hosts will be highlighted.

PMCID: PMC3227422 PMID: 22162717 [PubMed - in process]

3. J Vet Cardiol. 2011 Dec;13(4):277-81. Epub 2011 Nov 3.

Suspected Bartonella-associated myocarditis and supraventricular tachycardia in a cat.

Nakamura RK, Zimmerman SA, Lesser MB.

Advanced Veterinary Care Center, 15926 Hawthorne Blvd, Lawndale, CA 90260, USA.

A 4-year old female spayed domestic short hair cat presented for evaluation of a tachyarrhythmia identified on routine physical examination. Supraventricular tachycardia (SVT) was identified on electrocardiogram (ECG). Echocardiogram failed to identify any structural heart disease. A positive Bartonella antibody titer was identified on serological evaluation. The cat received anti-arrhythmics for control of the SVT and azithromycin for Bartonella. After completion of antibiotic therapy, a four-fold decrease in the Bartonella antibody titer was measured and the cat was eventually weaned off anti-arrhythmic medications. At 1 week, 1 month and 3 month re-checks off all therapy, no SVT was identified.

Copyright © 2011 Elsevier B.V. All rights reserved.

PMID: 22051527 [PubMed - in process]

4. Am J Trop Med Hyg. 2011 Nov;85(5):931-3.

Molecular detection of Rickettsia felis, Bartonella henselae, and B. clarridgeiae in fleas from domestic dogs and cats in Malaysia.

Mokhtar AS, Tay ST.

Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. aidasyafinaz@hotmail.com

The presence of Rickettsia felis, Bartonella henselae and B. clarridgeiae in 209 fleas (Ctenocephalides felis) obtained from domestic cats and dogs in several locations in Malaysia was investigated in this study. Using a polymerase chain reaction specific for the citrate synthase (gltA) and 17-kD antigenic protein (17kD) genes of rickettsiae, we detected R. felis DNA in 6 (2.9%) fleas. For detection of bartonellae, amplification of the heme-binding protein (pap31) and riboflavin synthase (ribC) genes identified B. henselae and B. clarridgeiae DNA in 24 (11.5%) and 40 (19.1%) fleas, respectively. The DNA of B. henselae and B. clarridgeiae was detected in 10 (4.8%) fleas. Two B. henselae genogroups (Marseille and Houston-1) were detected in this study; genogroup Marseille (genotype Fizz) was found more often in the fleas. The findings in this study suggest fleas as potential vectors of rickettsioses and cat-scratch disease in this country.

PMCID: PMC3205644 [Available on 2012/11/1] PMID: 22049052 [PubMed - indexed for MEDLINE]

5. Vector Borne Zoonotic Dis. 2011 Oct 24. [Epub ahead of print]

Vector-Borne Diseases in Client-Owned and Stray Cats from Madrid, Spain.

Ayllón T, Diniz PP, Breitschwerdt EB, Villaescusa A, Rodríguez-Franco F, Sainz A.

1 Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad Complutense de Madrid , Madrid, Spain .

Abstract The role of various vector-borne pathogens as a cause of disease in cats has not been clearly determined. The current study evaluated risk factors, clinical and laboratory abnormalities associated with Ehrlichia spp., Anaplasma spp., Neorickettsia spp., Leishmania spp., and Bartonella spp. infection or exposure in 680 client-owned and stray cats from Madrid, Spain. Our results indicate that a large portion (35.1%) of the cat population of Madrid, Spain, is exposed to at least one of the five vector-borne pathogens tested. We found seroreactivity to Bartonella henselae in 23.8%, to Ehrlichia canis in 9.9%, to Anaplasma phagocytophilum in 8.4%, to Leishmania infantum in 3.7%, and to Neorickettsia risticii in 1% of the feline study population. About 9.9% of cats had antibody reactivity to more than one agent. L. infantum DNA was amplified from four cats (0.6%), B. henselae DNA from one cat (0.15%), and B. clarridgeiae DNA from another cat (0.15%).

PMID: 22022820 [PubMed - as supplied by publisher]

6. Vector Borne Zoonotic Dis. 2011 Oct 13. [Epub ahead of print]

Rickettsia felis and Bartonella spp. in Fleas from Cats in Albania.

Silaghi C, Knaus M, Rapti D, Shukullari E, Pfister K, Rehbein S.

1 Chair of Comparative Tropical Medicine and Parasitology, Faculty of Veterinary Medicine, Ludwig-Maximilians-University Munich , Munich, Germany .

Abstract Fleas can serve as vectors for bacterial pathogens like Bartonella and Rickettsia species, which have been isolated worldwide. However, the knowledge of the epidemiology of vector-borne diseases in general and thus on flea-borne diseases in Albania is limited. Therefore, from 78 free-roaming cats in Tirana, Albania, fleas (371 Ctenocephalides felis and 5 Ctenocephalides canis) were collected to examine them for the presence of Rickettsia and Bartonella species. Ten of the 371 C. felis (2.7%) were positive for Rickettsia felis, and 24 (6.5%) for Bartonella spp. (B. henselae and B. clarridgeiae). In total, fleas from 15 cats (19.2%) were positive for either one or the other of the pathogens. The results of this study provided evidence for the presence of R. felis (causing flea-borne spotted fever) and Bartonella spp. (causing cat scratch disease) in Albania. Thus, these infectious diseases should be considered as differential diagnoses when febrile symptoms are presented, especially after contact with cats or their fleas.

PMID: 21995262 [PubMed - as supplied by publisher]

7. Clin Exp Dermatol. 2011 Oct 10. doi: 10.1111/j.1365-2230.2011.04177.x. [Epub ahead of print]

Onset of cutaneous vasculitis and exacerbation of IgA nephropathy after Bartonella henselae infection.

Cozzani E, Cinotti E, Ameri P, Sofia A, Murialdo G, Parodi A.

Section of Dermatology, Department of Endocrinological and Medical Sciences, University of Genoa, Genoa, Italy Section of Internal Medicine, Department of Endocrinological and Medical Sciences, University of Genoa, Genoa, Italy Department of Internal Medicine, Nephrology Unit, University of Genoa, Genoa, Italy.

Bartonella henselae is the aetiological agent of cat-scratch disease. Recently, there have been reports of other conditions associated with this bacterium, including leucocytoclastic vasculitis, thrombocytopenic purpura, maculopapular and urticarial eruptions, granuloma annulare, erythema nodosum, erythema marginatum and erythema annulare. We report the first case, to our knowledge, of the simultaneous occurrence of cutaneous vasculitis and nephrotic syndrome in a 65-year-old woman with IgA nephropathy after a B. henselae infection transmitted by a cat scratch. The aetiopathogenetic role of B. henselae was hypothesized on the basis of the serological demonstration of acute B. henselae infection, the immunofluorescence findings, and the prompt resolution after azithromycin treatment. Patients reporting cat scratches or bites should undergo accurate clinical examination, routine laboratory examinations, urinalysis and clinical surveillance.

© The Author(s). CED © 2011 British Association of Dermatologists.

PMID: 21981612 [PubMed - as supplied by publisher]

8. Cell Microbiol. 2011 Oct 10. doi: 10.1111/j.1462-5822.2011.01711.x. [Epub ahead of print]

Analysis of the BadA stalk from Bartonella henselae reveals domain-specific and domain-overlapping functions in the host cell infection process.

Kaiser PO, Linke D, Schwarz H, Leo JC, Kempf VA.

Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Universitätsklinikum, Goethe-Universität, Paul Ehrlich Str.40, 60596 Frankfurt am Main, Germany. Max-Planck-Institut für Entwicklungsbiologie, Abteilung Proteinevolution, Spemannstr. 35, 72076 Tübingen, Germany. Max-Planck-Institut für Entwicklungsbiologie, Elektronenmikroskopie, Spemannstr. 35, 72076 Tübingen, Germany.

Human pathogenic Bartonella henselae cause cat scratch disease and vasculoproliferative disorders. An important pathogenicity factor of B. henselae is the trimeric autotransporter adhesin Bartonella adhesin A (BadA) which is modularly constructed and consists of a head, a long and repetitive neck-stalk module with 22 repetitive neck/stalk repeats and a membrane anchor. The BadA head is crucial for bacterial adherence to host cells, binding to several extracellular matrix proteins and for the induction of vascular endothelial growth factor (VEGF) secretion. Here, we analysed the biological role of the BadA stalk in the infection process in greater detail. For this purpose, BadA head-bearing and headless deletion mutants with different lengths (containing one or four neck/stalk repeats in the neck-stalk module) were produced and functionally analysed for their ability to bind to fibronectin, collagen and endothelial cells and to induce VEGF secretion. Whereas a head-bearing short version (one neck/stalk element) of BadA lacks exclusively fibronectin binding, a substantially truncated headless BadA mutant was deficient for all of these biological functions. The expression of a longer headless BadA mutant (four neck/stalk repeats) restored fibronectin and collagen binding, adherence to host cells and the induction of VEGF secretion. Our data suggest that (i) the stalk of BadA is exclusively responsible for fibronectin binding and that (ii) both the head and stalk of BadA mediate adherence to collagen and host cells and the induction of VEGF secretion. This indicates overlapping functions of the BadA head and stalk.

© 2011 Blackwell Publishing Ltd.

PMID: 21981119 [PubMed - as supplied by publisher]

9. Genet Mol Res. 2011 Aug 26;10(3):1789-818.

Proteomic and bioinformatic analysis of outer membrane proteins of the protobacterium Bartonella henselae (Bartonellaceae).

Li DM, Liu QY, Zhao F, Hu Y, Xiao D, Gu YX, Song XP, Zhang JZ.

Department of Vector Biology and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.

Bartonella henselae, an infectious agent causing cat-scratch disease and vasculoproliferative disorders in humans, is a fastidious facultative intracellular pathogen. The outer membrane proteins of B. henselae are key molecules that play a primary role in host-cell interactions. We isolated B. henselae outer membrane proteins, using the ionic detergent N-lauroyl sarcosine sodium salt and sodium carbonate, purification by two-dimensional (2-D) gel electrophoresis, and protein identification using mass spectrometry. Treatment with buffers containing ASB-14 and ZWITTERGENT 3-10 increased solubilization of B. henselae proteins, particularly proteins with basic pI. Three hundred and sixty-eight spots were detected from the sarcosine-insoluble outer membrane fraction; 94 distinct protein species were identified from 176 spots. In the outer membrane fraction from carbonate incubation, 471 spots were calculated and 259 spots were identified, which included 139 protein entries. There were six outer membrane proteins in the sarcosine-insoluble outer membrane fraction compared with nine outer membrane proteins from samples subjected to carbonate incubation. We used bioinformatic analysis to identify 44 outer membrane proteins by prediction of their domains and tertiary structures and documented the potential virulence factors. We established the 2-D reference maps of the outer membrane subproteome of B. henselae using the two different extraction methods, which were partly complementary to each other. Sodium carbonate extraction isolated low-abundance and basic proteins better than the lauroyl sarcosine sodium salt extraction, which enriched high-abundance porins.

PMID: 21948745 [PubMed - in process]

10. J Neuroophthalmol. 2011 Sep 21. [Epub ahead of print]

Cat Scratch Neuroretinitis: The Role of Acute and Convalescent Titers for Diagnosis.

Gulati A, Yalamanchili S, Golnik KC, Lee AG.

Department of Ophthalmology, The Methodist Hospital (AGL), Houston, Texas Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medical College (AGL, SY), New York, New York Department of Ophthalmology, University of Iowa Hospitals and Clinics (AGL), Iowa City, Iowa Department of Ophthalmology, University of Texas Medical Branch (AGL), Galveston, Texas Baylor College of Medicine (AG, AGL) Department of Ophthalmology, University of Cincinnati (KCG), Cincinnati, Ohio.

ABSTRACT: Cat scratch neuroretinitis (CSN) is a clinical diagnosis supported by serological testing. We present 2 cases of CSN in which initial acute titers were negative or equivocal for Bartonella henselae while convalescent titers were shown to be positive. We report these cases to emphasize that a single acute negative titer is insufficient to exclude the diagnosis of CSN and that convalescent titers should be obtained in patients for whom there is a high clinical suspicion of the disease.

PMID: 21941214 [PubMed - as supplied by publisher]

11. Vet Ophthalmol. 2011 Sep;14 Suppl 1:9-14. doi: 10.1111/j.1463-5224.2011.00901.x.

Bartonellosis in cats: a role in uveitis?

Stiles J.

Department of Veterinary Clinical Sciences, Purdue University School of Veterinary Medicine, West Lafayette, IN, USA. stilesj@purdue.edu

Bartonellosis has been widely studied in human and veterinary medicine over the past two decades. Despite this fact, it remains an enigmatic disease in many ways. The causative bacteria, Bartonella spp, are transmitted to cats by fleas and thus the prevalence in cat populations, particularly in temperate climates, is high. Most cats, whether infected naturally or experimentally, remain asymptomatic. Thus, correlating the presence of the organism to clinical disease, including uveitis, in cats has been difficult. This review summarizes what is known of the transmission and pathogenesis of Bartonella spp in cats, the possible role of the organism in feline ocular disease, as well methods of diagnosis and treatment.

© 2011 American College of Veterinary Ophthalmologists.

PMID: 21923819 [PubMed - in process]

12. Vector Borne Zoonotic Dis. 2011 Dec;11(12):1549-53. Epub 2011 Sep 15.

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.

1 School of Veterinary and Biomedical Sciences, Murdoch University , Murdoch, Western Australia, Australia .

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.

PMID: 21919728 [PubMed - in process]

13. PLoS Negl Trop Dis. 2011 Sep;5(9):e1301. Epub 2011 Sep 6.

Bacteriological and molecular identification of Bartonella species in cats from different regions of China.

Yuan C, Zhu C, Wu Y, Pan X, Hua X.

Shanghai Jiaotong University, Shanghai, People's Republic of China.

With the improvements in diagnostic techniques, Bartonella henselae (B. henselae) infection has recently been recognized to cause a widening spectrum of diseases. Cats are the natural reservoir hosts of B. henselae. The current study aims to investigate the prevalence of B. henselae infection in the cat populations in China. Polymerase chain reaction (PCR) and bacterial cultures confirm that 12.7% of the tested cats were positive for the infection. Old age and outdoor exposure were statistically associated with the infection. Multilocus sequence typing and eBURST analysis of the cat isolates collected in the present study show that 65.4% of the isolates belong to sequence type 1 (ST1). Three new STs (ST16-18) were identified in Midwestern China. These results may aid our understanding of the population structure of B. henselae in China and the relationship between human and cat strains in subsequent studies.

PMCID: PMC3167793 PMID: 21909443 [PubMed - in process]

14. Acta Crystallogr Sect F Struct Biol Cryst Commun. 2011 Sep 1;67(Pt 9):1078-83. Epub 2011 Aug 16.

Structure of a Nudix hydrolase (MutT) in the Mg(2+)-bound state from Bartonella henselae, the bacterium responsible for cat scratch fever.

Buchko GW, Edwards TE, Abendroth J, Arakaki TL, Law L, Napuli AJ, Hewitt SN, Van Voorhis WC, Stewart LJ, Staker BL, Myler PJ.

Seattle Structural Genomics Center for Infectious Disease, http://www.ssgcid.org, USA. garry.buchko@pnnl.gov

Cat scratch fever (also known as cat scratch disease and bartonellosis) is an infectious disease caused by the proteobacterium Bartonella henselae following a cat scratch. Although the infection usually resolves spontaneously without treatment in healthy adults, bartonellosis may lead to severe complications in young children and immunocompromised patients, and there is new evidence suggesting that B. henselae may be associated with a broader range of clinical symptoms then previously believed. The genome of B. henselae contains genes for two putative Nudix hydrolases, BH02020 and BH01640 (KEGG). Nudix proteins play an important role in regulating the intracellular concentration of nucleotide cofactors and signaling molecules. The amino-acid sequence of BH02020 is similar to that of the prototypical member of the Nudix superfamily, Escherichia coli MutT, a protein that is best known for its ability to neutralize the promutagenic compound 7,8-dihydro-8-oxoguanosine triphosphate. Here, the crystal structure of BH02020 (Bh-MutT) in the Mg(2+)-bound state was determined at 2.1 Å resolution (PDB entry 3hhj). As observed in all Nudix hydrolase structures, the α-helix of the highly conserved `Nudix box' in Bh-MutT is one of two helices that sandwich a four-stranded mixed β-sheet with the central two β-strands parallel to each other. The catalytically essential divalent cation observed in the Bh-MutT structure, Mg(2+), is coordinated to the side chains of Glu57 and Glu61. The structure is not especially robust; a temperature melt obtained using circular dichroism spectroscopy shows that Bh-MutT irreversibly unfolds and precipitates out of solution upon heating, with a T(m) of 333 K.

PMCID: PMC3169405 PMID: 21904053 [PubMed - in process]

15. Semin Arthritis Rheum. 2011 Dec;41(3):511-6. Epub 2011 Aug 15.

Vertebral Osteomyelitis: An Unusual Presentation of Bartonella henselae Infection.

Graveleau J, Grossi O, Lefebvre M, Redon H, Caignon JM, Pallardy A, Bodet-Milin C, Néel A, Hamidou MA.

Service de Médecine Interne, Centre Hospitalier Universitaire Hôtel Dieu, Nantes, France.

OBJECTIVES: To report cases of cat scratch disease with vertebral osteomyelitis. METHODS: We describe clinical features, diagnostic, treatment, and outcome of 2 patients with vertebral osteomyelitis due to Bartonella henselae and provide a review of the relevant literature. RESULTS: A 47-year-old man was investigated for fever, splenomegaly, and cervical adenopathy. A lymphoma was suspected on the clinical picture, the laboratory tests, and the computed tomographic scan. [(18)F]-fluoro-2-deoxy-d-glucose-positron emission tomography detected splenic nodules and a hypermetabolic focus of C7 vertebral body compatible with a vertebral osteomyelitis on magnetic resonance imaging. B henselae infection was confirmed by polymerase chain reaction performed on lymph node biopsy. A 34-year-old woman was investigated for fever and right upper quadrant abdominal pain. She had consulted 2 weeks before for a unique lesion of right index and an axillar adenopathy that have improved spontaneously. A technetium bone scan performed 1 week later because of a thoracic backache demonstrated an increased uptake of the T6 vertebra. Vertebral magnetic resonance imaging was compatible with a T6 osteomyelitis. B henselae infection was confirmed by serology (seroconversion). Both patients were treated with rifampin and doxycycline and recovered within 3 months. CONCLUSIONS: B henselae vertebral osteomyelitis can involve immunocompetent adults. In the case of vertebral osteomyelitis with negative blood cultures, recent history of local lymphadenopathy and cat exposure must be investigated and B henselae serology must be performed. Nevertheless, even if serology is positive, vertebral biopsy is required to rule out other pathogens or malignancy. B henselae infection can be confirmed by polymerase chain reaction performed on vertebral or lymph node biopsy.

Copyright © 2011 Elsevier Inc. All rights reserved.

PMID: 21840042 [PubMed - in process]

16. Infection. 2011 Aug 9. [Epub ahead of print]

Bilateral Bartonella henselae neuroretinitis with stellate maculopathy in a 6-year-old boy.

Metz CH, Buer J, Bornfeld N, Lipski A.

Eye Clinic, Center for Ophthalmology, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany, claudia.metz@uk-essen.de.

PURPOSE: Bartonella henselae, the cause of cat-scratch disease in humans, may lead to characteristic vision-threatening ocular findings, which importantly indicate diagnosis. METHODS: This is an observational case report of a 6-year-old boy who presented with bilateral stellate maculopathy and lymphadenopathy. RESULTS: After serologic verification of B. henselae infection, systemic azithromycin therapy initiated the full recovery of visual acuity and bilateral complete resolution of stellate exudates during the following months. CONCLUSION: Stellate maculopathy should always include the differential diagnosis of B. henselae infection. In this rare case of bilateral stellate maculopathy, we observed full recovery of function following systemic macrolide therapy.

PMID: 21826435 [PubMed - as supplied by publisher]

17. J Vet Med Sci. 2011 Dec;73(11):1513-6. Epub 2011 Jul 7.

A Serological Investigation of Bartonella henselae Infection in Cats in Turkey.

Guzel M, Celebi B, Yalcin E, Koenhemsi L, Mamak N, Pasa S, Aslan O.

Department of Internal Medicine, Faculty of Veterinary, University of Ondokuz Mayis.

Bartonella henselae is the causative agent of cat scratch disease (CSD) in humans. Cats are the main reservoir of this bacterium and may infect humans through scratches and bites. The purpose of this study was to determine the B. henselae seroprevalence in cats in Turkey. A total of 298 cats blood samples were collected from six different provinces of Turkey. Sera were tested for the presence of anti-B. henselae IgG antibodies by indirect fluorescent antibody test (IFA). The seroprevalence of B. henselae was 27.9% (83/298) for the cats examined in this study. The seroprevalence of cats by province was significantly higher in Bursa (41.3%), Adana (33.9%), Aydin (27.5%) and Burdur (32.3%) than in Kayseri (17.9%) and Istanbul (12.5%). Statistically significant differences were not observed between cat sexes and living conditions of cats. The results revealed that B. henselae is an important zoonotic pathogen in Turkey.

PMID: 21737965 [PubMed - in process]

18. 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.

Institute for Microbiology, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany.

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 - indexed for MEDLINE]

19. Case Report Med. 2011;2011:183937. Epub 2011 May 5.

Systemic Bartonella henselae Infection in Immunocompetent Adult Presenting as Fever of Unknown Origin.

Zenone T.

Department of Internal Medicine, Centre Hospitalier Général de Valence, 179 boulevard Marechal Juin, 26953 Valence Cedex 9, France.

Systemic clinical presentations of infection caused by Bartonella henselae are rare in immunocompetent adults. We report four cases with hepatic and/or splenic involvement, presenting as fever of unknown origin. We discuss diagnosis and treatment of this infection. Bartonella henselae serology allows an easy diagnosis of hepatosplenic involvement in cat scratch disease, a clinical picture that appears to be underrecognized.

PMCID: PMC3099194 PMID: 21629850 [PubMed]

20. Comp Immunol Microbiol Infect Dis. 2011 Jul;34(4):299-314. doi: 10.1016/j.cimid.2011.04.005. Epub 2011 May 25.

Bartonella species and their ectoparasites: selective host adaptation or strain selection between the vector and the mammalian host?

Tsai YL, Chang CC, Chuang ST, Chomel BB.

Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.

A wide range of blood-sucking arthropods have either been confirmed or are suspected as important vectors in Bartonella transmission to mammals, including humans. Overall, it appears that the diversity of Bartonella species DNA identified in ectoparasites is much broader than the species detected in their mammalian hosts, suggesting a mechanism of adaptation of Bartonella species to their host-vector ecosystem. However, these mechanisms leading to the fitness between the vectors and their hosts still need to be investigated.

Copyright © 2011 Elsevier Ltd. All rights reserved.

PMID: 21616536 [PubMed - indexed for MEDLINE]

21. Pediatr Radiol. 2011 May 19. [Epub ahead of print]

Thoracic vertebral osteomyelitis with paraspinous mass and intraspinal extension: An atypical presentation of cat-scratch disease.

Al-Rahawan MM, Gray BM, Mitchell CS, Smith SD.

Department of Pediatrics, University of Illinois College of Medicine at Peoria, 530 NE Glen Oak Ave., Peoria, IL, 61637, USA.

Children with cat-scratch disease (CSD) commonly present with fever and tender lymphadenopathy. The disease is mild and manifestations of infection resolve spontaneously within several weeks. However, some children with CSD have unusual features that present diagnostic challenges. Children with atypical CSD may present with prolonged fever, hepatosplenic disease or ocular disease. We performed an MRI on a child who presented with persistent back pain. The MRI demonstrated a paravertebral mass with intraspinous extension and the collapse of T7 vertebral body. A biopsy was reported to show a small round blue cell tumor. An evaluation for malignancy was negative, but Bartonella henselae DNA was detected by polymerase chain reaction on the biopsy specimen. We present this case because it is a rare but important radiological presentation of CSD.

PMID: 21594549 [PubMed - as supplied by publisher]

22. J Feline Med Surg. 2011 Aug;13(8):553-7. Epub 2011 May 13.

Prevalence of Bartonella species, haemoplasmas and Toxoplasma gondii in cats in Scotland.

Bennett AD, Gunn-Moore DA, Brewer M, Lappin MR.

Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA. alexanderbennett@mac.com

The objective of this study was to determine the prevalence rates for select infectious agents of cats presented to the Royal (Dick) School of Veterinary Studies at the University of Edinburgh, Scotland. Whole blood, serum, and oral mucosal and nail bed swabs were collected. While Ehrlichia species, Anaplasma species or Rickettsia felis DNA were not amplified from any cat, 44.2% of the cats had evidence of infection or exposure to either a Bartonella species (15.3% were seropositive and 5.8% polymerase chain reaction (PCR) positive), a haemoplasma (28.6% PCR positive), and/or Toxoplasma gondii (19.2% seropositive). No Bartonella species DNA was amplified from the nail or oral mucosal swabs despite a 5.8% amplification rate from the blood samples. This finding likely reflects the absence of Ctenocephalides felis infection from our study population, as this organism is a key component for Bartonella species translocation in cats. The results from this study support the use of flea control products to lessen exposure of cats (and people) to Bartonella species and support discouraging the feeding of raw meat to cats and preventing them from hunting to lessen T gondii infection.

Copyright © 2011 ISFM and AAFP. Published by Elsevier Ltd. All rights reserved.

PMID: 21570883 [PubMed - indexed for MEDLINE]

23. Adv Exp Med Biol. 2011;715:51-70.

Adhesins of Bartonella spp.

O'Rourke F, Schmidgen T, Kaiser PO, Linke D, Kempf VA.

Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Universitätsklinikum, Johann Wolfgang Goethe-Universität, Frankfurt am Main, Germany. ORourke@med.uni-frankfurt.de

Adhesion to host cells represents the first step in the infection process and one of the decisive features in the pathogenicity of Bartonella spp. B. henselae and B. quintana are considered to be the most important human pathogenic species, responsible for cat scratch disease, bacillary angiomatosis, trench fever and other diseases. The ability to cause vasculoproliferative disorders and intraerythrocytic bacteraemia are unique features of the genus Bartonella. Consequently, the interaction with endothelial cells and erythrocytes is a focus in Bartonella research. The genus harbours a variety of trimeric autotransporter adhesins (TAAs) such as the Bartonella adhesin A (BadA) of B. henselae and the variably expressed outer-membrane proteins (Vomps) of B. quintana, which display remarkable variations in length and modular construction. These adhesins mediate many of the biologically-important properties of Bartonella spp. such as adherence to endothelial cells and extracellular matrix proteins and induction of angiogenic gene programming. There is also significant evidence that the laterally acquired Trw-conjugation systems of Bartonella spp. mediate host-specific adherence to erythrocytes. Other potential adhesins are the filamentous haemagglutinins and several outer membrane proteins. The exact molecular functions of these adhesins and their interplay with other pathogenicity factors (e.g., the VirB/D4 type 4 secretion system) need to be analysed in detail to understand how these pathogens adapt to their mammalian hosts.

PMID: 21557057 [PubMed - indexed for MEDLINE]

24. Pediatr Infect Dis J. 2011 Jan;30(1):89, 93-4.

Bone pain and fever in an adolescent and his sibling. Cat scratch disease (CSD).

Boggs SR, Fisher RG.

Division of Pediatric Infectious Diseases, Eastern Virginia Medical School and Children's Hospital of The King's Daughters, 601 Children's Lane, Norfolk, VA 23507, USA. boggssr@chkd.org

PMID: 21513084 [PubMed - indexed for MEDLINE]

25. J Parasitol. 2011 Apr;97(2):256-8. Epub 2010 Oct 14.

Seroprevalence of Toxoplasma gondii and concurrent Bartonella spp., feline immunodeficiency virus, feline leukemia virus, and Dirofilaria immitis infections in Egyptian cats.

Al-Kappany YM, Lappin MR, Kwok OC, Abu-Elwafa SA, Hilali M, Dubey JP.

United States Department of Agriculture, Agricultural Research Service, Animal and Natural Resources Institute, Animal Parasitic Diseases Laboratory, Building 1001, Beltsville, Maryland 20705-2350 jitender.dubey@ars.usda.gov.

Toxoplasma gondii and Bartonella spp. are zoonotic pathogens of cats. Feline immunodeficiency virus (FIV) and feline leukemia virus (FeLv) are related to human immunodeficiency virus and human leukemia virus, respectively, and these viruses are immunosuppressive. In the present study, the prevalence of antibodies to T. gondii , Bartonella spp., FIV, as well as FeLv and Dirofilaria immitis antigens was determined in sera from feral cats (Felis catus) from Cairo, Egypt. Using a modified agglutination test, antibodies to T. gondii were found in 172 (95.5%) of the 180 cats with titers of 1∶5 in 9, 1∶10 in 9, 1∶20 in 3, 1∶40 in 5, 1∶80 in 5, 1∶160 in 15, 1∶320 in 22, and 1∶640 or higher in 104. Thus, 57.4% had high T. gondii titers. Antibodies to Bartonella spp. were found in 105 (59.6%) of 178, with titers of 1∶64 in 45, 1∶128 in 39, 1∶256 in 13, 1∶512 in 3, 1∶1,024 in 4, and 1∶2,048 in 1 cat. Antibodies to FIV were detected in 59 (33.9%) of 174 cats. Of 174 cats tested, antigens to FeLv, and D. immitis were detected in 8 (4.6%) and 6 (3.4%) cats, respectively. The results indicate a high prevalence of T. gondii, Bartonella spp., and FIV infections in cats from Cairo, Egypt. This is the first report of Bartonella spp., and D. immitis infection in cats in Egypt.

PMID: 21506874 [PubMed - indexed for MEDLINE]

26. Parasit Vectors. 2011 Apr 18;4:61.

Absence of zoonotic Bartonella species in questing ticks: first detection of Bartonella clarridgeiae and Rickettsia felis in cat fleas in the Netherlands.

Tijsse-Klasen E, Fonville M, Gassner F, Nijhof AM, Hovius EK, Jongejan F, Takken W, Reimerink JR, Overgaauw PA, Sprong H.

Laboratory for Zoonoses and Environmental Microbiology, National Institute for Public Health and Environment (RIVM), Bilthoven, The Netherlands.

BACKGROUND: Awareness for flea- and tick-borne infections has grown in recent years and the range of microorganisms associated with these ectoparasites is rising. Bartonella henselae, the causative agent of Cat Scratch Disease, and other Bartonella species have been reported in fleas and ticks. The role of Ixodes ricinus ticks in the natural cycle of Bartonella spp. and the transmission of these bacteria to humans is unclear. Rickettsia spp. have also been reported from as well ticks as also from fleas. However, to date no flea-borne Rickettsia spp. were reported from the Netherlands. Here, the presence of Bartonellaceae and Rickettsiae in ectoparasites was investigated using molecular detection and identification on part of the gltA- and 16S rRNA-genes. RESULTS: The zoonotic Bartonella clarridgeiae and Rickettsia felis were detected for the first time in Dutch cat fleas. B. henselae was found in cat fleas and B. schoenbuchensis in ticks and keds feeding on deer. Two Bartonella species, previously identified in rodents, were found in wild mice and their fleas. However, none of these microorganisms were found in 1719 questing Ixodes ricinus ticks. Notably, the gltA gene amplified from DNA lysates of approximately 10% of the questing nymph and adult ticks was similar to that of an uncultured Bartonella-related species found in other hard tick species. The gltA gene of this Bartonella-related species was also detected in questing larvae for which a 16S rRNA gene PCR also tested positive for "Candidatus Midichloria mitochondrii". The gltA-gene of the Bartonella-related species found in I. ricinus may therefore be from this endosymbiont. CONCLUSIONS: We conclude that the risk of acquiring Cat Scratch Disease or a related bartonellosis from questing ticks in the Netherlands is negligible. On the other hand fleas and deer keds are probable vectors for associated Bartonella species between animals and might also transmit Bartonella spp. to humans.

PMCID: PMC3087693 PMID: 21501464 [PubMed - indexed for MEDLINE]

27. Vet Pathol. 2011 Apr 13. [Epub ahead of print]

Identification of Bartonella henselae in 2 Cats With Pyogranulomatous Myocarditis and Diaphragmatic Myositis.

Varanat M, Broadhurst J, Linder KE, Maggi RG, Breitschwerdt EB.

Most cats infected with Bartonella henselae remain outwardly healthy carriers for years; however, self-limiting fever, transient anemia, neurologic dysfunction, lymphadenopathy, reproductive disorders, aortic valvular endocarditis, and neutrophilic myocarditis have been described in experimentally or naturally infected cats. Two cats in a North Carolina shelter died with pyogranulomatous myocarditis and diaphragmatic myositis. Bacteria were visualized in the lesions by Warthin-Starry silver impregnation and by B. henselae immunohistochemistry. B. henselae DNA was amplified and sequenced from the heart of 1 cat and from multiple tissue samples, including heart and diaphragm, from the second cat. This study supports a potential association between B. henselae and what has been historically described as "transmissible myocarditis and diaphragmitis" of undetermined cause in cats.

PMID: 21490304 [PubMed - as supplied by publisher]

28. Parasit Vectors. 2011 Apr 13;4:54.

Adhesion and host cell modulation: critical pathogenicity determinants of Bartonella henselae.

Franz B, Kempf VA.

University Hospital of the Johann Wolfgang Goethe-University, Institute for Medical Microbiology and Infection Control, Frankfurt am Main, Germany.

Bartonella henselae, the agent of cat scratch disease and the vasculoproliferative disorders bacillary angiomatosis and peliosis hepatis, contains to date two groups of described pathogenicity factors: adhesins and type IV secretion systems. Bartonella adhesin A (BadA), the Trw system and possibly filamentous hemagglutinin act as promiscous or specific adhesins, whereas the virulence locus (Vir)B/VirD4 type IV secretion system modulates a variety of host cell functions. BadA mediates bacterial adherence to endothelial cells and extracellular matrix proteins and triggers the induction of angiogenic gene programming. The VirB/VirD4 type IV secretion system is responsible for, e.g., inhibition of host cell apoptosis, bacterial persistence in erythrocytes, and endothelial sprouting. The Trw-conjugation system of Bartonella spp. mediates host-specific adherence to erythrocytes. Filamentous hemagglutinins represent additional potential pathogenicity factors which are not yet characterized. The exact molecular functions of these pathogenicity factors and their contribution to an orchestral interplay need to be analyzed to understand B. henselae pathogenicity in detail.

PMCID: PMC3083372 PMID: 21489243 [PubMed - indexed for MEDLINE]

29. J Med Entomol. 2011 Mar;48(2):445-52.

Prevalence of Rickettsia felis and the first identification of Bartonella henselae Fizz/CAL-1 in cat fleas (Siphonaptera: Pulicidae) from Taiwan.

Tsai KH, Huang CG, Fang CT, Shu PY, Huang JH, Wu WJ.

Infectious Diseases Research and Education Center, Department of Health, Executive Yuan and National Taiwan University, Taipei, Taiwan.

Cat fleas (Ctenocephalides felis [Bouché]) are the primary ectoparasites of dog and cat populations. In this study, we report the monthly population dynamics of Rickettsia felis and Bartonella spp. (two zoonotic pathogens that can cause human disease) in cat fleas collected from dogs and cats in Taipei, Taiwan, from December 2006 to December 2007. Natural R. felis infection in individual cat fleas was assessed by polymerase chain reaction (PCR) using pRF-, ompB-, and gltA-specific primer pairs. Samples positive by PCR were confirmed with DNA sequencing. R. felis was detected in cat fleas year round, and the average infection rate was 21.4% (90 of 420) in 2007. Cat fleas also play an important role in the transmission of Bartonella between reservoirs and other mammalian hosts. In this study, we used primer pairs specific for the Bartonella gltA and rpoB genes to detect Bartonella infections. Of the 420 cat fleas tested, 38 were positive by PCR for Bartonella. Sequence similarities to Bartonella henselae, Bartonella clarridgeiae, and Bartonella koehlerae were observed in 6.2% (26 of 420), 2.1% (9 of 420), and 0.7% (3 of 420) of the fleas, respectively. Based on the pap31 gene sequence, several amplicons of the B. henselae detected in the cat fleas could be subgrouped into three strains: Fizz/CAL-1 (n = 18), Marseille (n = 5), and Houston-1 (n = 3). These results demonstrate that cat fleas infected with R. felis are endemic to Taiwan, and highlight the role of C. felis in Bartonella transmission between reservoirs and other mammal hosts and demonstrate the genetic variability of B. henselae in Taiwan.

PMID: 21485388 [PubMed - indexed for MEDLINE]

30. J Clin Microbiol. 2011 Jun;49(6):2132-7. Epub 2011 Apr 6.

Multilocus sequence typing of Bartonella henselae in the United Kingdom indicates that only a few, uncommon sequence types are associated with zoonotic disease.

Chaloner GL, Harrison TG, Coyne KP, Aanensen DM, Birtles RJ.

Department for Infection Biology, Institute for Infection and Global Health and School of Veterinary Science, University of Liverpool, South Wirral CH64 7TE, United Kingdom. g.chaloner@liv.ac.uk

Bartonella henselae is one of the most common zoonotic agents acquired from companion animals (cats) in industrialized countries. Nonetheless, although the prevalence of infections in cats is high, the number of human cases reported is relatively low. One hypothesis for this discrepancy is that B. henselae strains vary in their zoonotic potential. To test this hypothesis, we employed structured sampling to explore the population structure of B. henselae in the United Kingdom and to determine the distribution of strains associated with zoonotic disease within this structure. A total of 118 B. henselae strains were delineated into 12 sequence types (STs) using multilocus sequence typing. We observed that most (85%) of the zoonosis-associated strains belonged to only three genotypes, i.e., ST2, ST5, and ST8. Conversely, most (74%) of the feline isolates belonged to ST4, ST6, and ST7. The difference in host association of ST2, ST5, and ST8 (zoonosis associated) and ST6 (feline) was statistically significant (P < 0.05), indicating that a few, uncommon STs were responsible for the majority of symptomatic human infections.

PMCID: PMC3122756 PMID: 21471345 [PubMed - indexed for MEDLINE]

31. Emerg Infect Dis. 2011 Apr;17(4):705-7.

Seasonality of cat-scratch disease, France, 1999-2009.

Sanguinetti-Morelli D, Angelakis E, Richet H, Davoust B, Rolain JM, Raoult D.

Université de Méditerranée, Marseille, France.

Cat-scratch disease is seasonal in the United States and Japan; but no data are available from Europe. To assess the seasonality of the disease in France, we analyzed lymph node biopsy specimens collected during 1999-2009. Most (87.5%) cases occurred during September-April and peaked in December.

PMID: 21470466 [PubMed - indexed for MEDLINE]

32. Am J Med. 2011 Mar;124(3):e1-2.

Challenges in the clinical management of blood-culture negative endocarditis: case of Bartonella henselae infection.

Gupta D, Green J, Franco-Paredes C, Lerakis S.

PMID: 21396492 [PubMed - indexed for MEDLINE]

33. Diagn Cytopathol. 2011 Mar;39(3):210-3. doi: 10.1002/dc.21401.

Combining cytomorphology and serology for the diagnosis of cat scratch disease.

Youssef D, Shams WE, El Abbassi A, Moorman JP, Al-Abbadi MA.

Department of Medicine, Division of Infectious Diseases, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37684, USA.

Cat scratch disease (CSD) is a self limited zoonotic disease that presents most commonly as a regional lymphadenopathy. We are reporting a case of a 25-year-old male patient who presented with fever and large right inguinal lymphadenopathy. The diagnosis of cat scratch disease was confirmed based on the characteristic cytopathological features on aspirate smears from the lymph node and the serological titers for Bartonella henselae. This case report emphasizes the importance of combining Bartonella serology, and cytopathology in the diagnostic work-up of febrile lymphadenopathy and suspected CSD since the culture of this organism is arduous.

Copyright © 2010 Wiley-Liss, Inc.

PMID: 21319324 [PubMed - indexed for MEDLINE]

34. Am J Dermatopathol. 2011 Jul;33(5):513-5.

Bacillary angiomatosis in an immunocompetent child: a case report and review of the literature.

Zarraga M, Rosen L, Herschthal D.

Palmetto General Hospital, Hialeah, FL, USA. drmbzarraga@gmail.com

Bacillary angiomatosis is an infectious disease caused by 2 gram-negative bacilli, Bartonella henselae and Bartonella quintana. This disease is characterized by vascular proliferations in the skin and/or visceral organs, and typically manifests in immunocompromised patients. However, we report a case of a 10-year-old immunocompetent female child with a questionable history of being scratched by a cat. Although initially diagnosed as a pyogenic granuloma, a diagnosis of bacillary angiomatosis was made based on histologic examination of the excised lesion demonstrating interstitial bacillary deposition on Warthin-Starry silver stain. The patient was successfully treated with 2 weeks of azithromycin after which all symptoms resolved.

PMID: 21285862 [PubMed - indexed for MEDLINE]

35. Vector Borne Zoonotic Dis. 2011 Jul;11(7):991-2. Epub 2011 Feb 1.

Rickettsia felis and Bartonella henselae in fleas from Lebanon.

Mba PA, Marié JL, Rolain JM, Davoust B, Beaucournu JC, Raoult D, Parola P.

Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes, UMR CNRS 6236-IRD UMR 198, Faculté de Médecine, WHO Collaborative Center for Rickettsioses and Other Arthropod Borne Bacterial Diseases, Université de la Méditerranée, Marseille, France.

A total of 155 fleas collected in 2009 in Lebanon from 16 cats (104 Ctenocephalides felis specimens, 1 C. canis specimen) and 2 dogs (50 C. canis specimens) were tested for the presence of Rickettsia spp. and Bartonella spp. using molecular methods, including real-time quantitative polymerase chain reaction (PCR), regular PCR, and sequencing of amplified PCR products. Rickettsia felis, the agent of the emerging flea-borne spotted fever in humans, was identified in 17 (16%) C. felis cat fleas. Bartonella henselae, an agent of cat scratch disease, was identified in three (2.9%) C. felis. Our results emphasize the potential risk of these emerging flea-borne infections in Lebanon.

PMID: 21284512 [PubMed - in process]

36. Cornea. 2011 Jul;30(7):807-14.

Molecular detection of Bartonella henselae for the diagnosis of cat scratch disease and bacillary angiomatosis of the conjunctiva.

Mitchell BM, Font RL.

Department of Ophthalmology, Ophthalmic Pathology Laboratory, Cullen Eye Institute, Baylor College of Medicine, Houston, TX, USA.

PURPOSE: The purpose of this study was to evaluate clinical cases of cat scratch disease (CSD) and bacillary angiomatosis involving the conjunctiva by special stains and transmission electron microscopy (TEM) and to compare these findings with the results from species-specific polymerase chain reaction (PCR) analysis of the same specimens. METHODS: Six potential cases of CSD and 2 possible cases of bacillary angiomatosis of the conjunctiva were analyzed by light microscopy, the Warthin-Starry technique, TEM, and PCR. DNA isolated from cultured Bartonella henselae, B. bacilliformis, B. quintana, and B. elizabethae were used as control templates for establishment of the PCR sensitivity and specificity. Cultured DNA was also used as appropriate positive controls during analysis of the clinical specimens. RESULTS: The histological studies, electron microscopy, and the PCR analysis confirmed the identification of the bacilli within the involved tissues. Furthermore, molecular diagnosis by PCR allowed for speciation of the infecting Bartonella organisms in 6 of the 8 cases and correlated with the histological findings. CONCLUSIONS: The PCR-based identification of Bartonella correlated well with the results of light microscopy and TEM and provided a simple and rapid method of diagnosis to the species level. The molecular analysis may prove to be beneficial in enhancing the current diagnostic techniques for CSD and bacillary angiomatosis.

PMID: 21282991 [PubMed - indexed for MEDLINE]

37. J Am Vet Med Assoc. 2011 Feb 1;238(3):311-7.

Prevalence of infectious diseases in cats and dogs rescued following Hurricane Katrina.

Levy JK, Lappin MR, Glaser AL, Birkenheuer AJ, Anderson TC, Edinboro CH.

Maddie's Shelter Medicine Program, Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610, USA. levyjk@ufl.edu

OBJECTIVE: To determine the prevalence of infectious diseases of animal and zoonotic importance in cats and dogs rescued and transferred from the Gulf Coast region following Hurricane Katrina. DESIGN: Cross-sectional study. ANIMALS: 414 dogs and 56 cats rescued and transferred from the Gulf Coast region within 4 months after the hurricane. PROCEDURES: EDTA-anticoagulated blood and serum samples were tested via PCR and serologic assays for infectious diseases. RESULTS: In dogs, prevalence was highest for anti-West Nile virus (WNV) antibodies (218/390 [55.9%]), Dirofilaria immitis antigen (195/400 [48.8%]), anti-Toxoplasma gondii antibodies (92/366 [25.1%]), and hemotropic mycoplasma DNA (40/345 [11.9%]). The DNA of Bartonella spp, Ehrlichia spp, or Babesia spp or anti-canine influenza virus antibodies were identified in < 2% of dogs. In cats, prevalence was highest for antibodies against Bartonella spp and DNA of Bartonella spp combined (49/55 [89.1 %]), anti-T gondii antibodies (13/55 [23.6%]), hemotropic mycoplasma DNA (5/47 [10.6%]), anti-WNV antibodies (5/48 [10.4%]), D immitis antigen (4/50 [8.0%]), and anti-FIV antibodies (4/56 [7.1%]). A total of 308 (74.4%) dogs and 52 (92.9%) cats had evidence of previous or current vector-borne infections. CONCLUSIONS AND CLINICAL RELEVANCE: Cats and dogs rescued from the disaster region had evidence of multiple infectious diseases. The dispersal of potentially infectious animals to other regions of North America where some infections were not typically found could have contributed to new geographic ranges for these organisms or to underdiagnosis in affected animals because of a low index of suspicion in regions with low disease prevalence.

PMID: 21281213 [PubMed - indexed for MEDLINE]

38. Arq Bras Oftalmol. 2010 Dec;73(6):537-8.

Optic neuropathy secondary to cat scratch disease: case report.

Aragão RE, Ramos RM, Bezerra AF, Cavalcanti Júnior RB, Albuquerque TL.

Hospital Universitário Walter Cantídio, Universidade Federal do Ceará, Fortaleza, CE, Brazil. ricardomarrocos@yahoo.com

Comment in Arq Bras Oftalmol. 2011 Apr;74(2):147.

Optic neuropathy due to cat scratch disease is a relatively infrequent occurrence associated with macular star formation and is characterized by sudden painless loss of vision mostly unilateral. Bartonella henselae is well recognized as the etiologic agent in cat scratch disease. Ocular complications of the disease occur in up to 10% of patients and include neuroretinitis. Ocular bartonelosis is usually self-limited with complete or near-complete recovery of vision in otherwise healthy patients. A case of a boy with neuroretinitis caused by B. henselae is reported.

PMID: 21271032 [PubMed - indexed for MEDLINE]

39. Int Ophthalmol. 2011 Apr;31(2):125-8. Epub 2011 Jan 26.

Unusual retinal manifestations of cat scratch disease.

Pinna A, Puglia E, Dore S.

Institute of Ophthalmology, University of Sassari, 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 hand motion. 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.

PMID: 21267628 [PubMed - indexed for MEDLINE]

40. Am Fam Physician. 2011 Jan 15;83(2):152-5.

Cat-scratch Disease.

Klotz SA, Ianas V, Elliott SP.

University of Arizona, Tucson, 85724, USA. sklotz@u.arizona.edu

Cat-scratch disease is a common infection that usually presents as tender lymphadenopathy. It should be included in the differential diagnosis of fever of unknown origin and any lymphadenopathy syndrome. Asymptomatic, bacteremic cats with Bartonella henselae in their saliva serve as vectors by biting and clawing the skin. Cat fleas are responsible for horizontal transmission of the disease from cat to cat, and on occasion, arthropod vectors (fleas or ticks) may transmit the disease to humans. Cat-scratch disease is commonly diagnosed in children, but adults can present with it as well. The causative microorganism, B. henselae, is difficult to culture. Diagnosis is most often arrived at by obtaining a history of exposure to cats and a serologic test with high titers (greater than 1:256) of immunoglobulin G antibody to B. henselae. Most cases of cat-scratch disease are self-limited and do not require antibiotic treatment. If an antibiotic is chosen, azithromycin has been shown in one small study to speed recovery. Infrequently, cat-scratch disease may present in a more disseminated form with hepatosplenomegaly or meningoencephalitis, or with bacillary angiomatosis in patients with AIDS.

PMID: 21243990 [PubMed - indexed for MEDLINE]

41. Laryngoscope. 2010;120 Suppl 4:S222.

Cat scratch disease presenting as acute mastoiditis.

Cheung VW, Moxham JP.

University of British Columbia, Division of Otolaryngology-Head and Neck Surgery, Canada. veroniquewan@gmail.com

OBJECTIVE: To present the first published case of Cat Scratch Disease presenting as acute mastoiditis and review the relevant literature to discuss the Otolaryngologic manifestations of this disease and its treatment. DESIGN: A case report and literature review of the Otolaryngologic manifestations of Cat Scratch Disease. METHODS: A case report of a clinical scenario followed by a standard literature review. PubMed, EMBASE, and Cochrane database were used to find articles related to the Otolaryngologic manifestations of Cat Scratch Disease. RESULTS: A 6 year-old female presented to the Otolaryngologist with the typical appearance of acute mastoiditis. CT Scan confirmed breakdown of the osseous septae of the mastoid and mastoidectomy was undertaken. Granulation tissue and infected lymph nodes adjacent to the mastoid cortex were positive for Cat Scratch Disease. The patient was treated expectantly and recovered uneventfully. CONCLUSION: This is the first literature report of Cat Scratch Disease presenting as an acute mastoiditis.

PMID: 21225820 [PubMed - indexed for MEDLINE]

42. Arch Neurol. 2011 Jan;68(1):122-6.

Suspecting optic neuritis, diagnosing Bartonella cat scratch disease.

Gan JJ, Mandell AM, Otis JA, Holmuhamedova M, Perloff MD.

Department of Neurology, Boston University School of Medicine, Boston University Medical Center, Boston, USA.

BACKGROUND: Bartonella cat scratch disease is classically a febrile illness, in conjunction with lymphadenopathy and cat exposure. OBJECTIVE: To report 2 atypical cases of cat scratch disease with only blurred vision and headache. DESIGN: Case reports. SETTING: University hospital. PATIENTS: Two young adults with unilateral blurred vision, retro-orbital headache, and a positive Bartonella henselae serologic result, without fever or lymphadenopathy. MAIN OUTCOME MEASURES: Funduscopic examination and B henselae serologic findings. RESULTS: Both patients had optic disc swelling and a macular star on funduscopic examination, suggestive of infection. Infection was confirmed by positive serologic results. CONCLUSION: Cat scratch disease should be considered in the differential diagnosis for patients presenting with blurred vision and headache, even in the absence of fever, lymphadenopathy, or both.

PMID: 21220684 [PubMed - indexed for MEDLINE]

43. Rev Chilena Infectol. 2010 Oct;27(5):417-22.

[Cat scratch disease associated neuroretinitis: clinical report and review of the literature].

[Article in Spanish]

Pérez G J, Munita S JM, Araos B R, López G JP, Stevenson A R, González A P, Pérez C D, Noriega R LM.

Clinica Alemana, Santiago, Chile. Departamento de Medicina Interna.

Cat scratch disease is the main clinical presentation of Bartonella henselae infection. However, ocular manifestations of bartonellosis occur in about 5 to 10% of the patients, mainly presenting as neuroretinitis, choroiditis or oculoglandular syndrome of Parinaud. We describe two patients with documented B. henselae infection and typical ocular compromise. Both patients were treated and had a favorable visual outcome.

PMID: 21186508 [PubMed - indexed for MEDLINE]

44. Future Microbiol. 2010 Nov;5(11):1719-31.

Bartonella infection: treatment and drug resistance.

Biswas S, Rolain JM.

CNRS-IRD, UMR 6236, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, 27 boulevard Jean-Moulin, Marseille cedex 05, France.

Bartonella species, which belong to the α-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.

PMID: 21133691 [PubMed - indexed for MEDLINE]

45. Emerg Infect Dis. 2010 Dec;16(12):1983-5.

Multispacer typing of Bartonella henselae isolates from humans and cats, Japan.

Yanagihara M, Tsuneoka H, Sugasaki M, Nojima J, Ichihara K.

Yamaguchi University, Ube, Yamaguchi, Japan. m-yanagi@yamaguchi-u.ac.jp

To determine genotypic distribution of and relationship between human and cat strains of Bartonella henselae,we characterized 56 specimens using multispacer typing (MST). Of 13 MST genotypes identified, 12 were grouped into cluster 1. In Japan, human infections can be caused by B. henselae strains in cluster 1.

PMID: 21122238 [PubMed - indexed for MEDLINE]

46. Emerg Infect Dis. 2010 Dec;16(12):1963-5.

Bartonella henselae in skin biopsy specimens of patients with cat-scratch disease.

Angelakis E, Edouard S, La Scola B, Raoult D.

Université de Méditerranée, Marseille, France.

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.

PMID: 21122232 [PubMed - indexed for MEDLINE]

47. Mem Inst Oswaldo Cruz. 2010 Nov;105(7):873-8.

Prevalence of Bartonella henselae and Bartonella clarridgeiae in cats in the south of Brazil: a molecular study.

Staggemeier R, Venker CA, Klein DH, Petry M, Spilki FR, Cantarelli VV.

Laboratório de Biomedicina, Universidade Feevale, Novo Hamburgo, RS, Brasil. rstaggemeier@gmail.com

Bartonella spp are the causative agent of cat scratch disease in humans. Cats are the natural reservoir of these bacteria and may infect humans through scratches, bites or fleas. Blood samples from 47 cats aged up to 12 months were collected for this study. All animals were lodged in municipal animal shelters in the Vale do Sinos region, Rio Grande do Sul, Brazil. Bartonella spp were detected by genus-specific polymerase chain reaction (PCR) and when the PCR was positive, the species were determined by DNA sequencing. A Giemsa-stained blood smear was also examined for the presence of intraerythrocytic elements suggestive of Bartonella spp infection. Phylogenetic analysis was also performed for all positive samples. Using molecular detection methods, Bartonella spp were detected in 17.02% (8/47) of the samples. In seven out of eight samples confirmed to be positive for Bartonella spp, blood smear examination revealed the presence of intraerythrocytic elements suggestive of Bartonella spp. Phylogenetic analysis characterized positive samples as Bartonella henselae (5) or Bartonella clarridgeiae (3). To the best of our knowledge, this is the first molecular study demonstrating the presence of Bartonella spp in cats from the Southern Region of Brazil.

PMID: 21120356 [PubMed - indexed for MEDLINE]

48. Cornea. 2011 Apr;30(4):468-71.

Cat-scratch uveitis confirmed by histological, serological, and molecular diagnoses.

Font RL, Del Valle M, Mitchell BM, Boniuk M.

Ophthalmic Pathology Laboratory, Cullen Eye Institute, Baylor College of Medicine, Houston, TX, USA. rfont@bcm.edu

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.

PMID: 21099401 [PubMed - indexed for MEDLINE]

49. Mikrobiyol Bul. 2010 Jul;44(3):489-494.

[Fever of unknown origin and detection of Bartonella henselae IgG seropositivity: a case report.]

[Article in Turkish]

Celebi B, Yalçın E, Babür C.

Refik Saydam Hıfzıssıhha Merkezi Başkanlığı, Salgın Hastalıklar Araştırma Müdürlüğü, Ankara, Türkiye. vetbekir@yahoo.com.

Bartonella henselae, is a gram-negative bacterium which causes cat scratch disease (CSD) in man. There are sporadic case reports of CSD in Turkey. Cats play an important reservoir role for B.henselae transmission to man. In this report, a cat owner with fever of unknown origin was presented. Bartonella spp. was isolated from the blood culture of cat which had chronic progressive gingivostomatitis. B.henselae was identified by amplification of a region of citrate synthase (gltA) gene by using polymerase cha-in reaction and typed as genotype I by restriction fragment length polymorphism method. Following this identification the cat owner was investigated for the history of CSD and it was learned that he had a history of fever of unknown origin. The investigation of the patient's serum for the presence of specific B.henselae antibodies by immune fluorescence antibody test (Vircell, Spain) revealed B.henselae IgG type antibodies at a titer of 1:128. Gingivostomatitis in cats may act as a reservoir for Bartonella infection. Thus during the evaluation of patients with fever of unknown origin, Bartonella infections should be considered and possible contact with cats/dogs should be investigated.

PMID: 21064000 [PubMed - as supplied by publisher]

50. Berl Munch Tierarztl Wochenschr. 2010 Sep-Oct;123(9-10):369-76.

Relevance of feline calicivirus, feline immunodeficiency virus, feline leukemia virus, feline herpesvirus and Bartonella henselae in cats with chronic gingivostomatitis.

Belgard S, Truyen U, Thibault JC, Sauter-Louis C, Hartmann K.

Medizinische Kleintierklinik der Ludwig-Maximilians-Universität München, Germany.

Despite its common occurrence, the aetiology of chronic gingivostomatitis in cats remains uncertain. Aetiology is likely multifactorial, and several infectious agents may be associated with chronic gingivostomatitis. The purpose of this study was to investigate the prevalence of feline calicivirus (FCV), feline immunodeficiency virus (FIV), feline leukemia virus (FeLV), feline herpesvirus (FHV), and Bartonella henselae (B. henselae) in cats with chronic gingivostomatitis and in an age-matched control group. In addition, other factors, e. g., environmental conditions were investigated. In 52 cats with chronic gingivostomatitis and 50 healthy age-matched control cats, the presence of FCV ribonucleic acid (RNA), and FHV deoxyribonucleic acid (DNA) (polymerase chain reaction [PCR] from oropharyngeal swabs), and B. henselae DNA (PCR from oropharyngeal swabs and blood), as well as FeLV antigen (serum), and antibodies against FCV, B. henselae, and FIV (serum) were examined. FCV RNA was significantly more common in cats with chronic gingivostomatitis (53.8%, p < 0.001) than in controls (14.0%); a significant difference was also found in the prevalence of antibodies to FCV between the cats with chronic gingivostomatitis (78.8%, p = 0.023) and controls (58.0%). Of the other infectious agents investigated, there was no significant difference in the prevalence between the cats with chronic gingivostomatitis and the controls. The results of this study allow the conclusion that FCV, but no other infectious agents, is commonly associated with chronic gingivostomatitis in cats.

PMID: 21038808 [PubMed - indexed for MEDLINE]

51. Ocul Immunol Inflamm. 2011 Feb;19(1):62-4. Epub 2010 Oct 31.

Occlusive vasculitis and optic disk neovascularization associated with neuroretinitis.

Fonollosa A, Galdos M, Artaraz J, Perez-Irezabal J, Martinez-Alday N.

Department of Ophthalmology, Cruces Hospital, University of the Basque Country, Vizcaya, Spain. 36427afc@comb.es

PURPOSE: To report a case of neuroretinitis associated with ischemic nasal branch retinal vein occlusion, periphlebitis, and neovascularization of the optic disk. METHODS: Case report. RESULTS: A 32-year-old man presented with a typical image of neuroretinitis, retinal hemorrhages and sheathing of the retinal veins in the nasal retina. His left hand had been bitten by a kitten 8 weeks before. Serology for Bartonella henselae was negative. On the 6th week of follow-up, optic disk neovascularization developed, which required retinal photocoagulation. Photocoagulation was performed again at the 12th and 18th week revision since further new vessels had developed. At the 32nd week of follow-up neovascularization had regressed. CONCLUSIONS: Neuroretinitis may be associated with severe complications such as retinal vascular occlusions and optic disk neovascularization.

PMID: 21034304 [PubMed - indexed for MEDLINE]

52. Vector Borne Zoonotic Dis. 2011 May;11(5):471-7. Epub 2010 Oct 25.

Bartonella henselae and the potential for arthropod vector-borne transmission.

Mosbacher ME, Klotz S, Klotz J, Pinnas JL.

Third World Veterinary, Fountain Hills, Arizona 85269, USA. markmosbacher@hotmail.com

INTRODUCTION: Bartonella henselae, the causative agent of the illness referred to as 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 B. henselae. MATERIALS AND METHODS: Literature regarding arthropod transmission of B. henselae was reviewed. RESULTS: B. henselae appears to be transmitted among cats and dogs in vivo exclusively by arthropod vectors (excepting perinatal transmission), not by biting and scratching. In the absence of these vectors disease does not spread. On the other hand, disease can be spread to humans by bites and scratches, and it is highly likely that it is spread as well by arthropod vectors. DISCUSSION: Clinicians should be aware that a common illness, infection with B. henselae, can be transmitted by arthropod vectors and a history of an animal scratch or bite is not necessary for disease transmission.

PMID: 20973657 [PubMed - in process]

53. Nihon Rinsho. 2010 Jun;68 Suppl 6:244-7.

[Cat-scratch disease].

[Article in Japanese]

Maruyama S.

Laboratory of Veterinary Public Health, Department of Veterinary Medicine, College of Bio-resource Sciences, Nihon University.

PMID: 20942049 [PubMed - indexed for MEDLINE]

54. 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 © 2010 Elsevier Inc. All rights reserved.

PMID: 20933137 [PubMed - indexed for MEDLINE]

55. Vet Microbiol. 2011 Mar 24;148(2-4):238-45. Epub 2010 Sep 21.

Combined MLST and AFLP typing of Bartonella henselae isolated from cats reveals new sequence types and suggests clonal evolution.

Mietze A, Morick D, Köhler H, Harrus S, Dehio C, Nolte I, Goethe R.

Institut für Mikrobiologie, Stiftung Tierärztliche Hochschule Hannover, Germany.

Bartonella species are Gram-negative, fastidious bacteria. Bartonella henselae is found in cats and transmitted to humans via cat scratches or bites causing cat-scratch disease, characterized by clinical symptoms with varying severity. The prevalence of bartonellosis among humans in Germany appears to be high, and severe clinical cases have been described. However, epidemiological data of B. henselae in cats are rare. In this study we determined the detection rates of Bartonella ssp. in cats by culture and real-time PCR. Furthermore, B. henselae isolates were genetically characterized by highly discriminatory amplified fragment length polymorphism (AFLP) and multilocus sequence typing (MLST). Bartonella spp. were isolated by culture from 11 (2.2%) of 507 blood samples. Out of 169 blood samples additionally analyzed by PCR, 28 (16.6%) were found positive for Bartonella spp., illustrating the advantage of PCR in Bartonella spp. detection. PCR-REA identified B. henselae in 27 cats and Bartonella clarridgeiae in one cat. B. henselae isolates from different geographical regions in Germany were genetically characterized by AFLP and MLST. Both methods confirmed genetic diversity of B. henselae on the strain level. MLST identified 11 new sequence types, all of them assigned to three clonal complexes as determined by eBURST. AFLP typing revealed genetic relation among the B. henselae isolates from the same geographical region. Combining AFLP typing and MLST/eBURST analyses revealed that B. henselae of the same AFLP subcluster belonged to the same clonal complex. Altogether these results indicate that B. henselae may evolve clonally.

Copyright © 2010 Elsevier B.V. All rights reserved.

PMID: 20863631 [PubMed - indexed for MEDLINE]

56. Diagn Microbiol Infect Dis. 2010 Oct;68(2):174-6.

A first Japanese case of Bartonella henselae-induced endocarditis diagnosed by prolonged culture of a specimen from the excised valve.

Tsuneoka H, Yanagihara M, Otani S, Katayama Y, Fujinami H, Nagafuji H, Asari S, Nojima J, Ichihara K.

Department of Basic Laboratory Science, Graduate School of Medicine, Yamaguchi University, 1-1 Minami-Kogushi, Ube, Yamaguchi, Japan. htsune@yamaguchi-u.ac.jp

Bartonella henselae, the causative agent of cat scratch disease, is increasingly recognized as a cause of culture-negative endocarditis. This report describes the first Japanese case, which was diagnosed after a prolonged culture of the excised aortic valve. High IgG and IgM titers to B. henselae pointed to a subacute course of the disease.

Copyright © 2010 Elsevier Inc. All rights reserved.

PMID: 20846591 [PubMed - indexed for MEDLINE]

57. Rev Esp Quimioter. 2010 Sep;23(3):109-14.

[Treatment of human infections caused by Bartonella spp.].

[Article in Spanish]

Pérez-Martínez L, Blanco JR, Oteo JA.

Area de Enfermedades Infecciosas, Hospital San Pedro-Centro de Investigación Biomédica de La Rioja, Logroño, Spain.

Infections by Bartonella spp. include a wide spectrum of emerging and re-emerging infectious diseases. There is not a universal therapy for this infection, therefore treatment should be chosen individually. The aim of this review is to update the therapeutics aspects of this kind of infections.

PMID: 20844840 [PubMed - indexed for MEDLINE]

58. BMC Med Genomics. 2010 Sep 13;3:40.

Impairment of circulating endothelial progenitors in Down syndrome.

Costa V, Sommese L, Casamassimi A, Colicchio R, Angelini C, Marchesano V, Milone L, Farzati B, Giovane A, Fiorito C, Rienzo M, Picardi M, Avallone B, Marco Corsi M, Sarubbi B, Calabrò R, Salvatore P, Ciccodicola A, Napoli C.

Institute of Genetics and Biophysics A, Buzzati-Traverso, IGB-CNR, Naples, Italy.

BACKGROUND: Pathological angiogenesis represents a critical issue in the progression of many diseases. Down syndrome is postulated to be a systemic anti-angiogenesis disease model, possibly due to increased expression of anti-angiogenic regulators on chromosome 21. The aim of our study was to elucidate some features of circulating endothelial progenitor cells in the context of this syndrome. METHODS: Circulating endothelial progenitors of Down syndrome affected individuals were isolated, in vitro cultured and analyzed by confocal and transmission electron microscopy. ELISA was performed to measure SDF-1α plasma levels in Down syndrome and euploid individuals. Moreover, qRT-PCR was used to quantify expression levels of CXCL12 gene and of its receptor in progenitor cells. The functional impairment of Down progenitors was evaluated through their susceptibility to hydroperoxide-induced oxidative stress with BODIPY assay and the major vulnerability to the infection with human pathogens. The differential expression of crucial genes in Down progenitor cells was evaluated by microarray analysis. RESULTS: We detected a marked decrease of progenitors' number in young Down individuals compared to euploid, cell size increase and some major detrimental morphological changes. Moreover, Down syndrome patients also exhibited decreased SDF-1α plasma levels and their progenitors had a reduced expression of SDF-1α encoding gene and of its membrane receptor. We further demonstrated that their progenitor cells are more susceptible to hydroperoxide-induced oxidative stress and infection with Bartonella henselae. Further, we observed that most of the differentially expressed genes belong to angiogenesis, immune response and inflammation pathways, and that infected progenitors with trisomy 21 have a more pronounced perturbation of immune response genes than infected euploid cells. CONCLUSIONS: Our data provide evidences for a reduced number and altered morphology of endothelial progenitor cells in Down syndrome, also showing the higher susceptibility to oxidative stress and to pathogen infection compared to euploid cells, thereby confirming the angiogenesis and immune response deficit observed in Down syndrome individuals.

PMCID: PMC2949777 PMID: 20836844 [PubMed - indexed for MEDLINE]

59. Int J Med Microbiol. 2011 Jan;301(1):7-15. Epub 2010 Sep 15.

Bartonella spp.: throwing light on uncommon human infections.

Kaiser PO, Riess T, O'Rourke F, Linke D, Kempf VA.

Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Universitätsklinikum, Johann Wolfgang Goethe-Universität, Paul Ehrlich-Str. 40, 60596 Frankfurt am Main, Germany.

After 2 decades of Bartonella research, knowledge on transmission and pathology of these bacteria is still limited. Bartonella spp. have emerged to be important pathogens in human and veterinary medicine. For humans, B. henselae is considered to represent the most relevant zoonotic Bartonella species and is responsible for cat scratch disease, bacillary angiomatosis, and other disorders. Over the years, many Bartonella species have been isolated from humans, cats, dogs, and other mammals, and infections range from an asymptomatic state (e.g., animal-specific species) to even life-threatening diseases (e.g., Oroya fever). It is obvious that the analysis of pathogenicity mechanisms underlying Bartonella infections is needed to increase our understanding of how these pathogens adapt to their mammalian hosts resulting in acute or chronic diseases.

Copyright © 2010. Published by Elsevier GmbH.

PMID: 20833105 [PubMed - indexed for MEDLINE]

60. 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.

PMID: 20825068 [PubMed - indexed for MEDLINE]

61. 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, USA.

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.

PMID: 20823366 [PubMed - indexed for MEDLINE]

62. J Feline Med Surg. 2010 Dec;12(12):923-8.

Bartonella species, feline herpesvirus-1, and Toxoplasma gondii PCR assay results from blood and aqueous humor samples from 104 cats with naturally occurring endogenous uveitis.

Powell CC, McInnis CL, Fontenelle JP, Lappin MR.

Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA. ceep@colostate.edu

Toxoplasma gondii, Bartonella henselae and feline herpesvirus-1 (FHV-1) have been implicated as causative agents in feline uveitis. The usefulness of serum and aqueous humor (AH) antibody testing for these agents is limited as antibodies can be detected in both healthy cats and cats with uveitis. Very few studies using polymerase chain reaction (PCR) assays to amplify organism DNA from samples from cats with uveitis have been performed. In this study, assays to detect T gondii antibodies, feline leukemia virus antigen, feline immunodeficiency virus antibody, and Bartonella species antibodies were performed on serum and PCR assays for amplification of T gondii, Bartonella species, and FHV-1 DNA were performed on blood and AH samples from 104 cats with endogenous uveitis and 19 healthy cats. Results suggest the addition of the PCR assay to the diagnostic work-up for cats with uveitis will increase the detection of T gondii and FHV-1; however, the diagnostic usefulness of these additional data is not clear.

Copyright © 2010 ISFM and AAFP. Published by Elsevier Ltd. All rights reserved.

PMID: 20817587 [PubMed - indexed for MEDLINE]

63. Clin Dermatol. 2010 Sep-Oct;28(5):483-8.

Skin diseases associated with Bartonella infection: facts and controversies.

Piérard-Franchimont C, Quatresooz P, Piérard GE.

Department of Dermatopathology, University Hospital of Liège, Liège, Belgium.

The genus Bartonella is composed of a series of species and subspecies. Ten of them are responsible for human infections. The best-identified diseases are cat scratch disease (B henselae and possibly B clarridgeiae), trench fever (B quintana), bacillary angiomatosis (B quintana and B henselae), and the spectrum of verruga peruana, Carrion disease, and Oroya fever (B bacilliformis). Controversies exist about the implication of a few other microorganisms being involved in these diseases. Several other conditions have been associated with the presence of Bartonella spp, but these observations await confirmation.

Copyright 2010 Elsevier Inc. All rights reserved.

PMID: 20797506 [PubMed - indexed for MEDLINE]

64. Parasit Vectors. 2010 Aug 24;3:76.

PCR amplification of Bartonella koehlerae from human blood and enrichment blood cultures.

Breitschwerdt EB, Maggi RG, Robert Mozayeni B, Hegarty BC, Bradley JM, Mascarelli PE.

Intracellular Pathogens Research Laboratory and the Center for Comparative Medicine and Translational Research, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA. ed_breitschwerdt@ncsu.edu.

ABSTRACT:BACKGROUND: Cats appear to be the primary reservoir host for Bartonella koehlerae, an alpha Proteobacteria that is most likely transmitted among cat populations by fleas (Ctenocephalides felis). Bartonella koehlerae has caused endocarditis in a dog and in one human patient from Israel, but other clinically relevant reports involving this bacterium are lacking. Despite publication of numerous, worldwide epidemiological studies designed to determine the prevalence of Bartonella spp. bacteremia in cats, B. koehlerae has never been isolated using conventional blood agar plates. To date, successful isolation of B. koehlerae from cats and from the one human endocarditis patient has consistently required the use of chocolate agar plates. RESULTS: In this study, Bartonella koehlerae bacteremia was documented in eight immunocompetent patients by PCR amplification and DNA sequencing, either prior to or after enrichment blood culture using Bartonella alpha Proteobacteria growth medium. Presenting symptoms most often included fatigue, insomnia, joint pain, headache, memory loss, and muscle pain. Four patients were also infected with Bartonella vinsonii subsp. berkhoffii genotype II. After molecular documentation of B. koehlerae infection in these patients, a serological test was developed and serum samples were tested retrospectively. Bartonella koehlerae antibodies were not detected (titers < 1:16) in 30 healthy human control sera, whereas five of eight patient samples had B. koehlerae antibody titers of 1:64 or greater. CONCLUSIONS: Although biased by a study population consisting of individuals with extensive arthropod and animal exposure, the results of this study suggest that B. koehlerae bacteremia is more common in immunocompetent people than has been previously suspected. Future studies should more thoroughly define modes of transmission and risk factors for acquiring infection with B. koehlerae. In addition, studies are needed to determine if B. koehlerae is a cause or cofactor in the development of arthritis, peripheral neuropathies or tachyarrhythmias in patients.

PMCID: PMC2936392 PMID: 20735840 [PubMed - in process]

65. J Neurol Neurosurg Psychiatry. 2011 Jun;82(6):707-8. Epub 2010 Aug 14.

Neuralgic amyotrophy associated with Bartonella henselae infection.

Stek CJ, van Eijk JJ, Jacobs BC, Enting RH, Sprenger HG, van Alfen N, van Assen S.

PMID: 20710009 [PubMed - indexed for MEDLINE]

66. Med Vet Entomol. 2010 Dec;24(4):449-55. doi: 10.1111/j.1365-2915.2010.00901.x.

Real-time and multiplex real-time polymerase chain reactions for the detection of Bartonella henselae within cat flea, Ctenocephalides felis, samples.

Robinson MT, Morgan ER, Woods D, Shaw SE.

School of Clinical Veterinary Science, University of Bristol, Langford, UK. m.robinson@bristol.ac.uk

Bartonella henselae (Rhizobiales: Bartonellacae), the agent of cat-scratch disease, is an emerging bacterial pathogen which can be transmitted via infective faecal material of Ctenocephalides felis Bouché (Siphonaptera: Pulicidae). Worldwide, B. henselae has been identified in 1-53% of felines and 2.9-17.4% of fleas. Although culture is the routine method for detection, the procedure is time-consuming and is rarely used for isolation directly from flea vectors. The current study reports the development of a quantitative real-time polymerase chain reaction (qPCR) to detect and quantify B. henselae organisms from vector samples. The qPCR is specific and detects as few as 2.5 genome copies. To enable direct quantification of Bartonella organisms in different vector samples, we developed a qPCR to detect C. felis DNA that also acts as an extraction control. Combining both PCRs into a multiplex format validates B. henselae results when sampling flea populations, although there is a reduction in sensitivity. This reduction might be counteracted by a different combination of probe fluorophores.

© 2010 The Authors. Medical and Veterinary Entomology © 2010 The Royal Entomological Society.

PMID: 20704655 [PubMed - indexed for MEDLINE]

67. J Clin Microbiol. 2010 Oct;48(10):3782-5. Epub 2010 Aug 11.

Human coinfection with Bartonella henselae and two hemotropic mycoplasma variants resembling Mycoplasma ovis.

Sykes JE, Lindsay LL, Maggi RG, Breitschwerdt EB.

Department of Medicine & Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, CA 95616, USA. jesykes@ucdavis.edu

Two variants of an organism resembling the ovine hemoplasma, Mycoplasma ovis, were detected by PCR in blood samples from a veterinarian in Texas. Coinfection with similar variants has been described in sheep. This represents the first report of human infection with this organism. The veterinarian was coinfected with Bartonella henselae.

PMCID: PMC2953074 PMID: 20702675 [PubMed - indexed for MEDLINE]

68. FEMS Microbiol Lett. 2010 Sep 1;310(2):158-67. Epub 2010 Jul 9.

Identification of candidate proteins for the diagnosis of Bartonella henselae infections using an immunoproteomic approach.

Saisongkorh W, Kowalczewska M, Azza S, Decloquement P, Rolain JM, Raoult D.

URMITE CNRS-IRD UMR6236, IFR 48, Faculté de Médecine et de Pharmacie, Marseille, France.

Bartonella henselae is an emerging gram-negative facultative intracellular pathogen transmitted via Ctenocephalides felis (cat fleas) or cat scratches. Bartonellosis is present mainly in the form of cat scratch disease (CSD), bacillary angiomatosis and infective endocarditis (IE). The methods used to diagnose B. henselae rely on culturing, immunofluorescent assays and molecular techniques. The objective of the present study was to identify candidate proteins for the serodiagnosis of bartonellosis with the differential discrimination of both clinical scenarios: CSD and IE. For this, an immunoproteomic approach combined with 2-DE, immunoblotting and matrix-assisted laser desorption/ionization time-of-flight MS has been developed. Immunoproteomic profiles of sera collected from patients with CSD and IE were compared with those of blood donors. We identified several candidate proteins as phage-encoding Pap31 protein and an outer membrane protein of BH11510 that, in our view, might be useful for the serodiagnosis of bartonellosis.

PMID: 20695898 [PubMed - indexed for MEDLINE]

69. Int Ophthalmol. 2010 Oct;30(5):553-8. Epub 2010 Jul 30.

Cat-scratch disease: ocular manifestations and visual outcome.

Curi AL, Machado D, Heringer G, Campos WR, Lamas C, Rozental T, Gutierres A, Orefice F, Lemos E.

Department of Ophthalmology, Instituto de Pesquisa Clinica Evandro Chagas, IPEC-FIOCRUZ, R. Francisco Dutra 150/801, Cep: 24220-150, Icaraí, Niterói, Rio de Janeiro, Brazil. andre.curi@ipec.fiocruz.br

To describe the intra-ocular manifestations of cat-scratch disease (CSD) found at two uveitis reference centers in Brazil. Retrospective case series study. Review of clinical records of patients diagnosed with CSD in the Uveitis Department of São Geraldo Hospital and the Ophthalmology Department of the Instituto de Pesquisa Clínica Evandro Chagas-FIOCRUZ, from 2001 to 2008. In the 8-year period, 24 patients with the diagnosis of CSD were identified. Twelve patients were male and 12 female. The mean age was 27.04 years (range 7-56). Sixteen patients (66.6%) presented with a history of a cat scratch and all patients reported cat exposure. Visual acuity ranged from counting fingers to 1.0 in the affected eye. Thirteen patients presented with bilateral disease. Sixteen (66.6%) patients complained of systemic symptoms, including fever, lymphadenopathy, liver and spleen enlargement and rash. All patients presented with serum antibodies (IgG) to Bartonella henselae. Thirty-seven eyes were affected. The most common findings were small areas of retinal infiltrates which occurred in 11 eyes (29.7%) and angiomatous lesions which occurred in nine eyes (24.3%). Neuroretinitis occurred in only six eyes (16.2%). The most common findings of CSD in our study were retinal infiltrates and angiomatous lesions. CSD patients may present with significant visual loss. Patients may benefit from systemic treatment with antibiotics.

PMID: 20668914 [PubMed - indexed for MEDLINE]

70. Zhonghua Bing Li Xue Za Zhi. 2010 Apr;39(4):225-9.

[Application of Warthin-Starry stain, immunohistochemistry and transmission electron microscopy in diagnosis of cat scratch disease].

[Article in Chinese]

Huang J, Dai L, Lei S, Liao DY, Wang XQ, Luo TY, Chen Y, Hang ZB, Li GD, Dong DD, Xu G, Gu ZC, Hao JL, Hua P, He L, Duan FL.

Department of Pathology, West China Hospital, Sichuan University, Chengdu 610041, China.

OBJECTIVE: To evaluate the diagnostic utility of Warthin-Starry silver stain, immunohistochemistry and transmission electron microscopy in the detection of human Bartonella henselae infection and pathologic diagnosis of cat scratch disease (CSD). METHODS: The paraffin-embedded lymph node tissues of 77 histologically-defined cases of cat scratch disease collected during the period from January, 1998 to December, 2008 were retrieved and studied using Warthin-Starry silver stain (WS stain) and mouse monoclonal antibody against Bartonella henselae (BhmAB stain). Five cases rich in bacteria were selected for transmission electron microscopy. RESULTS: Under electron microscope, the organisms Bartonella henselae appeared polymorphic, round, elliptical, short rod or bacilliform shapes, ranged from 0.489 to 1.110 microm by 0.333 to 0.534 microm and often clustered together. Black short rod-shaped bacilli arranged in chains or clumps were demonstrated in 61.0% (47/77) of CSD by WS stain. The organisms were located outside the cells and lie mainly in the necrotic debris, especially near the nodal capsule. In 72.7% (56/77) of the cases, dot-like, granular as well as few linear positive signals were observed using BhmAB immunostain and showed similar localization. Positive results for both stains were identified in 59.7% (46/77) of the cases. When applying both stains together, Bartonella henselae was observed in 74.0% (57/77) of the case. The difference between the results obtained by WS stain and BhmAB immunostain was of statistical significance (P < 0.05). CONCLUSIONS: Bartonella henselae is the causative pathogen of cat scratch disease. WS stain, BhmAB immunostain and transmission electron microscopy are helpful in confirming the histologic diagnosis. Immunostaining using BhmAB can be a better alternative than WS stain in demonstrating the organisms.

PMID: 20654119 [PubMed - indexed for MEDLINE]

71. Vet Microbiol. 2010 Dec 15;146(3-4):371-5. Epub 2010 Jun 1.

Oral shedding of Bartonella in cats: correlation with bacteremia and seropositivity.

Namekata DY, Kasten RW, Boman DA, Straub MH, Siperstein-Cook L, Couvelaire K, Chomel BB.

Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.

Cats are the main reservoirs of zoonotic Bartonella henselae, B. clarridgeiae and B. koehlerae, transmitted among cats by cat fleas. No study has investigated the presence of Bartonella in the saliva of bacteremic and non-bacteremic cats to correlate it to the level of bacteremia and the presence or absence of oral lesions. Shelter cats from northern California (n=130) and Michigan (n=50) were tested for Bartonella bacteremia by blood culture, presence of Bartonella antibodies and Bartonella DNA in oral swabs. Bacteremia was detected in 45 (25%) cats, mainly from northern California (n=40), which were highly flea infested and were 4 times more likely to be bacteremic than the non-flea-infested cats from Michigan. Overall, 69 (38.3%) cats had Bartonella PCR positive oral swabs. Bacteremic cats were almost 3 times (P=0.003) more likely to have PCR positive oral swabs (59%, 26/44) than non-bacteremic cats (32.5%, 44/135). However, there was no correlation between cats being bacteremic and having oral lesions. Antibody prevalences for B. henselae and B. clarridgeiae were 30% and 42.8%. B. henselae and B. clarridgeiae seropositive cats were almost 4 times (P=0.0001) and 3 times (P=0.003) more likely to have oral lesions than seronegative cats. Despite a higher prevalence (odds ratio=1.73; 95% confidence interval=0.88-3.38) of oral lesions in cats with oral swabs testing PCR positive, no statistical association could be demonstrated in this cat population.

Copyright © 2010 Elsevier B.V. All rights reserved.

PMID: 20646879 [PubMed - indexed for MEDLINE]

72. Rev Med Interne. 2011 Mar;32(3):e34-6. Epub 2010 Jun 19.

[Bilateral inguinal lymphadenopathy and erythema nodosum: an uncommon presentation of cat scratch disease].

[Article in French]

Khoudri I, Frémont G, Flageul B, Brière J, Dubertret L, Viguier M.

Service de dermatologie, université Paris-VII Denis-Diderot, hôpital Saint-Louis, Assistance publique-Hôpitaux de Paris, 1 avenue Claude-Vellefaux, Paris cedex 10, France.

Cat scratch disease is usually revealed by a proximal lymphadenopathy related to the inoculation site. We report a 22-year-old female who presented with erythema nodosum and bilateral inguinal lymphadenopathy. Serologic test and lymph node PCR detection for Bartonella henselae were negative. Nevertheless, the patient received doxycycline and clinical manifestations rapidly resolved. A follow-up detection of IgM and IgG against Bartonella henselae performed 1 month later was positive. This case report illustrates an original presentation of cat scratch disease and reminds us the lack of sensitivity of laboratory investigations.

Copyright © 2010 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

PMID: 20646798 [PubMed - indexed for MEDLINE]

73. Rev Med Interne. 2011 Apr;32(4):e46-8. Epub 2010 Jun 19.

[Unilateral neuroretinitis revealing cat-scratch disease].

[Article in French]

Zekraoui Y, Megzari A, El Alloussi T, Berraho A.

Service d'ophtalmologie B, CHU Ibn Sina, Rabat, Maroc. youssefzekraoui@yahoo.fr

We report a case of cat-scratch disease neuroretinitis. A 26-year-old man was referred for severe right visual loss. Posterior segment examination showed a papilledema with macular edema. Bartonella henselae immunoglobulin G testing was positive. Four weeks of antibiotic therapy combining oral ciprofloxacin and doxycycline led to progressive resolution of the neuroretinitis and improvement in visual acuity. This report reminds that B. henselae infection can be the cause of neuroretinitis. Its prognosis can be improved by early treatment.

Copyright © 2010 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

PMID: 20646795 [PubMed - indexed for MEDLINE]

74. Int J Pediatr. 2010;2010:763105. Epub 2010 Jun 15.

Neuroretinitis Caused by Bartonella henselae (Cat-Scratch Disease) in a 13-Year-Old Girl.

Durá-Travé T, Yoldi-Petri ME, Gallinas-Victoriano F, Lavilla-Oiz A, Bove-Guri M.

Pediatric Neurology Unit, Children's Hospital "Virgen del Camino", 31008 Pamplona, Spain.

Cat-scratch disease-related neuroretinitis is a relatively unusual pathology, with suspicious clinical epidemiological and serological diagnosis. We present a case of an adolescent suffering from unilateral neuroretinitis associated with Bartonella henselae infection characterized by abrupt loss of vision, optic disc swelling, and macular star exudates with optimal response to antibiotic treatment.

PMCID: PMC2902060 PMID: 20628521 [PubMed]

75. PLoS One. 2010 Jul 6;5(7):e11447.

Identification of the feline humoral immune response to Bartonella henselae infection by protein microarray.

Vigil A, Ortega R, Jain A, Nakajima-Sasaki R, Tan X, Chomel BB, Kasten RW, Koehler JE, Felgner PL.

Division of Infectious Diseases, Department of Medicine, University of California Irvine, Irvine, California, United States of America. vigila@uci.edu

BACKGROUND: Bartonella henselae is the zoonotic agent of cat scratch disease and causes potentially fatal infections in immunocompromised patients. Understanding the complex interactions between the host's immune system and bacterial pathogens is central to the field of infectious diseases and to the development of effective diagnostics and vaccines. METHODOLOGY: We report the development of a microarray comprised of proteins expressed from 96% (1433/1493) of the predicted ORFs encoded by the genome of the zoonotic pathogen Bartonella henselae. The array was probed with a collection of 62 uninfected, 62 infected, and 8 "specific-pathogen free" naïve cat sera, to profile the antibody repertoire elicited during natural Bartonella henselae infection. CONCLUSIONS: We found that 7.3% of the B. henselae proteins on the microarray were seroreactive and that seroreactivity was not evenly distributed between predicted protein function or subcellular localization. Membrane proteins were significantly most likely to be seroreactive, although only 23% of the membrane proteins were reactive. Conversely, we found that proteins involved in amino acid transport and metabolism were significantly underrepresented and did not contain any seroreactive antigens. Of all seroreactive antigens, 52 were differentially reactive with sera from infected cats, and 53 were equally reactive with sera from infected and uninfected cats. Thirteen of the seroreactive antigens were found to be differentially seroreactive between B. henselae type I and type II. Based on these results, we developed a classifier algorithm that was capable of accurately discerning 93% of the infected animals using the microarray platform. The seroreactivity and diagnostic potential of these antigens was then validated on an immunostrip platform, which correctly identified 98% of the infected cats. Our protein microarray platform provides a high-throughput, comprehensive analysis of the feline humoral immune response to natural infection with the alpha-proteobacterium B. henselae at an antigen-specific, sera-specific, and genome-wide level. Furthermore, these results provide novel insight and utility in diagnostics, vaccine development, and understanding of host-pathogen interaction.

PMCID: PMC2897887 PMID: 20625509 [PubMed - indexed for MEDLINE]

76. J Clin Microbiol. 2010 Sep;48(9):3295-300. Epub 2010 Jul 7.

Does a feline leukemia virus infection pave the way for Bartonella henselae infection in cats?

Buchmann AU, Kershaw O, Kempf VA, Gruber AD.

Department of Veterinary Pathology, Freie Universitaet Berlin, Robert-von-Ostertag-Strasse 15, 14163 Berlin, Germany.

Domestic cats serve as the reservoir hosts of Bartonella henselae and may develop mild clinical symptoms or none after experimental infection. In humans, B. henselae infection can result in self-limiting cat scratch disease. However, immunocompromised patients may suffer from more-severe courses of infection or may even develop the potentially lethal disease bacillary angiomatosis. It was reasoned that cats with immunocompromising viral infections may react similarly to B. henselae infection. The aim of our study was to investigate the influence of the most important viruses known to cause immunosuppression in cats-Feline leukemia virus (FeLV), Feline immunodeficiency virus (FIV), and Feline panleukopenia virus (FPV)-on natural B. henselae infection in cats. Accordingly, 142 cats from animal shelters were necropsied and tested for B. henselae and concurrent infections with FeLV, FIV, or FPV by PCR and immunohistochemistry. A significant association was found between B. henselae and FeLV infections (P = 0.00028), but not between B. henselae and FIV (P = 1.0) or FPV (P = 0.756) infection, age (P = 0.392), or gender (P = 0.126). The results suggest that susceptibility to B. henselae infection is higher in cats with concurrent FeLV infections, regardless of whether the infection is latent or progressive. Histopathology and immunohistochemistry for B. henselae failed to identify lesions that could be attributed specifically to B. henselae infection. We conclude that the course of natural B. henselae infection in cats does not seem to be influenced by immunosuppressive viral infections in general but that latent FeLV infection may predispose cats to B. henselae infection or persistence.

PMCID: PMC2937684 PMID: 20610682 [PubMed - indexed for MEDLINE]

77. FEMS Immunol Med Microbiol. 2010 Oct;60(1):44-8. doi: 10.1111/j.1574-695X.2010.00711.x.

Molecular typing of Bartonella henselae DNA extracted from human clinical specimens and cat isolates in Japan.

Yanagihara M, Tsuneoka H, Hoshide S, Ishido E, Umeda A, Tsukahara M, Nojima J, Ichihara K, Hino K, Hirai I, Yamamoto Y.

Department of Basic Laboratory Sciences, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan. m-yanagi@yamaguchi-u.ac.jp

Bartonella henselae is the causative agent of cat scratch disease (CSD). To clarify the population structure and relationship between human and cat strains of B. henselae, 55 specimens isolated in Japan, including 24 B. henselae DNA-positive clinical samples from CSD patients and 31 B. henselae isolates from domestic cats, were characterized by multilocus sequence typing (MLST) and the 16S-23S tRNA-Ala/tRNA-Ile intergenic spacer (S1) sequence, which were used previously for strain typing of B. henselae. Three different sequence types (STs) were identified by MLST, one of which was novel. Fifty-two strains (94.5%), including all strains detected in CSD patients, were assigned to ST-1. Eight S1 genotypes were observed, three of which were novel. The 52 ST-1 strains were classified into seven S1 genotypes, two of which were predominant in both human and cat strains. In addition, 5.5% of the strains (3/55) contained two different intergenic spacer S1 copies. These results indicate that the predominant B. henselae MLST ST-1 in Japan is a significantly genetically diverse population on the basis of the sequence diversity of intergenic spacer S1, and that highly prevalent S1 genotypes among cats are often involved in human infections.

© 2010 Federation of European Microbiological Societies. Published by Blackwell Publishing Ltd. All rights reserved.

PMID: 20602637 [PubMed - indexed for MEDLINE]

78. Yale J Biol Med. 2010 Jun;83(2):67-71.

Expressive aphasia as a presentation of encephalitis with Bartonella henselae infection in an immunocompetent adult.

Marienfeld CB, Dicapua DB, Sze GK, Goldstein JM.

Departments of Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06511, USA. carla.marienfeld@yale.edu

OBJECTIVE: To show the first clinically reported case of Cat Scratch Disease (CSD) presenting as a focal neurologic deficit in an immunocompetent adult. PATIENT: 59-year-old male with a history of a previous stroke. RESULTS: Examination showed an expressive aphasia, word substitution errors, and impaired repetition. A head CT and MRI showed no acute changes. The EEG findings were non-focal and did not show any epileptiform activity. The patient had a history of contact with stray kittens and previous axillary lymphadenopathy. Bartonella henselae serology titers were IgG positive 1:1024 (< 64) and IgM positive 1:20 (< 16). After antibiotic administration, the patient's symptoms and aphasia resolved. CONCLUSIONS: Focal presentations concerning for stroke or partial seizure activity may have underlying infectious etiology. We recommend consideration of CSD in the differential diagnosis of any adult with a history of lymphadenopathy, fever, and recent contact with a cat who presents with neurologic complications.

PMCID: PMC2892771 PMID: 20589186 [PubMed - indexed for MEDLINE]

79. J Feline Med Surg. 2010 Aug;12(8):631-6. Epub 2010 May 31.

Association between Bartonella species infection and disease in pet cats as determined using serology and culture.

Sykes JE, Westropp JL, Kasten RW, Chomel BB.

Department of Medicine and Epidemiology, School of Veterinary Medicine, One Shields Avenue, 2108 Tupper Hall, University of California, Davis, Davis, CA 95616, USA. jesykes@ucdavis.edu

This study's objective was to determine whether a relationship exists between infection or seropositivity to Bartonella species and clinical illness in cats. Blood samples were obtained for Bartonella species isolation and immunofluorescent antibody serology from 298 cats presenting to a tertiary referral hospital. Medical records were searched and the history, physical examination findings and the results of diagnostic testing relating to the visit at which Bartonella species testing was performed were recorded. Fifty-two (17%) samples were seropositive for Bartonella henselae, four (1%) for Bartonella clarridgeiae, and 57 (19%) for both organisms. Nineteen (6.4%) samples were culture positive, 17 for B henselae and two for B clarridgeiae. Gingivostomatitis was associated with Bartonella species isolation (P=0.001), but not seropositivity. There was no association with uveitis, neurologic signs, or chronic kidney disease, and a weak association between seropositivity and idiopathic lower urinary tract disease (feline interstitial cystitis) (P=0.05).

Copyright 2010 ISFM and AAFP. Published by Elsevier Ltd. All rights reserved.

PMID: 20570199 [PubMed - indexed for MEDLINE]

80. Vector Borne Zoonotic Dis. 2011 May;11(5):589-91. Epub 2010 Jun 23.

Unknown fever and back pain caused by Bartonella henselae in a veterinarian after a needle puncture: a case report and literature review.

Lin JW, Chen CM, Chang CC.

Department of Veterinary Medicine, College of Veterinary Medicine, National Chung Hsing University, Taichung, Taiwan.

Bartonella henselae, the etiologic agent of cat-scratch disease, rarely causes back pain and is considered to be transmitted through animal scratches and bites. Here we report a cat-scratch disease case possibly with an unusual route of transmission. The patient was a 32-year-old man, and he was working as a veterinarian in a private veterinary clinic. He sought for clinical help because of unknown fever and persistent back pain for at least a month after an accidental needle puncture. Through serological testing and molecular identifications, this clinical case was confirmed to be caused by B. henselae.

PMID: 20569013 [PubMed - in process]

81. J Infect Chemother. 2010 Dec;16(6):446-8. Epub 2010 Jun 22.

Antimicrobial susceptibility by Etest of Bartonella henselae isolated from cats and human in Japan.

Tsuneoka H, Yanagihara M, Nojima J, Ichihara K.

Department of Clinical Laboratory Science, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-kogushi, Ube, Yamaguchi 755-8505, Japan. htsune@yamaguchi-u.ac.jp

Bartonella henselae, a small fastidious Gram-negative bacillus, is the causative agent of cat-scratch disease (CSD). Because of difficulty in isolating the organism, there has been no report on its antibiotic susceptibility in Japan. We determined the minimal inhibitory concentrations (MICs) of eight antimicrobial agents against 32 isolates of B. henselae (31 from cats and one from a human in Japan) by the Etest method. MICs of all 32 isolates were <0.016 μg/ml for minocycline and ranged from ≤0.016 to 0.064 μg/ml for erythromycin, clarithromycin, azithromycin, ceftriaxone, and amoxicillin. MICs ranges of ciprofloxacin and gentamicin were from 0.064 to 0.25 μg/ml and from 0.5 to 3 μg/ml, respectively. All isolated strains showed high susceptibility to minocycline and macrolides antibiotics, which are currently used in the primary treatment of CSD in Japan. Although in vitro result of B. henselae susceptibility testing may not necessarily correlate with clinical response, these data are relevant in the choice of drugs for CSD treatment.

PMID: 20567991 [PubMed - indexed for MEDLINE]

82. PLoS Pathog. 2010 Jun 10;6(6):e1000946.

The Trw type IV secretion system of Bartonella mediates host-specific adhesion to erythrocytes.

Vayssier-Taussat M, Le Rhun D, Deng HK, Biville F, Cescau S, Danchin A, Marignac G, Lenaour E, Boulouis HJ, Mavris M, Arnaud L, Yang H, Wang J, Quebatte M, Engel P, Saenz H, Dehio C.

Unité Sous Contrat Bartonella, INRA, Maisons-Alfort, France. mvayssier@vet-alfort.fr

Bacterial pathogens typically infect only a limited range of hosts; however, the genetic mechanisms governing host-specificity are poorly understood. The alpha-proteobacterial genus Bartonella comprises 21 species that cause host-specific intraerythrocytic bacteremia as hallmark of infection in their respective mammalian reservoirs, including the human-specific pathogens Bartonella quintana and Bartonella bacilliformis that cause trench fever and Oroya fever, respectively. Here, we have identified bacterial factors that mediate host-specific erythrocyte colonization in the mammalian reservoirs. Using mouse-specific Bartonella birtlesii, human-specific Bartonella quintana, cat-specific Bartonella henselae and rat-specific Bartonella tribocorum, we established in vitro adhesion and invasion assays with isolated erythrocytes that fully reproduce the host-specificity of erythrocyte infection as observed in vivo. By signature-tagged mutagenesis of B. birtlesii and mutant selection in a mouse infection model we identified mutants impaired in establishing intraerythrocytic bacteremia. Among 45 abacteremic mutants, five failed to adhere to and invade mouse erythrocytes in vitro. The corresponding genes encode components of the type IV secretion system (T4SS) Trw, demonstrating that this virulence factor laterally acquired by the Bartonella lineage is directly involved in adherence to erythrocytes. Strikingly, ectopic expression of Trw of rat-specific B. tribocorum in cat-specific B. henselae or human-specific B. quintana expanded their host range for erythrocyte infection to rat, demonstrating that Trw mediates host-specific erythrocyte infection. A molecular evolutionary analysis of the trw locus further indicated that the variable, surface-located TrwL and TrwJ might represent the T4SS components that determine host-specificity of erythrocyte parasitism. In conclusion, we show that the laterally acquired Trw T4SS diversified in the Bartonella lineage to facilitate host-restricted adhesion to erythrocytes in a wide range of mammals.

PMCID: PMC2883598 PMID: 20548954 [PubMed - indexed for MEDLINE]

83. Cutis. 2010 May;85(5):231-6.

What's eating you? Cat flea (Ctenocephalides felis), Part 1: Clinical features and role as a disease vector.

Elston DM, Do H.

Department of Dermatology and Laboratory Medicine, Geisinger Medical Center, 100 N Academy Ave, Danville, PA 17822-5203, USA. dmelston@geisinger.edu

PMID: 20540412 [PubMed - indexed for MEDLINE]

84. Aust Vet J. 2010 May;88(5):160-5.

Prevalence of Bartonella species, Rickettsia felis, haemoplasmas and the Ehrlichia group in the blood of cats and fleas in eastern Australia.

Barrs VR, Beatty JA, Wilson BJ, Evans N, Gowan R, Baral RM, Lingard AE, Perkovic G, Hawley JR, Lappin MR.

Valentine Charlton Cat Centre, Faculty of Veterinary Science, The University of Sydney, New South Wales 2006, Australia. vanessa.barrs@sydney.edu.au

OBJECTIVES: To define the prevalence of Bartonella spp., Rickettsia felis, Mycoplasma haemofelis, 'Candidatus Mycoplasma haemominutum' (Mhm) and 'Candidatus Mycoplasma turicensis' (Mtc) in cats and their fleas in eastern Australia. DESIGN AND PROCEDURE: Conventional PCR assays that detect Bartonella spp., M. haemofelis, Mhm, Mtc, Rickettsia spp., Ehrlichia spp., Anaplasma spp. and Neorickettsia spp. were performed on DNA extracted from blood and fleas collected from 111 cats. Cat sera were assayed by ELISA for IgG of Bartonella spp. RESULTS: DNA of M. haemofelis, Mtc and Mhm was amplified from 1 (0.9%), 1 (0.9%) and 17 cats (15.3%), respectively. Only DNA of Mhm was amplified from the 62 of 111 pooled flea samples (flea sets; 55.9%). Overall, the prevalence rates for Bartonella spp. DNA in the cats and the flea sets was 16.2% (18 cats) and 28.8% (32 flea sets), respectively. Bartonella spp. IgG was detected in 42 cats (37.8%), of which 11 (26.2%) were positive for Bartonella spp. DNA in their blood. R. felis DNA was amplified from 22 flea sets (19.8%), but not from cats. Overall, DNA of one or more of the organisms was amplified from 27% (30) of cats and 67.6% (75) of the flea sets. CONCLUSIONS: This is the first Australian study to determine the prevalence of R. felis and B. clarridgeiae in both fleas and the cats from which they were collected. Flea-associated infectious agents are common in cats and fleas in eastern Australia and support the recommendation that stringent flea control be maintained on cats.

PMID: 20529020 [PubMed - indexed for MEDLINE]

85. J Feline Med Surg. 2010 Jun;12(6):476-82. Epub 2010 May 15.

Prevalence of selected infectious agents in cats in Ireland.

Juvet F, Lappin MR, Brennan S, Mooney CT.

University Veterinary Hospital School of Agriculture, Food Science & Veterinary Medicine, University College Dublin, Ireland. florence.juvet@ucd.ie

Vector-borne bacterial and rickettsial agents and Toxoplasma gondii, are common organisms in cats. Some are potentially zoonotic or may be transmitted via blood transfusion. The current study investigated the prevalence of these agents in cats from Dublin, Ireland, for which no published data exists. Whole blood (n=116) and sera (n=83) samples were obtained from 121 cats. DNA was extracted from blood and assayed using polymerase chain reaction techniques for Anaplasma species, Bartonella species, Ehrlichia species, Mycoplasma haemofelis, 'Candidatus Mycoplasma haemominutum', 'Candidatus Mycoplasma turicensis' and Rickettsia species. IgG and T gondii IgG and IgM serum antibodies were detected by enzyme-linked immunosorbent assay. DNA consistent with B henselae (3.4%), B clarridgeiae (0.8%), both Bartonella species (0.8%), C M haemominutum (12.9%), or M haemofelis (2.5%) was amplified from 24/116 blood samples (20.6%). Antibodies to T gondii and Bartonella species were detected in 28 (33.7%) and 22 (26.5%) of 83 sera, respectively.

Copyright 2010 ISFM and AAFP. Published by Elsevier Ltd. All rights reserved.

PMID: 20472484 [PubMed - indexed for MEDLINE]

86. Mol Ecol. 2010 Jun;19(11):2241-55. Epub 2010 May 6.

Rapid diversification by recombination in Bartonella grahamii from wild rodents in Asia contrasts with low levels of genomic divergence in Northern Europe and America.

Berglund EC, Ellegaard K, Granberg F, Xie Z, Maruyama S, Kosoy MY, Birtles RJ, Andersson SG.

Department of Molecular Evolution, Uppsala University, Uppsala, Sweden.

Bartonella is a genus of vector-borne bacteria that infect the red blood cells of mammals, and includes several human-specific and zoonotic pathogens. Bartonella grahamii has a wide host range and is one of the most prevalent Bartonella species in wild rodents. We studied the population structure, genome content and genome plasticity of a collection of 26 B. grahamii isolates from 11 species of wild rodents in seven countries. We found strong geographic patterns, high recombination frequencies and large variations in genome size in B. grahamii compared with previously analysed cat- and human-associated Bartonella species. The extent of sequence divergence in B. grahamii populations was markedly lower in Europe and North America than in Asia, and several recombination events were predicted between the Asian strains. We discuss environmental and demographic factors that may underlie the observed differences.

PMID: 20465583 [PubMed - indexed for MEDLINE]

87. Wiad Parazytol. 2010;56(1):1-9.

[Bartonella spp. as a zoonotic pathogens transmitting by blood-feeding arthropods].

[Article in Polish]

Adamska M.

Katedra Genetyki, Uniwersytet Szczeciński, al. Piastów 40B, 71-065 Szczecin. adamska.us@wp.pl

Prior to 1993, Bartonella bacilliformis was the only member of the Bartonella genus. Now, the genus Bartonella currently contains over 30 species of Gram-negative bacteria that parasitize mammalian erythrocytes and endothelial cells. Bartonella spp. have been isolated from a variety of mammal species, most often from rodents, ruminants and carnivores, and these animals are implicated as reservoirs for the genus Bartonella. The persistent bacteriemia is more readily documented in the primary reservoir species and may occur less frequently or to a much lower lever in accidental hosts. In the natural host, clinical manifestations of the infection may be minimal or unrecognizable. Several insects have been implicated in Bartonella transmission, including flies and ticks. The reservoir host and vector varying depending on the Bartonella species involved, although, neither the reservoir, nor the vector has been identified definitively for many recently described Bartonella species. Humans are natural reservoir hosts for two species: Bartonella bacilliformis and Bartonella quintana, but many animal-associated Bartonella can also cause disease in humans. Members of the genus Bartonella are involved in a variety of human diseases, such as Carrion's disease, cat scratch disease, trench fever, bacillary angiomatosis, endocarditis, pericarditis and neuroretinitis. Most cases of bartonellosis are now diagnosed by tests based on PCR or through serological tests using specific antigens.

PMID: 20450002 [PubMed - indexed for MEDLINE]

88. Clin Neurol Neurosurg. 2010 Sep;112(7):625-8. Epub 2010 May 2.

Rare infections mimicking MS.

Brinar VV, Habek M.

University of Zagreb, School of Medicine and University Hospital Centre Zagreb, Department of Neurology and Refferal Center for Demyelinating Diseases of the Central Nervous System, Zagreb, Croatia. vesna.brinar@zg.t-com.hr

Comment in Clin Neurol Neurosurg. 2011 Apr;113(3):259-60.

The diagnosis of multiple sclerosis (MS), despite well defined clinical criteria is not always simple. On many occasions it is difficult to differentiate MS from various non-MS idiopathic demyelinating disorders, specific and infectious inflammatory diseases or non-inflammatory demyelinating diseases. Clinicians should be aware of various clinical and MRI "red flags" that may point to the other diagnosis and demand further diagnostic evaluation. It is generally accepted that atypical clinical symptoms or atypical neuroimaging signs determine necessity for broad differential diagnostic work up. Of the infectious diseases that are most commonly mistaken for MS the clinician should take into account Whipple's disease, Lyme disease, Syphilis, HIV/AIDS, Brucellosis, HHV-6 infection, Hepatitis C, Mycoplasma and Creutzfeld-Jacob disease, among others. Cat scratch disease caused by Bartonella hensellae, Mediterranean spotted fever caused by Riketssia connore and Leptospirosis caused by different Leptospira serovars rarely cause focal neurological deficit and demyelinating MRI changes similar to MS. When atypical clinical and neuroimaging presentations are present, serology on rare infectious diseases that may mimic MS may be warranted. This review will focus on the infectious diseases mimicking MS with presentation of rare illustrative cases.

PMID: 20439131 [PubMed - indexed for MEDLINE]

89. Am J Pathol. 2010 Jun;176(6):2753-63. Epub 2010 Apr 15.

An immunocompromised murine model of chronic Bartonella infection.

Chiaraviglio L, Duong S, Brown DA, Birtles RJ, Kirby JE.

Department of Pathology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA.

Bartonella are ubiquitous gram-negative pathogens that cause chronic blood stream infections in mammals. Two species most often responsible for human infection, B. henselae and B. quintana, cause prolonged febrile illness in immunocompetent hosts, known as cat scratch disease and trench fever, respectively. Fascinatingly, in immunocompromised hosts, these organisms also induce new blood vessel formation leading to the formation of angioproliferative tumors, a disease process named bacillary angiomatosis. In addition, they cause an endothelial-lined cystic disease in the liver known as bacillary peliosis. Unfortunately, there are as yet no completely satisfying small animal models for exploring these unique human pathologies, as neither species appears able to sustain infection in small animal models. Therefore, we investigated the potential use of other Bartonella species for their ability to recapitulate human pathologies in an immunodeficient murine host. Here, we demonstrate the ability of Bartonella taylorii to cause chronic infection in SCID/BEIGE mice. In this model, Bartonella grows in extracellular aggregates, embedded within collagen matrix, similar to previous observations in cat scratch disease, bacillary peliosis, and bacillary angiomatosis. Interestingly, despite overwhelming infection later in disease, evidence for significant intracellular replication in endothelial or other cell types was not evident. We believe that this new model will provide an important new tool for investigation of Bartonella-host interaction.

PMCID: PMC2877837 PMID: 20395436 [PubMed - indexed for MEDLINE]

90. J Am Vet Med Assoc. 2010 Apr 15;236(8):869-73.

Evaluation of topical application of 10% imidacloprid-1% moxidectin to prevent Bartonella henselae transmission from cat fleas.

Bradbury CA, Lappin MR.

Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA. cabrad@colostate.edu

OBJECTIVE: To determine whether monthly topical administration of a combination of 10% imidacloprid and 1% moxidectin would lessen flea (Ctenocephalides felis) transmission of Bartonella henselae among cats. DESIGN: Controlled trial. ANIMALS: 18 specific pathogen-free cats housed in 3 groups of 6. PROCEDURES: 3 enclosures were separated by mesh to allow fleas to pass among groups yet prevent cats from contacting one another. One group was inoculated IV with B henselae, and after infection was confirmed, the cats were housed in the middle enclosure. This infected group was flanked by a group that was treated topically with 10% imidacloprid-1% moxidectin monthly for 3 months and by an untreated group. On days 0, 15, 28, and 42, 100 fleas/cat were placed on each of the 6 cats in the B henselae-infected group. Blood samples were collected from all cats weekly for detection of Bartonella spp via PCR assay, bacterial culture, and serologic assay. RESULTS: B henselae infection was confirmed in the cats infected IV and in all untreated cats after flea exposure; none of the cats treated with the imidacloprid-moxidectin combination became infected. CONCLUSIONS AND CLINICAL RELEVANCE: In this setting, monthly topical administration of 10% imidacloprid-1% moxidectin reduced flea infestation, compared with infestation in untreated cats, and thus prevented flea transmission of B henselae to treated cats. Regular monthly use of this flea control product in cats may lessen the likelihood of humans acquiring B henselae infection.

PMID: 20392182 [PubMed - indexed for MEDLINE]

91. Transbound Emerg Dis. 2010 Jun;57(3):201-4. Epub 2010 Mar 14.

Isolation and characterization of Bartonella strains in cats in Italy.

Capitta P, Zobba R, Masala G, Cocco R, Tola S, Parpaglia ML.

Istituto Zooprofilattico Sperimentale della Sardegna, Sassari, Italy.

Bartonella henselae and Bartonella clarridgeiae were isolated in two cats in Sardinia, Italy. Infection by B. clarridgeiae was characterized by fever and submandibular lymph nodes enlargement while B. henselae infection was asymptomatic. This is the first report of B. clarridgeiae in a cat in Italy and the first isolation of B. henselae and B. clarridgeiae in Sardinia.

PMID: 20345572 [PubMed - indexed for MEDLINE]

92. Transfus Med. 2010 Aug 1;20(4):280-2. Epub 2010 Mar 24.

Blood donor infected with Bartonella henselae.

Magalhães RF, Cintra ML, Barjas-Castro ML, Del Negro GM, Okay TS, Velho PE.

PMID: 20345384 [PubMed - indexed for MEDLINE]

93. Rev Med Liege. 2010 Feb;65(2):78-80.

[A clinical case of spontaneous involution of systemic cat scratch disease].

[Article in French]

Loeckx I, Tuerlinckx D, Jespers S, Marchant AS, Bodart E.

Service de Pédiatrie, Université Catholique de Louvain, Cliniques Universitaires de Mont-Godinne, 5530 Yvoir, Belgique.

Typical Cat-scratch disease (CSD) manifests as regional lymphadenopathy following cat scratch and sometimes associated with mild fever. There is a lot of atypical manifestations and some of those have systemic involvement. Hepatosplenic CSD is a systemic presentation associating fever of unknown origin with nodules in the liver and/or the spleen. Ultrasound abdominal examination shows nodules (3-30 mm) in the spleen and/or in the liver. Diagnostic is based on serology for B henselae (always IgG + and sometimes IgM +), or polymerase chain reaction (PCR) on the liver to test for the presence of B henselae. Hepatosplenic CSD is rare and therefore underdiagnosed. There is no consensus about the treatment but most of the authors suggest to treat with rifampicine. We report a case of a 4-years-old girl presenting with fever of unknown origin (FUO), high inflammatory markers with normal leukocytosis and hepatosplenic nodules. The diagnosis of CSD was made retrospectively. Evolution was favourable even though no specific antibiotic treatment for Bartonella henselae was administrated.

PMID: 20344917 [PubMed - indexed for MEDLINE]

94. J Vet Emerg Crit Care (San Antonio). 2010 Feb;20(1):62-9.

Feline hemotropic mycoplasmas.

Sykes JE.

Department of Medicine & Epidemiology, University of California - Davis, Davis, CA 95618, USA. jesykes@ucdavis.edu

OBJECTIVE: To describe the current understanding of the etiology, pathogenesis, diagnosis, and treatment of feline hemotropic mycoplasmosis (feline infectious anemia). 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 mycoplasmas. 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]

95. J Vet Emerg Crit Care (San Antonio). 2010 Feb;20(1):46-61.

Conventional and molecular diagnostic testing for the acute neurologic patient.

Nghiem PP, Schatzberg SJ.

Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30606, USA.

Erratum in J Vet Emerg Crit Care (San Antonio). 2010 Oct;20(5):538.

OBJECTIVE: The aim of this review is to describe and evaluate both conventional and molecular diagnostic testing utilized in dogs and cats with acute neurologic diseases. Various types of polymerase chain reaction (PCR) are explored along with novel molecular diagnostic testing that ultimately may prove useful in the critical care setting. DATA SOURCES: PUBMED was searched to obtain relevant references material using keywords: 'canine OR feline meningitis AND meningoencephalitis,''feline infectious peritonitis,''canine distemper,''canine OR feline AND toxoplasma,''canine neospora,''canine OR feline AND rickettsia,''granulomatous meningoencephalitis,''steroid responsive meningitis arteritis,''necrotizing encephalitis,''novel neurodiagnostics,''canine OR feline AND CNS borrelia,''canine OR feline AND CNS bartonella,''canine OR feline AND CNS fungal,''nested OR multiplex OR degenerate OR consensus OR CODEHOP AND PCR.' Research findings from the authors' laboratory and current veterinary textbooks also were utilized. HUMAN DATA SYNTHESIS: Molecular diagnostic testing including conventional, real-time, and consensus and degenerate PCR and microarray analysis are utilized routinely for the antemortem diagnosis of infectious meningoencephalitis (ME) in humans. Recently, PCR using consensus degenerate hybrid primers (CODEHOP) has been used to identify and characterize a number of novel human viruses. VETERINARY DATA SYNTHESIS: Molecular diagnostic testing such as conventional and real-time PCR aid in the diagnosis of several important central nervous system infectious agents including canine distemper virus, Toxoplasma gondii, Neospora caninum, rickettsial species, and others. Recently, broadly reactive consensus and degenerate PCR reactions have been applied to canine ME including assays for rickettsial organisms, Borrelia spp. and Bartonella spp., and various viral families. CONCLUSIONS: In the acute neurologic patient, there are several key infectious diseases that can be pursued by a combination of conventional and molecular diagnostic testing. It is important that the clinician understands the utility, as well as the limitations, of the various neurodiagnostic tests that are available.

PMID: 20230434 [PubMed - indexed for MEDLINE]

96. J Med Microbiol. 2010 Jun;59(Pt 6):743-5. Epub 2010 Mar 11.

Evaluation of sensitivity, specificity and cross-reactivity in Bartonella henselae serology.

Vermeulen MJ, Verbakel H, Notermans DW, Reimerink JH, Peeters MF.

PMID: 20223899 [PubMed - indexed for MEDLINE]

97. Acta Trop. 2010 Jul-Aug;115(1-2):137-41. Epub 2010 Mar 3.

Bartonella spp. infection in HIV positive individuals, their pets and ectoparasites in Rio de Janeiro, Brazil: serological and molecular study.

Lamas CC, Mares-Guia MA, Rozental T, Moreira N, Favacho AR, Barreira J, Guterres A, Bóia MN, de Lemos ER.

Laboratório de Hantaviroses e Rickettsioses, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil. cristianelamas@gmail.com

BACKGROUND: Bartonella is the agent of cat-scratch disease, but is also responsible for more severe conditions such as retinitis, meningoencephalitis, endocarditis and bacillary angiomatosis. Its seroprevalence is unknown in Brazil. METHODS: Patients in an AIDS clinic, asymptomatic at the time of the study, were enrolled prospectively. They answered a structured questionnaire and had blood taken for serological and molecular assays. Cat breeder's pets were tested serologically and collected ectoparasites were tested by molecular biology techniques. Blood donors, paired by age and sex, were tested for Bartonella IgG antibodies. RESULTS: 125 HIV positive patients with a median age of 34 were studied; 61 were male and 75% were on HAART. Mean most recent CD4 count was 351-500 cells/mm(3). A high rate of contact with ticks, fleas and lice was observed. Bartonella IgG seroreactivity rate was 38.4% in HIV positive individuals and breeding cats was closely associated with infection (OR 3.6, CI 1.1-11.9, p<0.05). No difference was found between the sexes. Titers were 1:32 in 39 patients, 1:64 in seven, 1:128 in one and 1:256 in one. In the control group, IgG seroreactivity to Bartonella spp. was 34%, and female sex was correlated to seropositivity. Fourteen of 61 (23%) males vs 29/64 (45.3%) females were seroreactive to Bartonella (OR 2.8, CI 1.2-6.5, p<0.01). Titers were 1:32 in 29 patients, 1:64 in ten and 1:128 in four. CONCLUSIONS: Bartonella spp. seroprevalence is high in HIV positive and in blood donors in Rio de Janeiro. This may be of public health relevance.

2010 Elsevier B.V. All rights reserved.

PMID: 20206113 [PubMed - indexed for MEDLINE]

98. An Pediatr (Barc). 2010 Apr;72(4):290-1. Epub 2010 Mar 2.

[Neuroretinitis in cat-scratch disease].

[Article in Spanish]

Durá Travé T, Yoldi Petri ME, Lavilla Oiz A, Molins Castiella T.

PMID: 20199895 [PubMed - indexed for MEDLINE]

99. Korean J Lab Med. 2010 Feb;30(1):34-7.

A report of cat scratch disease in Korea confirmed by PCR amplification of the 16S-23S rRNA intergenic region of Bartonella henselae.

Suh B, Chun JK, Yong D, Lee YS, Jeong SH, Yang WI, Kim DS.

Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea.

We report a case of cat scratch disease in an 8-yr-old girl who presented with fever and enlargement of both axillary lymph nodes. Both aerobic and anaerobic cultures of the lymph node aspirate were negative for microbial growth. Gram staining and Warthin-Starry silver staining did not reveal any organism. Purified DNA from the PCR-amplicon of the 16S-23S rRNA intergenic region was sequenced and showed 99.7% identity with the corresponding sequence of Bartonella henselae strain Houston-1. Our findings suggest that the internal transcribed spacer is a reliable region for PCR identification of Bartonella species. In patients with lymphadenitis, a history of contact with cats or dogs necessitates the use of diagnostic approaches that employ not only the conventional staining and culture but also molecular methods to detect B. henselae.

PMID: 20197720 [PubMed - indexed for MEDLINE]

100. Trends Parasitol. 2010 Apr;26(4):197-204. Epub 2010 Feb 23.

Flea-associated zoonotic diseases of cats in the USA: bartonellosis, flea-borne rickettsioses, and plague.

McElroy KM, Blagburn BL, Breitschwerdt EB, Mead PS, McQuiston JH.

Centers for Disease Control and Prevention, Division of Viral and Rickettsial Diseases, 1600 Clifton Road, Atlanta, GA 30333, USA.

Cat-scratch disease, flea-borne typhus, and plague are three flea-associated zoonoses of cats of concern in the USA. Although flea concentrations may be heaviest in coastal and temperate climates, fleas and flea-borne disease agents can occur almost anywhere in the USA. Understanding flea-borne pathogens, and the associated risks for owners and veterinarians, is important to reduce the likelihood of zoonotic infection.

Published by Elsevier Ltd.

PMID: 20185369 [PubMed - indexed for MEDLINE]

101. Cutis. 2010 Jan;85(1):37-42.

Inoculation bartonellosis in an adult: a case report.

Bolton JG, Galeckas KJ, Satter EK.

Branch Medical Clinic, Marine Corps Air Station, PO Box 452002, San Diego, CA 92145, USA. joanna.bolton@med.navy.mil

Cat-scratch disease (CSD) and bacillary angiomatosis (BA) are caused by a gram-negative bacilli classified under the genus Bartonella (formerly Rochalimaea). Patient history, symptoms, and histopathology often fall along a continuum; therefore, both conditions should be considered in the differential diagnosis. We report a case of an 83-year-old immunocompetent woman who presented with a pyogenic granuloma-like lesion on her dorsal left wrist. The histologic differential diagnosis included an inoculation site from a cat scratch infected with Bartonella and BA. Because the patient had only 1 lesion at the site of a prior cat scratch, the lesion was diagnosed as inoculation bartonellosis. We also review the epidemiologic, clinical, and histopathologic features of CSD and BA.

PMID: 20184210 [PubMed - indexed for MEDLINE]

102. Vet Dermatol. 2009 Oct;20(5-6):509-14.

Presence of Bartonella species and Rickettsia species DNA in the blood, oral cavity, skin and claw beds of cats in the United States.

Lappin MR, Hawley J.

Department of Clinical Sciences, College of Veterinary Medicine, Fort Collins, CO, USA. mlappin@mail.colostate.edu

The purpose of this study was to determine the prevalence of Bartonella species and Rickettsia species DNA in the blood, oral cavity, skin and claw beds of feral cats without evidence of skin disease that were housed in Alabama (n = 24), Florida (n = 27) and Colorado (n = 32). Samples were assessed by use of polymerase chain reaction assays. The Bartonella species IgG prevalence was also determined. While Bartonella species DNA was not amplified from any sample from Colorado cats, it was commonly amplified from blood (56.9%), skin (31.4%), claws (17.6%) and gingiva (17.6%) of the 51 cats housed in Alabama and Florida. All 10 flea groups assessed in this study were infected with a Bartonella species or R. felis. Bartonella species IgG titres did not accurately predict bacteraemia (positive predictive value = 57.1%; negative predictive value = 82.1%). Bartonella species DNA was amplified from blood of cats with and without C. felis. Rickettsia felis DNA was only detected in or on the skin of one cat and the gingiva of an additional cat. It was concluded that cats can be an occupational health risk for veterinarians, particularly in areas with high prevalence of Ctenocephalides felis. Further study is required to determine whether Bartonella species or Rickettsia species infections of cats are associated with dermatological disease. The combination of Bartonella species serological test results with Bartonella species PCR or culture is likely to give the most accurate information concerning the current infection status of individual cats.

PMID: 20178489 [PubMed - indexed for MEDLINE]

103. J Appl Microbiol. 2010 Sep;109(3):743-50. doi: 10.1111/j.1365-2672.2010.04679.x.

Bartonellosis, an increasingly recognized zoonosis.

Chomel BB, Kasten RW.

Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA 95616, USA. bbchomel@ucdavis.edu

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.

© 2010 The Authors. Journal compilation © 2010 The Society for Applied Microbiology.

PMID: 20148999 [PubMed - indexed for MEDLINE]

104. J Feline Med Surg. 2010 Jun;12(6):483-6. Epub 2010 Feb 6.

Successful treatment of Bartonella henselae endocarditis in a cat.

Perez C, Hummel JB, Keene BW, Maggi RG, Diniz PP, Breitschwerdt EB.

Intracellular Pathogens Research Laboratory, Center for Comparative Medicine and Translational Research, College of Veterinary Medicine, North Carolina State University (NCSU), Raleigh, NC, United States.

This report describes the clinical presentation, diagnosis and treatment of a cat with vegetative valvular endocarditis temporally associated with natural infection with Bartonella henselae. Lethargy, abnormal gait and weakness were the main clinical signs that resulted in referral for diagnostic evaluation. Using a novel and sensitive culture approach, B henselae was isolated from the blood. Following antibiotic therapy there was total resolution of clinical signs, the heart murmur, the valvular lesion by echocardiography, and no Bartonella species was isolated or amplified from a post-treatment blood culture. In conjunction with previous case reports, infective endocarditis can be associated with natural B henselae infection in cats; however, early diagnosis and treatment may result in a better prognosis than previously reported.

Copyright 2010 ISFM and AAFP. Published by Elsevier Ltd. All rights reserved.

PMID: 20138559 [PubMed - indexed for MEDLINE]

105. J Feline Med Surg. 2010 Jun;12(6):447-50. Epub 2010 Feb 6.

Feline immunodeficiency virus, feline leukemia virus and Bartonella species in stray cats on St Kitts, West Indies.

Kelly PJ, Moura L, Miller T, Thurk J, Perreault N, Weil A, Maggio R, Lucas H, Breitschwerdt E.

Ross University School of Veterinary Medicine, PO Box 334, West Farm, Saint Kitts and Nevis. pkelly@rossvet.edu.kn

Stray cats trapped in various areas of Basseterre, the capital of St Kitts in the West Indies, were tested for infection with feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV) using commercial kits. Of 99 (51 male and 48 female) cats trapped in 2006/7, 15% (12 males and three females) were positive for FIV while none were positive for FeLV. Of 72 (41 males and 31 females) cats trapped in 2009, 14% (nine males and one female) were positive for FIV while none were positive for FeLV. Polymerase chain reaction analysis revealed DNA of Bartonella species in whole blood collected from 60/95 (63%) cats trapped in 2006/7. Sequencing of the 16S-23S rRNA gene intergenic transcribed spacer (ITS) region of a convenience sample of nine amplicons and the 11 isolates made from 43 blood samples which were cultured using Bartonella alpha Proteobacteria (BAPGM) enrichment medium revealed B henselae (14) and B clarridgeiae (six).

Copyright 2010 ISFM and AAFP. Published by Elsevier Ltd. All rights reserved.

PMID: 20138558 [PubMed - indexed for MEDLINE]

106. Vet Pathol. 2010 Jan;47(1):163-6.

Peliosis hepatis in cats is not associated with Bartonella henselae infections.

Buchmann AU, Kempf VA, Kershaw O, Gruber AD.

Department of Veterinary Pathology, Freie Universitaet Berlin, Robert-von-Ostertag-Strasse 15, Berlin, Germany. gruber.achim@vetmed.fu-berlin.de

Peliosis hepatis is a vasculoproliferative disorder of the liver with infectious and noninfectious causes. In humans and dogs, Bartonella henselae has been linked to peliosis hepatis. Although domestic cats are the natural reservoir of B. henselae and although peliosis hepatis is common in this species, an association between this condition and infection with B. henselae has never been investigated in cats. In this study, 26 cases of peliosis hepatis in cats were tested for B. henselae infection by nested polymerase chain reaction and immunohistochemistry. The authors failed to detect B. henselae nucleic acid or antigen in any of the affected liver specimens. These findings suggest that, unlike in humans and dogs, peliosis hepatis in cats may not be significantly associated with a B. henselae infection.

PMID: 20080497 [PubMed - indexed for MEDLINE]

107. Pediatr Infect Dis J. 2010 May;29(5):472-3.

Renal microabscesses due to Bartonella infection.

Salehi N, Custodio H, Rathore MH.

General Academic and Hospital Pediatrics, University of Florida College of Medicine, Jacksonville, FL, USA.

We report a case of cat scratch disease with bilateral renal microabscesses. This case is unique in that there were no other abscesses found intrabdominally. A previously healthy child was admitted with a 12-day history of fever and headaches. Bartonella henselae titers were initially IgG 1:640 and IgM 1:100, and later IgG >1:2560 and IgM >1:800. An abdominal ultrasound examination was normal but CT scan revealed microabscesses in both kidneys.

PMID: 20072078 [PubMed - indexed for MEDLINE]

108. Pediatr Int. 2010 Aug;52(4):533-5. doi: 10.1111/j.1442-200X.2010.03066.x.

High prevalence of antibodies against Bartonella henselae with cervical lymphadenopathy in children.

Asano T, Ichiki K, Koizumi S, Kaizu K, Hatori T, Fujino O.

Department of Pediatrics, Nippon Medical School, Chiba Hokusoh Hospital, Chiba, Japan. vff13540@nifty.ne.jp

BACKGROUND: Cat-scratch disease is the most common form of Bartonella henselae infection. Although reports have shown that CSD is relatively common, they have not shown the prevalence of seropositivity for Bartonella henselae in cases of cervical lymphadenitis and Kawasaki disease, which are relatively common diseases in children. METHODS: We evaluated the presence of immunoglobulin (Ig) G- and IgM-class antibodies against Bartonella henselae in children with cervical lymphadenitis, Kawasaki disease, and infectious diseases without lymphadenopathy in a semi-rural area in Japan. RESULTS: We found that the positivity rate for the IgG antibody against Bartonella henselae in patients with cervical lymphadenitis who owned cats or dogs was significantly higher than that in patients with Kawasaki disease and infectious diseases without lymphadenopathy. However, the average age of children with cervical lymphadenitis did not significantly differ when compared to those with other infectious diseases. CONCLUSION: Our serological study showed that Bartonella henselae infection may contribute to the etiology of cervical lymphadenitis in children.

© 2010 Japan Pediatric Society.

PMID: 20059723 [PubMed - indexed for MEDLINE]

109. Med Mal Infect. 2010 Jun;40(6):319-30. Epub 2009 Dec 29.

[Bartonella henselae, an ubiquitous agent of proteiform zoonotic disease].

[Article in French]

Edouard S, Raoult D.

CNRS, UMR6236, IRD 198, unité de recherche sur les maladies infectieuses tropicales et emergentes, Centre national de référence des Rickettsies, Bartonella et Coxiella, faculté de médecine, université de la Méditerranée, boulevard Jean-Moulin, Marseille cedex 5, France. sophie.edouard@ap-hm.fr

Bartonella henselae is the causative agent of cat scratch disease, a human infection usually characterized by persistent regional lymphadenopathy. It is transmitted to humans by cat scratches or bites. Cats are the major reservoir for this bacterium thus B. henselae has a worldwide distribution. The bacterial pathogenicity may bay emphasized by the immune status of the infected host. Angiomatosis or hepatic peliosis are the most frequent clinical manifestations in immunocompromised patients. B. henselae is also responsible for endocarditis in patients with valvular diseases, and may induce various clinical presentations such as: bacteriemia, retinitis, musculoskeletal disorders, hepatic or splenic diseases, encephalitis, or myocarditis. Several diagnostic tools are available; they may be combined and adapted to every clinical setting. B. henselae is a fastidious bacterium; its diagnosis is mainly made by PCR and blood tests. No treatment is required for the benign form of cat scratch disease. For more severe clinical presentations, the treatment must be adapted to every clinical presentation.

PMID: 20042306 [PubMed - indexed for MEDLINE]

110. J Antimicrob Chemother. 2010 Mar;65(3):581-2. Epub 2009 Dec 18.

Molecular mechanisms of Bartonella henselae resistance to azithromycin, pradofloxacin and enrofloxacin.

Biswas S, Maggi RG, Papich MG, Breitschwerdt EB.

PMID: 20022937 [PubMed - indexed for MEDLINE]

111. Vet Microbiol. 2010 Jan 27;140(3-4):347-59. Epub 2009 Nov 18.

Bartonellosis.

Guptill L.

Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA. guptillc@purdue.edu

Bartonellosis is a constellation of clinical conditions affecting human beings and a variety of animals. Many Bartonella infections are zoonotic, with some of the most commonly reported zoonotic manifestations of infection including cat scratch disease, bacillary angiomatosis, endocarditis, and neuroretinitis. Companion animals serve as reservoirs for several zoonotic species of Bartonella, and may also serve as sentinels for zoonotic Bartonella species harbored by wildlife. This article provides an overview of bartonellosis of dogs and cats, and discusses public health implications of animal bartonellosis.

Copyright 2009 Elsevier B.V. All rights reserved.

PMID: 20018462 [PubMed - indexed for MEDLINE]

112. J Infect Chemother. 2009 Dec;15(6):414-6.

Cat scratch disease presenting with a retroperitoneal abscess in a patient without animal contacts.

Koga T, Taguchi J, Suzuki M, Higa Y, Kamimura T, Nishimura M, Arakawa M.

Asakura Medical Association Hospital, 422-1 Raiha, Asakura, Fukuoka, 838-0069, Japan. koga.tk@asakura-med.or.jp

Cat scratch disease (CSD) is usually diagnosed in patients presenting with regional lymphadenopathy and pyrexia that follow contacts with animals. We describe here a young adult male patient who presented with marked pyrexia and a retroperitoneal abscess without relevant medical histories, illustrating that CSD can be a diagnostic challenge on selected occasions.

PMID: 20012734 [PubMed - indexed for MEDLINE]

113. J Clin Microbiol. 2010 Feb;48(2):617-8. Epub 2009 Dec 9.

Comparative activity of pradofloxacin, enrofloxacin, and azithromycin against Bartonella henselae isolates collected from cats and a human.

Biswas S, Maggi RG, Papich MG, Keil D, Breitschwerdt EB.

Intracellular Pathogens Research Laboratory, Center for Comparative Medicine and Translational Research, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina 27606, USA.

Using Bartonella henselae isolates from cats and a human, the activity of pradofloxacin was compared with those of enrofloxacin and azithromycin. By Etest and disc diffusion assay, pradofloxacin showed greater antimicrobial activity than did other antibiotics. We conclude that pradofloxacin may prove useful for the treatment of B. henselae infections.

PMCID: PMC2815609 PMID: 20007401 [PubMed - indexed for MEDLINE]

114. 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, 1413 Tulane Avenue, New Orleans, LA 70112, USA. firshad@tulane.edu

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 - indexed for MEDLINE]

115. J Feline Med Surg. 2010 Apr;12(4):314-21. Epub 2009 Dec 2.

Association of Bartonella species, feline calicivirus, and feline herpesvirus 1 infection with gingivostomatitis in cats.

Dowers KL, Hawley JR, Brewer MM, Morris AK, Radecki SV, Lappin MR.

Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA. kdowers@colostate.edu

Feline gingivostomatitis (FGS) is a common syndrome in cats; feline calicivirus (FCV), feline herpesvirus 1 (FHV-1), and Bartonella species are common differential diagnoses. In this study, blood from 70 cats with FGS and 61 healthy control cats was tested for Bartonella species antibodies in serum by enzyme-linked immunosorbent assay and Western blot immunoassay and DNA in blood using a conventional polymerase chain reaction assay. Additionally, fresh oral biopsies from cats with FGS (n=42) and 19 healthy controls were tested for FCV RNA, FHV-1 DNA and Bartonella species DNA. The prevalence rates for Bartonella species antibodies and DNA in the blood and the tissues did not differ between the two groups. FHV-1 DNA was also not significantly different between groups. Only FCV RNA was present in significantly more cats with FGS (40.5%) than control cats (0%). The results suggest that FCV was associated with FGS in some of the cats.

Copyright 2009 ISFM and AAFP. Published by Elsevier Ltd. All rights reserved.

PMID: 19959386 [PubMed - indexed for MEDLINE]

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

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

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.

PMID: 19941605 [PubMed - indexed for MEDLINE]

117. Vet Microbiol. 2010 May 19;142(3-4):346-51. Epub 2009 Oct 20.

Detection of Bartonella spp. in neotropical felids and evaluation of risk factors and hematological abnormalities associated with infection.

Guimaraes AM, Brandão PE, Moraes W, Kiihl S, Santos LC, Filoni C, Cubas ZS, Robes RR, Marques LM, Neto RL, Yamaguti M, Oliveira RC, Catão-Dias JL, Richtzenhain LJ, Messick JB, Biondo AW, Timenetsky J.

Departmento de Microbiologia, Instituto de Ciências Biomédicas, Universidade de São Paulo (USP), São Paulo, SP, Brazil.

Although antibodies to Bartonella henselae have been described in all neotropical felid species, DNA has been detected in only one species, Leopardus wiedii. The aim of this study was to determine whether DNA of Bartonella spp. could be detected in blood of other captive neotropical felids and evaluate risk factors and hematological findings associated with infection. Blood samples were collected from 57 small felids, including 1 Leopardus geoffroyi, 17 L. wiedii, 22 Leopardus tigrinus, 14 Leopardus pardalis, and 3 Puma yagouaroundi; 10 blood samples from Panthera onca were retrieved from blood banks. Complete blood counts were performed on blood samples from small felids, while all samples were evaluated by PCR. DNA extraction was confirmed by amplification of the cat GAPDH gene. Bartonella spp. were assessed by amplifying a fragment of their 16S-23S rRNA intergenic spacer region; PCR products were purified and sequenced. For the small neotropical felids, risk factors [origin (wild-caught or zoo-born), gender, felid species, and flea exposure] were evaluated using exact multiple logistic regression. Hematological findings (anemia, polycythemia/hyperproteinemia, leukocytosis and leukopenia) were tested for association with infection using Fisher's exact test. The 635bp product amplified from 10 samples (10/67=14.92%) was identified as B. henselae by sequencing. Small neotropical felid males were more likely to be positive than females (95% CI=0.00-0.451, p=0.0028), however other analyzed variables were not considered risk factors (p>0.05). Hematological abnormalities were not associated with infection (p>0.05). This is the first report documenting B. henselae detection by PCR in several species of neotropical felids.

Copyright 2009 Elsevier B.V. All rights reserved.

PMID: 19913372 [PubMed - indexed for MEDLINE]

118. Otolaryngol Pol. 2009 May-Jun;63(3):271-3.

[Cat scratch disease--an underestimated diagnosis].

[Article in Polish]

Szaleniec J, Oleś K, Składzień J, Strek P.

Katedra Klinika Otolaryngologii UJCM w Krakowie. asiat@uci.agh.edu.pl

INTRODUCTION: Cat scratch disease is a rare and frequently underestimated cause of lymphadenopathy, which may occur also in the head and neck. The infection is most commonly caused by intracellular bacilli Bartonella, transmitted by domestic animals. AIM: We present a case report of a patient treated in the Department of Otolaryngology UJCM in Krakow. The patient presented with a neck tumor. Due to unclear clinical manifestation he underwent surgical treatment. The postoperative histopathological examination suggested cat scratch disease. In detailed anamnesis the patient admitted contact with cats and dogs in his household. No posoperative complications were observed. CONCLUSIONS: In every case of neck tumor it is advisable to consider cat scratch disease, remembering that exclusion of a neoplastic process remains a priority.

PMID: 19886535 [PubMed - indexed for MEDLINE]

119. Vector Borne Zoonotic Dis. 2010 May;10(4):415-9.

Cervical lymphadenitis in a patient coinfected with Toxoplasma gondii and Bartonella henselae.

Yoon HJ, Lee WC, Choi YS, Cho S, Song YG, Choi JY, Kim CO, Kim EJ, Kim JM.

Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea.

Cat scratch disease, caused by Bartonella henselae, is a worldwide zoonosis that is most frequently associated with the bite or scratch of a kitten under 6 months of age, as well as from a fleabite. Toxoplsma gondii is also another important zoonotic agent in cats and humans, which is mainly acquired by ingestion of food or water that is contaminated with oocytes shed by cats or by eating undercooked or raw meat containing tissue cysts. Here, we report a first case of young patient with cervical lymphadenitis, which shows serological and histological evidence of B. henselae and T. gondii coinfection in Korea with literature review.

PMID: 19874186 [PubMed - indexed for MEDLINE]

120. Jpn J Ophthalmol. 2009 Sep;53(5):490-3. Epub 2009 Oct 22.

Seroprevalence of Bartonella henselae in patients with uveitis and healthy individuals in Tokyo.

Kamoi K, Yoshida T, Takase H, Yokota M, Kawaguchi T, Mochizuki M.

Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan. koju.oph@tmd.ac.jp

PURPOSE: To compare the seroprevalence of Bartonella henselae, a pathogen of cat scratch disease, in patients with uveitis and in healthy individuals. METHODS: Serum samples were collected from 197 consecutive patients with various entities of uveitis at Tokyo Medical and Dental University Hospital, and from 83 healthy age- and sex-matched volunteers. Anti-Bartonella IgG and IgM antibodies were examined by indirect immunofluorescent antibody. RESULTS: Serum antibodies to B. henselae were positive in 39 of 197 (19.8%) patients with uveitis, and in 21 of 83 (25.3%) of the healthy volunteers. There was no statistical difference in the seroprevalence between the two groups. The overall seroprevalence of B. henselae was 60 of 280 (21.4%). CONCLUSIONS: The seroprevalence of B. henselae was similar in both patients with uveitis and in healthy volunteers in Tokyo, Japan. These data indicate that a significant number of healthy individuals are asymptomatic carriers of B. henselae, which should be kept in mind when a diagnosis of cat scratch disease is made.

PMID: 19847604 [PubMed - indexed for MEDLINE]

121. Transpl Infect Dis. 2009 Oct;11(5):474.

Blood transfusion as an alternative bartonellosis transmission in a pediatric liver transplant.

Velho PE.

Comment on Transpl Infect Dis. 2008 Dec;10(6):431-3.

PMID: 19804481 [PubMed - indexed for MEDLINE]

122. Rev Chilena Infectol. 2009 Aug;26(4):363-9. Epub 2009 Sep 23.

[Cat-scratch disease with bone compromise: atypical manifestation].

[Article in Spanish]

Rodríguez C M, Giachetto L G, Cuneo E A, Gutiérrez B Mdel C, Shimchack R M, Pírez G MC.

Instituto de Pediatría, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.

Fever, headache, myalgias and lymphadenopathy are characteristic manifestations of cat-scratch disease but other less common findings are described in 2 to 10% of cases. We report two children that presented with hepatosplenic abscesses and bone involvement. One child, had multiple areas of increased uptake in the bone scintigram with a positive serology (IgG > 1/256, IgM slightly positive). The second child had destruction of the L2 vertebral body that compromised the channel and right foramen as visualized by MRI. In both cases, bacilli were observed in the bone biopsy by Warthing-Starry stain.

PMID: 19802407 [PubMed - indexed for MEDLINE]

123. Hong Kong Med J. 2009 Oct;15(5):391-3.

A serologically proven case of cat-scratch disease presenting with neuroretinitis.

Chu BC, Tam VT.

Caritas Medical Centre, Shamshuipo, Kowloon, Hong Kong. dr_cychu@yahoo.com.hk

Cat-scratch disease is a clinical syndrome that usually presents as a self-limiting illness featuring regional lymphadenopathy, fever, and small skin lesions in association with a cat scratch or bite. It is caused by the Gram-negative bacillus Bartonella henselae, which commonly affects children and young adults. Ocular bartonellosis is the most common atypical manifestation of cat-scratch disease. It can present with a wide spectrum of ocular diseases including neuroretinitis, Parinaud's oculoglandular syndrome, and other forms of intra-ocular inflammation. This case report describes cat-scratch disease neuroretinitis in a 10-year-old girl who presented with typical signs, including optic disc swelling and a macular star, preceded by pyrexia of unknown origin and cervical lymphadenopathy.

PMID: 19801700 [PubMed - indexed for MEDLINE]

124. Mikrobiyol Bul. 2009 Jul;43(3):391-401.

[Investigation of Bartonella henselae seroprevalence and related risk factors in blood donors admitted to Pamukkale University Blood Center].

[Article in Turkish]

Yilmaz C, Ergin C, Kaleli I.

Pamukkale Universitesi Tip Fakültesi, Mikrobiyoloji Anabilim Dali, Denizli. cansev@gmail.com

Bartonella henselae is an emerging infectious agent that mainly causes cat scratch disease, basillary angiomatosis and peliosis hepatitis. Although many basillary angiomatosis cases have been reported especially from the Mediterranean region of Turkey, adequate data about the seroprevalence of B. henselae in Turkey does not exist. The aim of this study was to investigate the seroprevalence of B. henselae in volunteer blood donors and the related risk factors. In this study, sera samples were randomly collected from 800 (771 man, 29 women; age range: 18-60 years) voluntary healthy blood donors admitted to Pamukkale University Research and Training Hospital. B. henselae (Houston-1 strain) total antibodies were investigated by an in-house indirect immunofluorescent antibody assay. Seropositivity was detected in 6% (48/800) of the donors. B. henselae (Houston-1) antibody titer was 1/64 in 40 of the donors, 1/128 in 4, 1/256 in 2, 1/512 in 1 and 1/1024 in 1 of the donors. Statistical analysis of epidemiological and demographical data revealed that high seroprevalence rates have been found in rabbit stockfarmers (p = 0.004), students staying at hostels (p = 0.04) and people with history of tick-bite (p = 0.03). No significant statistical differences were found in each related groups in terms of age, sex, chronic disorders, sport activities, outside behaviors, being injured by any wild or domestic animals, working outdoors, geographical properties of the area of inhabitance, hunting and travelling (p > 0.05). One of the high titer (1/512) antibody positive subjects was a cat owner and had a history of phlebotomus bite, pediculosis and sporting in open area while 1/1024 titer positive case was a farmer and a dog owner. Our healthy blood donors' seroprevalence results are similar to those of other Mediterranean countries. The analysis of epidemiological data revealed that tick bite history and rabbit stockfarming were the risk factors for B. henselae infection. Variability and regional intensity of vectors may provide important clues to spreading disease. Consequently, these data showed that bartonellosis is an emerging disease in our country and detailed questionnaire for blood donors may be helpful to prevent transmission. Further larger scale research is necessary to determine the seroprevalence of B. henselae and analyse the related risk factors in Mediterranean-type climate regions.

PMID: 19795614 [PubMed - indexed for MEDLINE]

125. Klin Padiatr. 2010 Mar;222(2):73-8. Epub 2009 Sep 29.

Cat scratch disease--heterogeneous in clinical presentation: five unusual cases of an infection caused by Bartonella henselae.

Weinspach S, Tenenbaum T, Schönberger S, Schaper J, Engers R, Rueggeberg J, Mackenzie CR, Wolf A, Mayatepek E, Schroten H.

Department of General Pediatrics, University Children's Hospital, Heinrich Heine University Düsseldorf, Moorenstrasse 5, Düsseldorf, Germany. weinspach@med.uni-duesseldorf.de

BACKGROUND: Cat-scratch disease (CSD) is common in children, however the wide spectrum of the clinical presentation of CSD may lead to delayed diagnosis. An atypical presentation of CSD includes in its differential diagnosis diseases such as tuberculosis, other mycobacterioses, Epstein-Barr-Virus infection (EBV) or malignant disease. Since, in a small number of cases, these diseases may be present concurrently with an active CSD, it is important to consider CSD early in the differential diagnosis and order the appropriate tests. These tests include serology and, where possible, histology including molecular diagnostic methods on tissue specimens. PATIENTS AND METHOD: We performed a case series of five patients treated in our hospital with a clinical diagnosis of cat-scratch disease, confirmed by serology. An analysis of the history and clinical symptoms associated specifically with an atypical presentation of CSD was performed. RESULTS: The clinical presentation of CSD no longer encompasses the original typical description from 1950, but rather presents with a wide spectrum of signs and symptoms, including the absence of a documented cat scratch, fever, primary lesions or peripheral lymphadenopathy. Low density lesions in spleen, liver and lymph nodes are typical findings in ultrasound, MRI, or CT. Ignoring CSD as a possibility in investigating possible malignancy or tuberculosis could lead to unnecessary hospitalisation and delay in the proper treatment. CONCLUSION: CSD should also be considered in differential diagnosis of any patient with intraabdominal lymphadenopathy, abdominal pain and fever of unknown origin. A careful history is important, however, often patients with CSD have no history of contact with cats. Therefore in atypical cases of CSD the finding of other clinical symptoms and performance of specific diagnostic tests is important. Our experience suggests that early serological testing for Bartonella henselae should be performed and may avoid invasive diagnostic procedures.

(c) Georg Thieme Verlag KG Stuttgart-New York.

PMID: 19790029 [PubMed - indexed for MEDLINE]

126. J Dermatol. 2009 Oct;36(10):548-50.

Rapid detection of Bartonella henselae heat shock protein DNA by nested polymerase chain reaction from swollen lymph nodes of a patient with cat-scratch disease.

Umekoji A, Fukai K, Yanagihara S, Ono E, Sowa J, Ishii M.

PMID: 19785710 [PubMed - indexed for MEDLINE]

127. Vet Ther. 2009 Spring-Summer;10(1-2):9-16.

Comparative in vivo adulticidal activity of a topical dinotefuran versus an imidacloprid-based formulation against cat fleas (Ctenocephalides felis) on cats.

Murphy M, Ball CA, Gross S.

Charles River Laboratories Preclinical Services Ireland, Carrentrila, Ballina, Co. Mayo, Ireland.

Fleas cause significant discomfort to pet cats and distress to their owners and are also vectors of disease severe infestations can cause anemia or flea allergy dermatitis and can lead to infections with Dipylidium caninum and Bartonella henselae. Rapid flea kill is an important feature of flea preventives. The efficacy of dinotefuran (Vectra for Cats and Kittens, Summit VetPharm) was compared with that of imidacloprid (Advantage, Bayer Animal Health) against Ctenocephalides felis when applied topically once on day 0. Cats were infested with 100 (+-3) C. felis on study days -1, 8, 15, 22, and 29. Live fleas were counted on study days 0 (2, 6, and 12 hours after treatment), 9, 16, 23, 29 (2, 6, and 12 hours after infestation), and 30. Cats treated with dinotefuran had significantly (P less than .05) fewer fleas than the control cats at all posttreatment examinations except day 29 at 2 hours after infestation and significantly (P less than .05) fewel fleas than cats treated with imidacloprid on days 0 (2 hours after treatment), 9, 16, 23, 29 (6 and 12 hours after infestation), and 30.

PMID: 19742443 [PubMed - indexed for MEDLINE]

128. Arch Soc Esp Oftalmol. 2009 Aug;84(8):389-94.

[Neuroretinitis. Clinical cases].

[Article in Spanish]

Valverde-Gubianas M, Ramos-López JF, López-Torres JA, Toribio-García M, Milla-Peñalver C, Gálvez Torres-Puchol J, Medialdea-Marcos S.

Servicio de Oftalmología, Hospital Universitario Virgen de las Nieves, Granada, España. marga_valverde@hotmail.com

OBJECTIVE: Evaluate the etiology and the most frequent funduscopic alterations of the neuroretinitis. METHODS: We present the case of a woman 24 years old with a 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.

PMID: 19728239 [PubMed - indexed for MEDLINE]

129. Vet Microbiol. 2010 Feb 24;141(1-2):182-5. Epub 2009 Aug 8.

Molecular detection of Bartonella henselae and Bartonella koehlerae from aortic valves of Boxer dogs with infective endocarditis.

Ohad DG, Morick D, Avidor B, Harrus S.

Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Israel.

Cardiac aortic valves from five dogs that died from acquired infective endocarditis were retrospectively molecularly screened for Bartonella infection. Identification was carried out using PCR targeting four gene fragments (rpoB, ribC, 16S rRNA and gltA), and the 16S-23S intergenic spacer (ITS). Bartonella henselae DNA was detected in aortic valve tissue from one Boxer dog with moderate subaortic stenosis (SAS). Bartonella koehlerae DNA was detected from the aortic valve of another Boxer dog with severe SAS. The latter dog was both a littermate and a housemate of the dog with the B. henselae infection. Other animals residing at the same household were also screened for Bartonella infection. B. henselae was molecularly detected in a spleen aspirate from the dogs' mother, and isolated and molecularly characterized from another housemate cat. This is the first molecular identification of B. henselae and B. koehlerae, two zoonotic Bartonella species, from valves of dogs with canine infective endocarditis, suggesting their role in the pathogenesis of this disease. Moreover, this is the first report describing the detection of B. koehlerae from dogs.

Copyright 2009 Elsevier B.V. All rights reserved.

PMID: 19716241 [PubMed - indexed for MEDLINE]

130. J Vet Intern Med. 2009 Nov-Dec;23(6):1273-7. Epub 2009 Aug 26.

Recurrent osteomyelitis in a cat due to infection with Bartonella vinsonii subsp. berkhoffii genotype II.

Varanat M, Travis A, Lee W, Maggi RG, Bissett SA, Linder KE, Breitschwerdt EB.

Intracellular Pathogens Research Laboratory, Center for Comparative Medicine and Translational Research, College of Veterinary Medicine, North Carolina State University (NCSU), Raleigh, NC 27606, USA.

PMID: 19709358 [PubMed - indexed for MEDLINE]

131. Otolaryngol Pol. 2009 Mar-Apr;63(2):154-7.

[Cat scratch disease--a diagnostic problem, case report].

[Article in Polish]

Dabrowska-Bień J, Pietniczka-Załeska M, Rowicki T.

Oddział Otolaryngologii Miedzyleskiego Szpitala Specjalistycznego w Warszawie. justinebien@gmail.com

AIM OF THE STUDY: Cat scratch disease as a possible cause of neck limphadenopathy. MATERIAL AND METHODS: We present a case of 40-years old men operated in our department on regional unilateral lymphadenopathy. The diagnosis of cat scratch disease was confirmed by the histopathologic examination. CONCLUSIONS: Regional lymphadenopathy with history of contact with cats or other animals suggests the diagnosis of cat scratch disease. If we considered this disease in differential diagnosis it would mean less traumatic treatment for the patient. Cat scratch disease is diagnosed in Poland very rarely; we need to spread the knowledge about this infectious disease.

PMID: 19681487 [PubMed - indexed for MEDLINE]

132. Pediatr Infect Dis J. 2009 Sep;28(9):848-50.

Cat scratch disease with cervical vertebral osteomyelitis and spinal epidural abscess.

Tasher D, Armarnik E, Mizrahi A, Liat BS, Constantini S, Grisaru-Soen G.

The Pediatric Infectious Diseases Unit, E. Wolfson Medical Center, Holon, Israel.

Cat scratch disease has variable clinical presentations and should be considered in the differential diagnosis of vertebral osteomyelitis and epidural abscess if there is a history of contact with cats. We report a 5-year-old boy with cat scratch disease who presented with painful torticollis and osteomyelitis of the cervical spine associated with an epidural abscess.

PMID: 19654566 [PubMed - indexed for MEDLINE]

133. Int J STD AIDS. 2009 Aug;20(8):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, UK. christopher.scott@chelwest.nhs.uk

We report the case of a patient who presented to a clinic for evaluation of inguinal lymphadenopathy. Histology of the lymph nodes revealed micoabscess formation suggesting infection with Lymphogranuloma venereum (LGV) or Bartonella henselae--the causative agent in cat scratch disease (CSD). The patient recalled no preceding animal exposure. Clinical and serological findings initially suggested early LGV but convalescent serology supported CSD. This serves as an important reminder that B. henselae infection should be considered a cause of regional lymphadenopathy in individuals suspected of having LGV.

PMID: 19625597 [PubMed - indexed for MEDLINE]

134. Wei Sheng Wu Xue Bao. 2009 Apr 4;49(4):429-37.

[Biological and molecular characteristics of a cat-borne Bartonella clarridgeiae].

[Article in Chinese]

Li D, Liu Q, Song X, Zhang J, Xu C, Yang X.

National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China. lidongmei@icdc.cn

OBJECTIVE: To characterize a Bartonella strain M9HN-SHQ from a blood culture of cat from Henan Province,China. METHODS: The organisms were subcultured in 5% CO2 at 37 degrees C on trypticase soy agar containing 5% sheep blood for 6 to 7 days. We analyzed the isolate using whole-cell fatty acid analysis,Etest for susceptibility testing, random amplified polymorphic DNA (RAPD), pulsed-field gel electrophoresis(PFGE) and sequence analysis of 16S rRNA, gltA, groEL, ftsZ, rpoB, ribC and 16S-23S rRNA intergenic spacer region. RESULTS: Isolate M9HN-SHQ stained faintly as a gram-negative rod but was easier to visualize when stained by the Gimenez technique. Most of the biochemical and cellular fatty acid properties of strain M9HN-SHQ were typical for bacteria of the Bartonella genus. The strain was susceptible to Cefotaxime sodium, Rifampin, Ciprofloxacin and other four antibiotics. Genotypic characterization of strain M9HN-SHQ, including RAPD, PFGE was distinguishable from the reference strains of B. henselae, B. elizabethae, B. vinsonii subsp. berkhoffii and B. grahamii. Sequence analysis of the genes from the seven chromosomal regions identified the strain M9HN-SHQ as B. clarridgeiae. CONCLUSION: To our knowledge,this is the first report that documents Bartonella clarridgeiae infections of domestic cats in China.

PMID: 19621628 [PubMed - indexed for MEDLINE]

135. Med Mal Infect. 2010 Mar;40(3):172-4. Epub 2009 Jul 17.

[Hepatic localization of cat scratch disease in an immunocompetent patient].

[Article in French]

Renou F, Raffray L, Gerber A, Moiton MP, Ferrandiz D, Yvin JL.

Service de médecine interne, maladies infectieuses et dermatologie, centre hospitalier départemental Félix-Guyon, allée des Topazes, Saint-Denis, France. fredericrenou@hotmail.com

INTRODUCTION: The cat-scratch disease is a benign inoculation disease and a well-known cause of localized lymphadenopathy. Visceral localizations are rare and occur mostly in immunocompetent patients. CASE: We report the case of a 57-year-old-man with lymphadenopathy of the right arm with hepatic nodules related to a Bartonella henselae infection. CONCLUSION: The cat-scratch disease must be screened for in case of hepatic and/or splenic nodules. A cause of immunodeficiency should be investigated.

PMID: 19616394 [PubMed - indexed for MEDLINE]

136. 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 - indexed for MEDLINE]

137. J Feline Med Surg. 2009 Aug;11(8):663-7. Epub 2009 Jun 26.

Serum feline pancreatic lipase immunoreactivity concentration and seroprevalences of antibodies against Toxoplasma gondii and Bartonella species in client-owned cats.

Bayliss DB, Steiner JM, Sucholdolski JS, Radecki SV, Brewer MM, Morris AK, Lappin MR.

Department of Clinical Sciences, Colorado State University, Fort Collins, CO, United States. dbayliss@medvetmemphis.com

Feline pancreatitis is a commonly suspected illness and it has been proposed that some cases of feline pancreatitis may be caused by infection with Toxoplasma gondii or Bartonella species. Feline pancreatic lipase immunoreactivity (fPLI) is a test performed on serum that is commonly combined with other clinical findings as an indirect aid in the diagnosis of pancreatitis. The purpose of this study was to determine if there are associations between fPLI concentration and the presence of serum antibodies against T gondii or Bartonella species. Serum samples from 458 cats, for which serum fPLI concentrations had already been determined, were assayed by enzyme-linked immunosorbent assay for the presence of T gondii immunoglobulin (Ig) G (IgG) and IgM antibodies, and Bartonella species IgG antibodies. The association between fPLI concentration and T gondii or Bartonella species antibodies was determined. No statistically significant association was found between fPLI concentration and T gondii or Bartonella species antibodies, suggesting that serological tests for the organisms are not useful in cases with increased fPLI concentration.

PMID: 19560385 [PubMed - indexed for MEDLINE]

138. Clin Imaging. 2009 Jul-Aug;33(4):318-21.

Computed tomography and magnetic resonance imaging of cat-scratch disease: a report of two cases.

Wang CW, Chang WC, Chao TK, Liu CC, Huang GS.

Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.

Cat-scratch disease (CSD) is a bacterial infection that typically causes swelling of the lymph nodes. The patients usually have a history of being scratched, bitten, or licked by cats and often by kittens. Understanding the characteristic radiological and clinical features may lead to a noninvasive diagnosis and prevent unnecessary invasive procedures. We report two cases of CSD with computed tomography and magnetic resonance imaging showing nodules or masses of lymphadenopathy with subcutaneous edema and fat infiltration in the lymphatic drainage area. The imaging features and clinical manifestations are described, and the differential diagnosis of CSD is discussed.

PMID: 19559357 [PubMed - indexed for MEDLINE]

139. Ann N Y Acad Sci. 2009 May;1166:120-6.

Bartonella endocarditis: a pathology shared by animal reservoirsand 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 when cases caused by Bartonella quintana, B. elizabethae, and B. henselae were reported. Since the first isolation of Bartonella vinsonii subspecies berkhoffii from a dog with endocarditis, this organism has emerged as an important pathogen in dogs and an emerging pathogen in people. Subsequently, four types of B. vinsonii subsp. berkhoffii have been described, all of which have been associated with endocarditis in dogs. A limited number of dog endocarditis cases have also been associated with B. clarridgeiae, B. washoensis, B. quintana, and B. rochalimae. The second canine B. clarridgeiae endocarditis case is presented. The clinical and pathological characteristics of Bartonella endocarditis in dogs are similar to disease observed in humans, more often affecting the aortic valve, presenting with highly vegetative lesions with accompanying calcification, and in most instances high antibody titers. Pathological features in dogs include a combination of fibrosis, mineralization, endothelial proliferation, and neovascularization with variable inflammation. Endocarditis has also been described in animal species, which are the natural reservoir of specific Bartonella species, once thought to be solely healthy carriers of these pathogens. A few Bartonella endocarditis cases, including B. henselae, have been reported in cats in the USA and Australia. The second case of B. henselae type Houston I identified in the USA is presented. Furthermore, two cases of B. bovis endocarditis were recently described in adult cows from France. Finally, on-going investigation of valvular endocarditis in free-ranging Alaskan sea otters suggests the involvement of Bartonella species.

PMID: 19538271 [PubMed - indexed for MEDLINE]

140. Vet Immunol Immunopathol. 2009 Dec 15;132(2-4):251-6. Epub 2009 May 18.

Immunogenicity of Bartonella henselae P26 in cats.

Feng S, Kasten RW, Werner JA, Hodzic E, Barthold SW, Chomel BB.

Center for Comparative Medicine, Schools of Medicine and Veterinary Medicine, University of California, One Shields Avenue, Davis, CA 95616, United States. sfeng@ucdavis.edu

Cat scratch disease (CSD) has an estimated prevalence of approximately 200,000 persons in the USA, and approximately 22,000 new cases occur annually. Cats are the natural carriers of Bartonella henselae, the agent for CSD. Zoonotic transmission of B. henselae can result in CSD in immunocompetent humans and bacillary angiomatosis in immunosuppressed humans. Infection in cats often goes undetected. Development of a vaccine to prevent feline infection is warranted to reduce the prevalence of infection in the feline population and to decrease the potential for zoonotic transmission. One of the immunoreactive proteins identified from our previous study was P26. In this study, we demonstrated that B. henselae recombinant P26 (rP26) was immunogenic in cats. Four cats immunized with rP26 and four control cats were challenged with B. henselae type I and blood samples were collected for culture, PCR, and serology. Immunization with rP26 did not provide protection against B. henselae infection in cats at the doses used in this study. However, p26 PCR proved to be more sensitive for detection of infection in cats compared to gltA PCR. Furthermore, ELISA using rP26 as the substrate was more sensitive than ELISA using B. henselae type I outer membrane proteins.

PMID: 19500857 [PubMed - indexed for MEDLINE]

141. Clin Microbiol Infect. 2009 Dec;15 Suppl 2:124-6. Epub 2009 May 18.

First isolation of Bartonella bovis from animals in French Guyana, South America.

Saisongkorh W, Barrassi L, Davoust B, de Broucker CA, Raoult D, Rolain JM.

Unité des Rickettsies, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, URMITE CNRS-IRD, UMR, Marseille, France.

PMID: 19456818 [PubMed - indexed for MEDLINE]

142. Clin Microbiol Infect. 2009 Dec;15 Suppl 2:130-1. Epub 2009 May 18.

Description of Bartonella spp. infections in a general hospital of Catalonia, Spain.

Sanfeliu I, Antón E, Pineda V, Pons I, Perez J, Font B, Segura F.

Microbiology Laboratory, UDIAT Centre Diagnòstic, Corporació Parc Taulí, Sabadell, Barcelona, Spain. isanfeliu@tauli.cat

PMID: 19456816 [PubMed - indexed for MEDLINE]

143. Clin Microbiol Infect. 2009 Dec;15 Suppl 2:134-5. Epub 2009 May 18.

Serological and molecular detection of Bartonella spp. in humans, cats and dogs from northern Sardinia, Italy.

Zobba R, Chessa G, Mastrandrea S, Pinna Parpaglia ML, Patta C, Masala G.

Dipartimento di Patologia e Clinica Veterinaria, Università degli Studi di Sassari, Sassari, Italy.

PMID: 19456814 [PubMed - indexed for MEDLINE]

144. Clin Microbiol Infect. 2009 Dec;15 Suppl 2:108-9. Epub 2009 Apr 30.

Bartonella infections in Italy.

Ciceroni L, Pinto A, Ciarrocchi S, Ciervo A.

Department of Infectious, Parasitic and Immune-mediated Diseases, Istituto Superiore di Sanità, Viale Regina Elena, Rome, Italy. ciceroni@iss.it

PMID: 19438634 [PubMed - indexed for MEDLINE]

145. Clin Microbiol Infect. 2009 Dec;15 Suppl 2:334-5. Epub 2009 May 2.

First detection of Rickettsia felis and Bartonella clarridgeiae in fleas from Laos.

Varagnol M, Parola P, Jouan R, Beaucournu JC, Rolain JM, Raoult D.

URMITE, UMR CNRS-IRD 6236, WHO Collaborative Center for Rickettsial Diseases and Other Arthropod-borne Bacterial Diseases, Marseille, France.

PMID: 19438611 [PubMed - indexed for MEDLINE]

146. Clin Microbiol Infect. 2009 Dec;15 Suppl 2:1-3. Epub 2009 Mar 26.

Evidence of Bartonella spp., Rickettsia spp. and Anaplasma phagocytophilum in domestic, shelter and stray cat blood and fleas, Portugal.

Alves AS, Milhano N, Santos-Silva M, Santos AS, Vilhena M, de Sousa R.

Universidade de Evora, Evora, Portugal.

PMID: 19416279 [PubMed - indexed for MEDLINE]

147. Enferm Infecc Microbiol Clin. 2010 Jan;28(1):64-5. Epub 2009 May 1.

[Embolic stroke as the first manifestation of Bartonella henselae endocarditis in an immunocompetent patient].

[Article in Spanish]

Sureda A, García D, Loma-Osorio P.

PMID: 19409676 [PubMed - indexed for MEDLINE]

148. Emerg Infect Dis. 2009 May;15(5):813-6.

Molecular epidemiology of feline and human Bartonella henselae isolates.

Bouchouicha R, Durand B, Monteil M, Chomel BB, Berrich M, Arvand M, Birtles RJ, Breitschwerdt EB, Koehler JE, Maggi R, Maruyama S, Kasten R, Petit E, Boulouis HJ, Haddad N.

Ecole Nationale Vétérinaire d'Alfort, Maisons Alfort, France.

Multiple locus variable number tandem repeat analysis was performed on 178 Bartonella henselae isolates from 9 countries; 99 profiles were distributed into 2 groups. Human isolates/strains were placed into the second group. Genotype I and II isolates shared no common profile. All genotype I isolates clustered within group B. The evolutive implications are discussed.

PMCID: PMC2687025 PMID: 19402978 [PubMed - indexed for MEDLINE]

149. Pol Merkur Lekarski. 2009 Feb;26(152):131-5.

[Diagnostics of cat scratch disease and present methods of bartonellosis recognition--a case report].

[Article in Polish]

Podsiadły E, Sapiejka E, Dabrowska-Bień J, Majkowski J, Tylewska-Wierzbanowska S.

National Institute of Public Health-National Institute of Hygiene, Unit of Rickettsiae, Chlamydiae and Spirochaetes, Warsaw, Poland. epodsiadly@pzh.gov.pl

Bartonella infections including cat scratch disease (CSD) is a group of infectious diseases which are diagnosed sporadically. Because of this fact the number of CSD cases in Poland is underestimated and their incidence is markedly lower in comparison to other European countries. The aim of our report is to present various diagnostic methods and possibilities on the basis of two cases with symptoms of CSD. The efficiency of specific Bartonella antibiotic therapy is also discussed.

PMID: 19388519 [PubMed - indexed for MEDLINE]

150. J Parasitol. 2009 Oct;95(5):1129-33. Epub 2009 Apr 22.

Seroprevalence of Toxoplasma gondii and concurrent Bartonella spp., feline immunodeficiency virus, and feline leukemia virus infections in cats from Grenada, West Indies.

Dubey JP, Lappin MR, Kwok OC, Mofya S, Chikweto A, Baffa A, Doherty D, Shakeri J, Macpherson CN, Sharma RN.

United States Department of Agriculture, Agricultural Research Service, Animal and Natural Resources Institute, Beltsville, Maryland 20705-2350, USA. jitender.dubey@ars.usda.gov

Toxoplasma gondii and Bartonella spp. are zoonotic pathogens of cats. Feline immunodeficiency virus (FIV) and feline leukemia virus (FeLv) are related to human immunodeficiency virus, and human leukemia virus, respectively; all of these viruses are immunosuppressive. In the present study, the prevalence of antibodies to T. gondi, Bartonella spp., FIV, as well as FeLv antigen were determined in sera from 75 domestic and 101 feral cats (Felis catus) from the Caribbean island of Grenada, West Indies. Using a modified agglutination test, antibodies to T. gondii were found in 23 (30.6%) of the 75 pet cats with titers of 1:25 in 1, 1:50 in 3, 1:400 in 4, 1:500 in 12, 1:800 in 2, and 1:1,600 in 1, and 28 (27.7%) of 101 feral cats with titers of 1:25 in 4, 1:50 in 7, 1:200 in 4, 1:400 in 1, 1:500 in 3, 1:800 in 2, 1:1,600 in 3, and 1:3,200 in 4. Overall, in both pet and feral cats, the seroprevalence increased with age. Antibodies to Bartonella spp. were found in 38 (50.6%) of the 75 pet cats and 52.4% of 101 feral cats. Antibodies to FIV were found in 6 domestic and 22 feral cats. None of the 176 cats was positive for FeLv antigen. There was no correlation among T. gondii, Bartonella spp., and FIV seropositivity.

PMID: 19385716 [PubMed - indexed for MEDLINE]

151. Epidemiol Infect. 2009 Nov;137(11):1568-73. Epub 2009 Apr 20.

Prevalence of Bartonella infection in cats and dogs in a metropolitan area, Thailand.

Inoue K, Maruyama S, Kabeya H, Kawanami K, Yanai K, Jitchum S, Jittaparapong S.

Laboratory of Veterinary Public Health, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Japan.

The prevalence of Bartonella infection was studied in 312 cats and 350 dogs in the Bangkok metropolitan areas, Thailand, between June 2001 and February 2003. Bartonella was isolated from 47 (16.3%) of 288 stray cats, but from none of the 24 pet cats studied. Of the 47 Bartonella-positive cats, 45 animals were infected with only B. henselae, one was infected with only B. clarridgeiae, and one with both B. henselae and B. clarridgeiae. 16S rRNA typing showed that 40 cats were infected with B. henselae type I, four with B. henselae type II, and one with both B. henselae types I and II. These results indicated that B. henselae, especially type I, was prevalent in stray cats that constituted a large Bartonella reservoir in Bangkok. B. clarridgeiae was isolated for the first time in Asia from one of 350 dogs.

PMID: 19379541 [PubMed - indexed for MEDLINE]

152. Clin Dermatol. 2009 May-Jun;27(3):271-80.

Bartonellosis.

Maguiña C, Guerra H, Ventosilla P.

Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano, Heredia, Apartado Postal 4314, Lima, Perú. ciromaguina@yahoo.com

Bartonella spp are fastidious bacteria that occur in the blood of man and mammals; they are usually vector borne but can also be transmitted by animal scratches and bites. The bartonelloses of medical importance comprise Carrión's disease, trench fever, cat-scratch disease, bacillary angiomatosis, and peliosis hepatis. Carrión's disease, known as Oroya fever in the acute phase and verruga peruana (Peruvian wart) in its chronic form, has curious manifestations that, until recently, have been restricted in their geographic distribution to dwellers of the high, dry Andean valleys, but new sites of disease are emerging. Trench fever is associated with louse-borne disease and homelessness. Cat-scratch disease, bacillary angiomatosis, and peliosis hepatis are increasingly being recognized as causes of human disease, especially in susceptible population groups such as HIV-infected persons. The Bartonella spp are considered emerging human pathogens. The clinical manifestations, differential diagnosis, laboratory diagnosis, and treatment of these conditions are discussed.

PMID: 19362689 [PubMed - indexed for MEDLINE]

153. Microbes Infect. 2009 May-Jun;11(6-7):716-20. Epub 2009 Apr 5.

Experimental infection of cats with Bartonella henselae resulted in rapid clearance associated with T helper 1 immune responses.

Kabeya H, Umehara T, Okanishi H, Tasaki I, Kamiya M, Misawa A, Mikami T, Maruyama S.

Laboratory of Veterinary Public Health, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa, Japan. kabeya@brs.nihon-u.ac.jp

Six cats were inoculated with Bartonella henselae strains A and B, which were isolated from the same naturally infected cat. The numbers of CD4(+) cells decreased following the infection. The levels of bacteremia were significantly correlated with the expression levels of IFN-gamma mRNA during the various stages of bacteremia and elimination of the bacteremia. Furthermore, the lower levels of TNF-alpha mRNA expression during the bacteremia related to the emergence of higher levels of bacteremia. These results indicate that the activation of cell-mediated immune responses, including IFN-gamma and TNF-alpha production, play an important role in elimination of B. henselae from bacteremic cats.

PMID: 19348961 [PubMed - indexed for MEDLINE]

154. Proteomics. 2009 Apr;9(7):1967-81.

Proteomic analysis of the bacterial pathogen Bartonella henselae and identification of immunogenic proteins for serodiagnosis.

Eberhardt C, Engelmann S, Kusch H, Albrecht D, Hecker M, Autenrieth IB, Kempf VA.

Institut für Medizinische Mikrobiologie und Hygiene, Klinikum der Eberhard-Karls-Universität, Tübingen, Germany.

Bartonella henselae is a slow growing, fastidious and facultative intracellular pathogen causing cat scratch disease and vasculoproliferative disorders. To date, knowledge about the pathogenicity of this human pathogenic bacterium is limited and, additionally, serodiagnosis still needs further improvement. Here, we investigated the proteome of B. henselae using 2-D SDS-PAGE and MALDI-TOF-MS. We provide a comprehensive 2-D proteome reference map of the whole cell lysate of B. henselae with 431 identified protein spots representing 191 different proteins of which 16 were formerly assigned as hypothetical proteins. To unravel immunoreactive antigens, we applied 2-D SDS-PAGE and subsequent immunoblotting using 33 sera of patients suffering from B. henselae infections. The analysis revealed 79 immunoreactive proteins of which 71 were identified. Setting a threshold of 20% seroreactivity, 11 proteins turned out to be immunodominant antigens potentially useful for an improved Bartonella-specific serodiagnosis. Therefore, we provide for the first time (i) a comprehensive 2-D proteome map of B. henselae for further proteome-based studies focussed on the pathogenicity of B. henselae and (ii) an integrated view into the humoral immune responses targeted against this newly emerged human pathogenic bacterium.

PMID: 19333998 [PubMed - indexed for MEDLINE]

155. Pediatr Dent. 2009 Jan-Feb;31(1):58-62.

Cat scratch disease: clinical considerations for the pediatric dentist.

Da Silva K, Chussid S.

Division of Pediatric Dentistry, College of Dental Medicine, Columbia University, New York, NY, USA. kd2132@columbia.edu

Cat scratch disease (CSD), caused by Bartonella henselae, is a self-limited chronic lymphadenopathy. It is transmitted commonly by a scratch or bite from cats or kittens. Diagnosis of CSD is often difficult, as it masquerades as other causes of cervical lymphadenopathy or submandibular gland pathology. The purpose of this paper was to report a unique case of a 6-year old male who had close contact with a domestic dog and developed CSD which progressed to suppuration. After treatment with antibiotics was unsuccessful, the patient was taken to the operating room for definitive care. As CSD children may be seen in the pediatric dental office, on awareness of its symptomatology can prevent unnecessary dental intervention and facilitate early treatment.

PMID: 19320261 [PubMed - indexed for MEDLINE]

156. Rev Med Interne. 2009 Jul;30(7):602-8. Epub 2009 Mar 19.

[Cat scratch disease with bone involvement: a case report and literature review].

[Article in French]

Roubaud-Baudron C, Fortineau N, Goujard C, Le Bras P, Lambotte O.

Service de médecine interne, CHU de Bicêtre, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre, France.

INTRODUCTION: Cat scratch disease is an infectious disease caused by Bartonella henselae. Most of the patients present with a lymphadenopathy associated with a local infection at the site of the cat scratch. Disseminated infection is uncommon. CASE REPORT: We report an immunocompetent 61-year-old woman who presented with a systemic cat scratch disease including a multifocal osteomyelitis. Diagnosis was confirmed by PCR on the adenopathy. A literature review identified 51 other cases of osteomyelitis associated with cat scratch disease, 14 of those confirmed by PCR. CONCLUSION: Bone involvement in cat scratch disease is rare, especially in adults. The diagnosis should be suspected on the basis of patient questioning. The antibiotherapy and the place of surgery are discussed.

PMID: 19303175 [PubMed - indexed for MEDLINE]

157. J Dtsch Dermatol Ges. 2009 Sep;7(9):767-69.

Bacillary angiomatosis.

[Article in English, German]

Lange D, Oeder C, Waltermann K, Mueller A, Oehme A, Rohrberg R, Marsch W, Fischer M.

Department of Dermatology and Venereology, University of Halle-Wittenberg, Halle (Saale), Germany. danica.lange@medizin.uni-halle.de

An infection with Bartonella henselae transmitted from domestic cats to humans by scratching normally leads to cat-scratch disease. When the human host has severe immunosuppression or HIV infection, the potentially life-threatening disease bacillary angiomatosis can develop. A 79-year-old man presented with livid-erythematous, angioma-like skin lesions. We considered a cutaneous infiltrate from his known chronic lymphocytic leukemia, Merkel cell carcinoma, cutaneous metastases of internal tumors, cutaneous sarcoidosis, mycobacterial infection and even atypical herpes simplex infection. The correct diagnosis was proven histologically and by PCR. Because of increasing numbers of immunosuppressed and HIV-positive patients, as well as an infection rate of 13% for B. henselae in domestic cats in Germany, one must be alert to the presence of bacillary angiomatosis.

PMID: 19298547 [PubMed - indexed for MEDLINE]

158. Arch Otolaryngol Head Neck Surg. 2009 Mar;135(3):243-8.

Polymerase chain reaction for pathogen identification in persistent pediatric cervical lymphadenitis.

Choi P, Qin X, Chen EY, Inglis AF Jr, Ou HC, Perkins JA, Sie KC, Patterson K, Berry S, Manning SC.

Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, WA, USA.

OBJECTIVE: To study routine culture-negative persistent cervical lymphadenitis in children treated surgically during a 10-year period (December 26, 1997, to October 1, 2007) at a single institution. DESIGN: Retrospective case series. SETTING: Tertiary university-based pediatric referral center. PATIENTS: Patients 18 years or younger with cervical lymphadenitis managed surgically (incision and drainage, curettage, and/or excisional lymphadenectomy) and medically (antibiotic therapy), culture-negative after 48 hours, and subsequently diagnosed using the polymerase chain reaction, extended culture incubation, and/or histopathologic evaluation. MAIN OUTCOME MEASURES: Number of surgical interventions, causative organisms, histopathologic features, and resolution of lymphadenitis. RESULTS: Ninety surgical procedures were performed in 60 patients. The cure rate was 23% (approximately 14 patients) with incision and drainage, 58% (approximately 35 patients) with curettage, and 95% (57 patients) with excisional lymphadenectomy. Nontuberculous mycobacteria were the most prevalent causative organisms, followed by Bartonella and Legionella organisms. Four of 6 patients with Bartonella infection had a history of cat exposure, and 4 of 6 patients with Legionella infection had a history of hot tub exposure. CONCLUSIONS: Excisional lymphadenectomy is the preferred treatment of mycobacterial persistent cervical lymphadenitis in children. Sufficient data are lacking for similar recommendations in patients with disease caused by Bartonella organisms, whereas for neck disease caused by Legionella organisms, excisional lymphadenectomy may be superior to incision and drainage. The polymerase chain reaction is useful for pathogen identification in pediatric cervical lymphadenitis, although it is less sensitive in identification of mycobacteria. To our knowledge, our study is the first to report multiple cases of legionellosis in otherwise healthy children. Legionella seems to be a previously unrecognized but relatively common pathogen in culture-negative persistent cervical lymphadenitis in children.

PMID: 19289701 [PubMed - indexed for MEDLINE]

159. Infection. 2009 Apr;37(2):166-7. Epub 2009 Mar 9.

Prevalence of Bartonella henselae antibodies in children and blood donors in Croatia.

Pandak N, Daković-Rode O, Cabraja I, Kristof Z, Kotarac S.

PMID: 19274430 [PubMed - indexed for MEDLINE]

160. Vet Res. 2009 Jul-Aug;40(4):27.

Dogs are more permissive than cats or guinea pigs to experimental infection with a human isolate of Bartonella rochalimae.

Chomel BB, Henn JB, Kasten RW, Nieto NC, Foley J, Papageorgiou S, Allen C, Koehler JE.

Department of Population Health and Reproduction, School of Veterinary Medicine,University of California, Davis, CA, USA. bbchomel@ucdavis.edu

Bartonella rochalimae was first isolated from the blood of a human who traveled to Peru and was exposed to multiple insect bites. Foxes and dogs are likely natural reservoirs for this bacterium. We report the results of experimental inoculation of two dogs, five cats and six guinea pigs with the only human isolate of this new Bartonella species. Both dogs became bacteremic for 5-7 weeks, with a peak of 10(3)-10(4) colony forming units (CFU)/mL blood. Three cats had low bacteremia levels (< 200 CFU/mL) of 6-8 weeks' duration. One cat that remained seronegative had two bacterial colonies isolated at a single culture time point. A fifth cat never became bacteremic, but seroconverted. None of the guinea pigs became bacteremic, but five seroconverted. These results suggest that dogs could be a reservoir of this strain of B. rochalimae, in contrast to cats and guinea pigs.

PMCID: PMC2695131 PMID: 19272295 [PubMed - indexed for MEDLINE]

161. Vet Pathol. 2009 Mar;46(2):277-81.

Identification of Bartonella henselae in an aborted equine fetus.

Johnson R, Ramos-Vara J, Vemulapalli R.

Animal Disease Diagnostic Laboratory, Purdue University, 406 South University, West Lafayette, IN 47907, USA. johnso50@purdue.edu

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-spirillar bacteria. Nucleotide sequence analysis of the bacterial 16S rRNA gene amplified from the DNA extracted from fetal tissues revealed 99.9% homology to that of B. henselae. The presence of B. henselae in the fetal tissues was further confirmed by polymerase chain reaction amplification and nucleotide sequence analysis of other Bartonella species-specific genes. Microorganisms were immunohistochemically labeled with a monoclonal antibody to B. henselae and were ultrastructurally characterized. Attempts to detect known causative agents of equine abortion were unsuccessful. Given the severity of vasculitis and the presence of intralesional bacteria, we concluded that B. henselae infection caused the abortion of this foal.

PMID: 19261640 [PubMed - indexed for MEDLINE]

162. Ned Tijdschr Geneeskd. 2009 Jan 31;153(5):174-80.

[Clinical thinking and decision making in practice. A man with abdominal pain, weight loss and fever].

[Article in Dutch]

Dekkers MJ, Dees A, Weidema WF, Bartelsman M, Veeken H, Hart W.

Afd. Interne Geneeskunde, Ikazia Ziekenhuis, Rotterdam. m.j.dekkers@solcon.nl

PMID: 19256242 [PubMed - indexed for MEDLINE]

163. J Vet Sci. 2009 Mar;10(1):85-7.

Prevalence of Bartonella henselae and Bartonella clarridgeiae in cats and dogs in Korea.

Kim YS, Seo KW, Lee JH, Choi EW, Lee HW, Hwang CY, Shin NS, Youn HJ, Youn HY.

Department of Veterinary Internal Medicine and BK21 Program for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul 151-742, Korea.

Blood, saliva, and nail samples were collected from 54 dogs and 151 cats and analyzed for the presence of Bartonella henselae with a novel nested polymerase chain reaction (PCR) method. Bartonella (B.) henselae was detected in feral cat blood (41.8%), saliva (44.1%), and nail (42.7%) samples. B. henselae was also detected in pet cat blood (33.3%), saliva (43.5%), and nail (29.5%) samples and in pet dog blood (16.6%), saliva (18.5%), and nail (29.6%) samples. Nine samples were infected with B. clarridgeiae and 2 were co-infected with B. henselae and B. clarridgeiae of blood samples of dogs. This report is the first to investigate the prevalence of B. henselae and B. clarridgeiae in dogs and cats in Korea, and suggests that dogs and cats may serve as potential Bartonella reservoirs.

PMCID: PMC2801096 PMID: 19255530 [PubMed - indexed for MEDLINE]

164. 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.

Clínica David, Unidad Oftalmológica, Morelia, Michoacan and General Hospital "Dr. Miguel Silva," SSA, Morelia, Michoacan - Mexico. tolodamota@yahoo.com.mx

PURPOSE: Bartonella henselae is the causal agent of cat scratch disease and one variation in its presentation is Leber neuroretinitis. The unilateral presence of exudation as a macular star and papilledema represent its most common presentation. METHODS: Observational case report. A 7-year-old girl presented a sudden decrease of visual acuity and bilateral macular exudation (macular star) as well as choroiditis. RESULTS: A complete recovery of visual acuity was seen after a 6-week follow-up. Erythromycin plus deflazacort treatment was given. CONCLUSIONS: The present case represents an unusual variety of cat scratch disease. This represents a challenge in the differential diagnosis of diseases such as Lyme disease and tuberculosis among others.

PMID: 19253255 [PubMed - indexed for MEDLINE]

165. Przegl Epidemiol. 2008;62(4):759-65.

[Prevalence IgG antibodies against Bartonella henselae in children with lymphadenopathy].

[Article in Polish]

Zarzycka B, Pieczara A, Skowron-Kobos J, Krzemiński Z.

Zakład Mikrobiologii Lekarskiej Uniwersytetu Medycznego w Lodzi. bzarzycka@o2.pl

Bartonella henselae is a cat scratch disease's etiological agent which is usually manifestated as regional lymphadenopathy. In differential diagnosis of lymphadenopathy infections about etiology B. henselae are rarely taken into consideration. Enlargement of lymph nodes observed in children more often than in adults are caused by bacterial, virus or parasitic factors. In this study immunoglobulines G class antibodies to B. henselae were determined among children with limphadenopathy. At 53 children with recognized lymphadenopathy IgG antibodies were determined by indirect immunofluoroscence method specific for B. henselae. Of the 53 subjects examined, positive results were got at 29 (55%) children. Of the 23 children with negative results of IgG antibodies in 9 children study was repeated. In 5 (56%) cases the increase of IgG antibodies were shown with relation to the first research. The cat scratch disease should be considered as a cause of lymphadenopathy at children because the frequency of occurance of antibodies IgG specific for B. henselae is high. In case of getting negative results, participation of B. henselae should not be out of question in limphadenopathy etiology at children and second determination should be repeted after 10-21 days since the first one.

PMID: 19209738 [PubMed - indexed for MEDLINE]

166. Pediatr Infect Dis J. 2009 Mar;28(3):258.

Back pain in a child caused by cat scratch disease.

ten Hove CH, Gubler FM, Kiezebrink-Lindenhovius HH.

PMID: 19209087 [PubMed - indexed for MEDLINE]

167. Am J Clin Pathol. 2009 Feb;131(2):250-6.

Evaluation of immunohistochemistry in identifying Bartonella henselae in cat-scratch disease.

Caponetti GC, Pantanowitz L, Marconi S, Havens JM, Lamps LW, Otis CN.

Department of Pathology, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA, USA.

Cat-scratch disease (CSD) is largely due to infection with Bartonella henselae. Microbiologic detection is difficult, and molecular testing is not readily available. A monoclonal antibody (mAB) to B henselae has become commercially available. We evaluated the usefulness of immunohistochemical analysis (IHC) for diagnosing CSD on surgical specimens and compared these results with polymerase chain reaction (PCR) detection and serologic testing for B henselae. We studied 24 formalin-fixed, paraffin-embedded (FFPE) cases of lymphadenitis with histologic and/or clinical suspicion of CSD. Control cases included 14 cases of lymphadenopathy other than CSD. FFPE tissue sections were evaluated with an mAB to B henselae, Steiner silver stain (SSS), and PCR that targeted B henselae and Bartonella quintana. Positive cases were as follows: SSS, 11 (46%); PCR, 9 (38%); and IHC, 6 (25%). Only 2 cases (8%) were positive for all 3 studies. All control cases were negative for IHC and PCR. The diagnostic sensitivity of these 3 tests is low for CSD. SSS seems to be the most sensitive test but is the least specific. PCR is more sensitive than IHC and may, therefore, serve as a helpful second-line test on all IHC- cases.

PMID: 19141385 [PubMed - indexed for MEDLINE]

168. Vet Rec. 2009 Jan 10;164(2):58-9.

Bartonella clarridgeiae in a cat in the UK.

Robinson MT, Hillman T, Langton DA, Shaw SE.

Acarus Laboratory, School of Clinical Veterinary Sciences, University of Bristol, Langford House, Langford, North Somerset. m.robinson@bristol.ac.uk

PMID: 19136687 [PubMed - indexed for MEDLINE]

169. BMJ Case Rep. 2009;2009. pii: bcr09.2008.0904. Epub 2009 Mar 17.

Localised retinal vasculitis in cat scratch disease.

Jacobs DJ, Scott ML, Slusher MM.

Wake Forest Eye Center, Medical Center Blvd, Winston-Salem, North Carolina 27157, USA.

We report an atypical presentation of ocular cat scratch disease (CSD) in an 8-year-old Caucasian male who presented with localised retinal arterial vasculitis and associated retinal oedema. His history of headaches, frequent contact with a kitten and a high Bartonella henslelae titre confirmed the diagnosis of CSD. Over an 18-month follow-up period, his best corrected visual acuity in the affected eye improved from 20/30-2 to 20/25+3 without treatment; however, the affected retinal artery remained sheathed.

PMCID: PMC3028126 PMID: 21686569 [PubMed]

170. J Med Case Reports. 2009 Sep 15;3:7405.

Serous labyrinthitis as a manifestation of cat scratch disease: a case report.

Kantas I, Katotomichelakis M, Vafiadis M, Kaloutsa ZV, Papadakis CE.

Department of Otolaryngology, 'G, Genimmatas' General Hospital, Karditsa, Thessaloniki, Greece. ikantas@hol.gr.

INTRODUCTION: Cat scratch disease is an infectious disease transmitted by young cats, in which the principal causative factor is Bartonella henselae. The typical course of cat scratch disease is usually benign and self-limited and requires only supportive therapy. However, cases lasting up to 2 years have been reported, and more serious complications may occur. Many manifestations of the disease have been reported by different medical disciplines. CASE PRESENTATION: A case of cat scratch disease in a 71-year-old Greek woman with an unusual clinical course is presented here. Serous otitis media was combined with rotational vertigo due to labyrinthitis. The invaded ear was ipsilateral to the inoculation site. CONCLUSION: Cervicofacial lymphadenopathy has been demonstrated as the most common otolaryngologic manifestation of cat scratch disease. Manifestation in the middle and inner ear has, to the best of our knowledge, not been reported before. Our report presents a patient with cat scratch disease with clinical signs and symptoms in the middle and inner ear.

PMCID: PMC2827160 PMID: 20519021 [PubMed]

171. Med Arh. 2009;63(5):297-9.

Color Doppler pseudolymphomatous manifestations of the cat scratch disease.

Smajlovic F, Ibralic M.

Faculty of Health Sciences, Sarajevo, Bosnia and Herzegovina.

Cat Scratch Disease (CSD) is an infectious illness, caused by the Bartonella henselae bacterium. Besides the common infective symptoms, swelling in the axillary and cervical region is very common and is usually evaluated by Color Doppler US (CDUS) (among other diagnostic methods). The aim of this work is to present ultrasound findings of the Cat Scratch Disease. During 2002 and 2003, we followed four patients (three male and one female) by CDUS, with different manifestations of the disease. The average age of the patients was 12. In all four cases, the local and generalized lymphadenopathy was found, and in two cases we found multiple focal hepatolienal lesions as well. The enlarged lymph nodes were found, with heterogeneous echogenicity of the cortex, and increased number of the hiluses, disturbed vascular structure and non specific hemodynamic. Hepatolienal lesions were hypoechogenic, round, unclear outline, and poorly vascularised. CDUS has proved to be a very sensitive imaging method in detection of pathomorphologic and hemodynamic changes of superficial lymph nodes and focal lesions of visceral organs in CSD. Opposite to the high sensitivity, its specificity is much lower, because of similar findings in lymphoma, TB lymphadenopathy and multiple visceral abscesses. Detailed anamnesis, clinical findings, with laboratory and specific serological tests (IgG, IgM), US characteristics, sometimes percutaneous aspiration biopsy as well, are crucial in determination of etiology of the disease.

PMID: 20380135 [PubMed - indexed for MEDLINE]

172. South Med J. 2008 Nov;101(11):1186.

Myocarditis due to Bartonella henselae.

Pipili C, Katsogridakis K, Cholongitas E.

PMID: 19088543 [PubMed - indexed for MEDLINE]

173. Can J Vet Res. 2008 Oct;72(5):411-9.

The prevalence of Bartonella, hemoplasma, and Rickettsia felis infections in domestic cats and in cat fleas in Ontario.

Kamrani A, Parreira VR, Greenwood J, Prescott JF.

Department of Pathobiology, Centre for Public Health and Zoonoses, University of Guelph, Ontario.

The prevalence of persistent bacteremic Bartonella spp. and hemoplasma infections was determined in healthy pet cats in Ontario. Blood samples from healthy cats sent to a diagnostic laboratory for routine health assessment over the course of 1 y were tested for Bartonella spp. using both polymerase chain reaction (PCR) and blood culture, and for the presence of hemoplasma by PCR. The overall prevalence of Bartonella spp. by PCR and by culture combined was 4.3% (28/646) [3.7% (24/646) Bartonella henselae, 0.6% (4/646) Bartonella clarridgeiae]. The novel B. henselae PCR developed for this study demonstrated nearly twice the sensitivity of bacterial isolation. The overall prevalence of hemoplasma was 4% (30/742) [3.3% (25/742) Candidatus Mycoplasma haemominutum, 0.7% (5/742) Mycoplasma haemofelis]. There was no significant difference between the prevalence of infection by season or by age (< or = 2 y, > 2 y). Candidatus Mycoplasma turicensis was identified, for the first time in Canada, in 1 cat. The prevalence of Bartonella (58%) and hemoplasma (47% M. haemofelis, 13% M. haemominutum) in blood from a small sampling (n = 45) of stray cats was considerably higher than that found in healthy pet cats. The prevalence of Rickettsia felis in cat fleas was also assessed. A pool of fleas from each of 50 flea-infested cats was analyzed for the presence of R. felis by PCR. Rickettsia felis was confirmed, for the first time in Canada, in 9 of the 50 samples. Therefore, the prevalence of Bartonella and hemoplasma infection in healthy pet cats is relatively low. Further, the control of cat fleas is important because of the public health significance of Bartonella and R. felis infection.

PMCID: PMC2568045 PMID: 19086373 [PubMed - indexed for MEDLINE]

174. Pediatr Int. 2008 Dec;50(6):823-4.

Cat scratch disease with encephalopathy in a 9-year-old girl.

Nishio N, Kubota T, Nakao Y, Hidaka H.

Department of Pediatrics, Kakegawa City General Hospital, Kakegawa, Japan.

Erratum in Pediatr Int. 2009 Apr;51(2):318. Kubuta, Toshiko [corrected to Kubota, Toshiko].

PMID: 19067901 [PubMed - indexed for MEDLINE]

175. J Parasitol. 2009 Jun;95(3):578-80.

Seroprevalence of Toxoplasma gondii and Bartonella spp. antibodies in cats from Pennsylvania.

Dubey JP, Bhatia CR, Lappin MR, Ferreira LR, Thorn A, Kwok OC.

United States Department of Agriculture, Agricultural Research Service, Animal and Natural Resources Institute, Animal Parasitic Diseases Laboratory, Building 1001, Beltsville, Maryland 20705-2350, USA. jitender.dubey@ars.usda.gov

Toxoplasma gondii and Bartonella spp. are zoonotic pathogens of cats. In the present study, the prevalence of antibodies to T. gondii and Bartonella spp. were determined in sera from 210 domestic cats from Bensalem, Pennsylvania. Using a modified agglutination test, antibodies to T. gondii were found in 41 (19.5%) of the 210 cats with titers of 1:25 in 4, 1:50 in 9, 1:100 in 7, 1:200 in 3, 1:400 in 3, 1:800 in 5, 1:1,600 in 4, and 1:3,200 or higher in 6. For T. gondii, seroprevalence increased with age of the cat: 15 of 113 (13.2 %) were seropositive compared with 26 of 97 (26.7%) older than 11 mo. Of these 210 cats, 54 (25.7%) were positive for Bartonella spp. antibodies, with titers of 1:64 in 20, 1:128 in 21, 1:256 in 9, and 1:512 in 4. Seventeen cats had antibodies to both organisms. There was no correlation between T. gondii and Bartonella spp. seropositivity. Overall the seroprevalence of T. gondii antibodies in cats in this population is much lower compared with those reported in other localities in the United States and other countries.

PMID: 19061304 [PubMed - indexed for MEDLINE]

176. Clin Vaccine Immunol. 2009 Feb;16(2):282-4. Epub 2008 Dec 3.

Development of an immunoglobulin M capture-based enzyme-linked immunosorbent assay for diagnosis of acute infections with Bartonella henselae.

Hoey JG, Valois-Cruz F, Goldenberg H, Voskoboynik Y, Pfiffner J, Tilton RC, Mordechai E, Adelson ME.

Antigen Discovery Division, Research and Development Department, Medical Diagnostic Laboratories, Hamilton, New Jersey 08690-3303, USA. jhoey@mdlab.com

We describe the development of an immunoglobulin M-specific enzyme-linked immunosorbent assay for the detection of an early antibody response to Bartonella henselae, the causative agent of cat scratch disease, bacillary angiomatosis, and endocarditis. This assay discriminates between B. henselae-positive and -negative patient samples with sensitivity and specificity values of 100% and 97.1%, respectively.

PMCID: PMC2643531 PMID: 19052161 [PubMed - indexed for MEDLINE]

177. 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.

PMCID: PMC2634615 PMID: 19046527 [PubMed - indexed for MEDLINE]

178. Emerg Infect Dis. 2008 Dec;14(12):1922-4.

Hemoplasma infection in HIV-positive patient, Brazil.

dos Santos AP, dos Santos RP, Biondo AW, Dora JM, Goldani LZ, de Oliveira ST, de Sá Guimarães AM, Timenetsky J, de Morais HA, González FH, Messick JB.

Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil. santos1@purdue.edu

Hemotrophic mycoplasmas infect a variety of mammals. Although infection in humans is rarely reported, an association with an immunocompromised state has been suggested. We report a case of a Mycoplasma haemofelis-like infection in an HIV-positive patient co-infected with Bartonella henselae.

PMCID: PMC2634649 PMID: 19046522 [PubMed - indexed for MEDLINE]

179. Int J Biochem Cell Biol. 2009 Mar;41(3):507-10. Epub 2008 Oct 25.

Bartonella henselae: subversion of vascular endothelial cell functions by translocated bacterial effector proteins.

Pulliainen AT, Dehio C.

Biozentrum, University of Basel, Klingelbergstrasse 70, CH-4056 Basel, Switzerland.

Bartonella henselae (Bh) is a worldwide distributed zoonotic pathogen. Depending on the immune status of the infected individual this bacterium can cause a wide spectrum of clinical manifestations, ranging from cat scratch disease (CSD) to bacillary angiomatosis (BA) and bacillary peliosis (BP). BA and BP are characterized by tumor-like lesions at the skin or in the inner organs, respectively. These structures display pathological sprouting of capillaries with enlarged and hyperproliferated vascular endothelial cells (ECs) that are frequently found in close association with bacteria. Here we review the cellular changes observed upon Bh infection of ECs in vitro and outline the role of the VirB type IV secretion system (T4SS) and its translocated effector proteins in the modulation of EC signalling cascades. The current model how this virulence system could contribute to the vasoproliferative activity of Bh is described.

PMID: 19010441 [PubMed - indexed for MEDLINE]

180. Lancet Infect Dis. 2008 Nov;8(11):663.

Hepatosplenic cat-scratch fever with seropositivity for Bartonella quintana?

Incandela S, Raoult D, Vitale G, Micalizzi A, Mansueto P.

Comment on Lancet Infect Dis. 2008 Feb;8(2):140.

PMID: 18992392 [PubMed - indexed for MEDLINE]

181. Zoonoses Public Health. 2009 May;56(4):169-75. Epub 2008 Nov 4.

Investigation of Bartonella henselae in cats in Ankara, Turkey.

Celebi B, Kilic S, Aydin N, Tarhan G, Carhan A, Babur C.

Communicable Diseases Research Department, Refik Saydam National Hygiene Center, Ankara, Turkey.

The purpose of this study was to determine Bartonella henselae prevalance in cats in Ankara. Whole bloods and sera collected from 256 cats were investigated for the presence feline Bartonella species by culture and sera were tested for the presence of antibodies against B. henselae IgG using immunofluorescence assay. Bartonella species were isolated by blood culture from 24 (9.4%) cats. Bartonella isolates were subjected to restriction fragment length polymorphism (RFLP) by using TaqI and HhaI endonucleases to identify species. Twenty-one isolates were determined as B. henselae and three of 24 isolates were determined as Bartonella clarridgeiae with RFLP. The bacteraemia prevalence and seroprevalence of B. henselae IgG antibodies in cats was detected as 8.2% and 18.6% respectively. This is the first report on B. henselea and B. clarridgeiae in cats in Turkey.

PMID: 18990198 [PubMed - indexed for MEDLINE]

182. Vector Borne Zoonotic Dis. 2009 Oct;9(5):469-77.

Ectoparasites and associated pathogens of free-roaming and captive animals in zoos of South Carolina.

Nelder MP, Reeves WK, Adler PH, Wozniak A, Wills W.

Department of Entomology, Soils & Plant Sciences, Clemson University, Clemson, South Carolina, USA. mnelder@rci.rutgers.edu

A survey of ectoparasites and their associated pathogens was conducted in two South Carolina zoos, from 2004 to 2007. Dead, wild birds and mammals, as well as captive animals examined during routine veterinary checks constituted the study populations. Ectoparasites were tested for species of Anaplasma, Bartonella, Coxiella burnetii, Ehrlichia, Rickettsia, and Trypanosoma. Forty-six species of ectoparasites were collected from 133 free-roaming and captive hosts and their associated nesting and bedding materials. Six vector-borne pathogens were detected molecularly in the ectoparasites, including Anaplasma phagocytophilum in the tick Ixodes dentatus Marx from an eastern cottontail rabbit, Bartonella clarridgeiae in the cat flea Ctenocephalides felis (Bouché) from a Virginia opossum, Bartonella sp. Oh6 in the squirrel flea Orchopeas howardi (Baker) from an eastern grey squirrel, Bartonella sp. T7498 in the sucking louse Neohaematopinus sciuri Jancke from a squirrel, Rickettsia sp. Rf2125 in C. felis from a zookeeper and a grizzly bear, and Rickettsiales sp. Ib 2006 in Ixodes brunneus Koch from an American crow. While the pathology of some of these pathogens is poorly known, Anaplasma phagocytophilum (causative agent of human granulocytic anaplasmosis) and Bartonella clarridgeiae (causative agent of a disease similar to cat-scratch disease) can infect humans. Ectoparasites and their pathogens, especially those originating from free-roaming animals, present a potential threat to captive animals and humans.

PMID: 18973443 [PubMed - indexed for MEDLINE]

183. Transfus Med. 2008 Oct;18(5):287-91.

Bartonella henselae survives after the storage period of red blood cell units: is it transmissible by transfusion?

Magalhães RF, Pitassi LH, Salvadego M, de Moraes AM, Barjas-Castro ML, Velho PE.

Department of Medical Clinic, Dermatology Division, School of Medical Sciences, State University of Campinas, Campinas, São Paulo, Brazil. renatafmagalhaes@uol.com.br

Bartonella henselae is the agent of cat scratch disease and bacillary angiomatosis. Blood donors can be asymptomatic carriers of B. henselae and the risk for transmission by transfusion should be considered. The objective of this study was to demonstrate that B. henselae remains viable in red blood cell (RBC) units at the end of the storage period. Two RBC units were split into two portions. One portion was inoculated with B. henselae and the other was used as a control. All units were stored at 4 degrees C for 35 days. Aliquots were collected on a weekly basis for culture in a dish with chocolate agar, ideal for the cultivation of this agent. Samples were collected on days 1 and 35 and taken for culture in Bact/Alert R blood culture bottles. Aliquots taken simultaneously were fixed in Karnovsky's medium for subsequent electron microscopy evaluation. Samples from infected bags successfully isolated B. henselae by chocolate agar culture, although Bact/Alert R blood culture bottles remained negative. Bartonella spp. structures within erythrocytes were confirmed by electron microscopy. The viability of B. henselae was demonstrated after a storage period of RBC units. These data reinforce the possibility of infection by transfusion of blood units collected from asymptomatic blood donors.

PMID: 18937735 [PubMed - indexed for MEDLINE]

184. 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'Gorman Building, Upper Maudlin Street, Bristol BS28BJ, UK. yonasc@hotmail.com

An unusual case of primary meningo-encephalitis followed by partial complex seizure in a 9-year-old boy was found to be a symptom of cerebral Bartonella henselae infection or cat scratch disease. Despite one clinical relapse at 4 weeks post-presentation, he remained seizure free on carbamazepine for one year. Six months after stopping carbamazepine, however, he developed deja vu phenomena and absence seizures with EEG abnormality. Restarting carbamazepine improved his symptoms.

PMID: 18843081 [PubMed - indexed for MEDLINE]

185. Pathol Biol (Paris). 2008 Nov-Dec;56(7-8):461-6. Epub 2008 Oct 7.

[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-Pauchet, 80054 Amiens, France. fridnyonly2001@yahoo.fr

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 - indexed for MEDLINE]

186. J Am Vet Med Assoc. 2008 Oct 1;233(7):1084-9.

Microbial culture of blood samples and serologic testing for bartonellosis in cats with chronic rhinosinusitis.

Berryessa NA, Johnson LR, Kasten RW, Chomel BB.

Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.

OBJECTIVE: To assess the role of Bartonella spp in chronic rhinosinusitis (CRS) by determining detection rates for the organism by serologic testing and microbial culture of blood samples for Bartonella spp in cats with CRS and control cats (cats with other nasal diseases, cats with systemic illnesses, and healthy cats). DESIGN: Prospective case-control study. ANIMALS: 19 cats with CRS, 10 cats with other nasal diseases, 15 cats with systemic illness, and 15 healthy cats. Procedures-Serologic testing for Bartonella clarridgeiae and Bartonella henselae and microbial culture of blood samples were conducted in all cats. In cats with CRS and cats with other nasal diseases, a nasal biopsy specimen was submitted, when available, for tissue PCR assay to detect Bartonella spp. RESULTS: 9 of 19 cats with CRS had positive results for serologic testing for 1 or both Bartonella spp; whereas, 4 of 10 cats with other nasal diseases, 2 of 15 cats with systemic diseases, and 4 of 15 healthy cats had positive results for serologic testing to detect Bartonella spp. These values did not differ significantly among groups. Microbial culture of blood samples yielded B henselae in 1 cat with a nasopharyngeal abscess. The PCR assay for Bartonella spp in nasal tissues yielded negative results for 9 of 9 cats with CRS and 5 of 5 cats with other nasal diseases. CONCLUSIONS AND CLINICAL RELEVANCE: A role for Bartonella spp in the pathogenesis of CRS in cats was not supported by results of this study.

PMID: 18828717 [PubMed - indexed for MEDLINE]

187. Eye (Lond). 2009 Jul;23(7):1607. Epub 2008 Sep 12.

Neuroretinitis secondary to concurrent infection with cat scratch disease and lyme disease.

Gupta PK, Patel R, Bhatti MT.

PMID: 18791545 [PubMed - indexed for MEDLINE]

188. Rev Laryngol Otol Rhinol (Bord). 2008;129(1):53-6.

[Cat scratch disease: a diagnosis to be aware of!].

[Article in French]

Aupy B, Conessa C, Clement P, Roguet E, Poncet JL.

Hôpital d'Instruction des Armées du Val de Grâce, Service d'ORL et Chirurgie Cervico-Faciale, 74 bvd de Port Royal, F-75005 Paris, France. barbara.aupy@wanadoo.fr

Subacute cervical lymphadenopathy among young adults may be of an infectious or malignant aetiology. We report two cases of young males with chronic cervical lymphadenopathy. A diagnosis of Cat scratch disease (CSD) was made by serological and molecular studies. CSD is one of the most frequent infectious lymphadenopathies among young people. Diagnosis of CSD is dependent on clinical, epidemiological, molecular and histological criteria. The detection of antibodies to Bartonella Henselae and the amplification of its DNA by Polymerase Chain Reaction (PCR) are the two main methods of laboratory diagnosis. The evolution of CSD is usually benign; however therapeutic management remains problematic, particularly in atypical forms.

PMID: 18777770 [PubMed - indexed for MEDLINE]

189. J Feline Med Surg. 2009 Feb;11(2):141-8. Epub 2008 Aug 29.

Prevalence of Bartonella species antibodies and Bartonella species DNA in the blood of cats with and without fever.

Lappin MR, Breitschwerdt E, Brewer M, Hawley J, Hegarty B, Radecki S.

Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA. mlappin@colostate.edu

The purpose of this study was to determine whether there are associations between Bartonella species antibody (enzyme-linked immunosorbent assay (ELISA) and Western blot (WB)) and polymerase chain reaction assay results in cats with and without fever. Afebrile control cats (39/93; 42.0%) were more likely to have Bartonella species antibodies than cats with fever (29/93; 31.2%). The difference in prevalence of Bartonella species deoxyribonucleic acid (DNA) in blood of cats with fever (14/81; 17.3%) as compared to afebrile control cats (6/81; 7.4%) approached statistical significance (P=0.0571). Bartonella species ELISA or WB results frequently did not correlate to the presence or absence of Bartonella species DNA in blood. The results of this study indicate that in cats, Bartonella species antibody tests cannot predict whether fever is due to Bartonella species infection and should not be used to determine the Bartonella species infection status.

PMID: 18760647 [PubMed - indexed for MEDLINE]

190. Comp Med. 2008 Aug;58(4):375-80.

P26-based serodiagnosis for Bartonella spp. infection in cats.

Werner JA, Feng S, Chomel BB, Hodzic E, Kasten RW, Barthold SW.

Center for Comparative Medicine, Schools of Medicine and Veterinary Medicine, University of California, Davis, CA, USA.

Bartonella henselae P26 has been identified as an immunodominant antigen expressed during feline infection. We used antisera from cats experimentally infected with B. henselae (n = 6), B. clarridgeiae (n = 4), or B. koehlerae (n = 2) and from a sample of naturally infected cats (B. henselae, n = 34; B. clarridgeiae, n = 1) to evaluate recombinant P26 (rP26) as a serodiagnostic antigen. Immunoblots using antisera from cats infected with B. henselae and B. clarridgeiae reacted strongly with rP26, whereas B. koehlerae antisera did not. A capture ELISA was designed to evaluate the kinetics of rP26 IgG in sera from experimentally infected cats. For B. henselae and B. clarridgeiae antisera, the kinetic profiles of reactivity were similar for rP26 capture ELISA and Bartonella spp. indirect fluorescence assay. However, for B. koehlerae antisera, reactivity in rP26 capture ELISA was consistently low. The serodiagnostic potential of rP26 capture ELISA was evaluated using sera from cats with known Bartonella sp. exposure histories. All 24 (100%) uninfected cats were seronegative, and 33 of 35 (94.3%) cats bacteremic for Bartonella spp. were seropositive. We propose that rP26-based serology can serve as a useful adjunct tool for the diagnosis of feline infection with B. henselae and B. clarridgeiae, but it may not be useful for feline infection with B. koehlerae.

PMCID: PMC2706038 PMID: 18724780 [PubMed - indexed for MEDLINE]

191. Otolaryngol Head Neck Surg. 2008 Sep;139(3):358-63.

Cat-scratch disease of the head and neck in a pediatric population: surgical indications and outcomes.

Munson PD, Boyce TG, Salomao DR, Orvidas LJ.

Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN 55905, USA.

OBJECTIVE: To identify the presentation of pediatric patients with head and neck manifestations of cat-scratch disease, one of the most common causes of subacute or chronic lymphadenitis in children, and to determine surgical indications and outcomes. STUDY DESIGN: Case series. SUBJECTS AND METHODS: All pediatric patients from infancy to age 19 years who presented with clinical symptoms of cat-scratch disease and had an IgG serological test result of more than 1:128 for Bartonella henselae. RESULTS: Nine patients had cat-scratch disease of the head and neck. Median age at presentation was 4 years; median time from symptom onset to presentation was 20 days. Six (67%) children underwent surgical procedures, and median time from presentation to surgical procedure was 43 days. CONCLUSION: Despite conservative treatment, a minority of pediatric patients with cat-scratch disease may require surgical drainage of abscess and removal of lymph nodes. Surgical treatment provides tissue for diagnosis, is generally well tolerated, affords improved recovery, and has minimal complications.

PMID: 18722212 [PubMed - indexed for MEDLINE]

192. Med Mal Infect. 2008 Sep;38(9):504-6. Epub 2008 Aug 15.

[Ocular bartonellosis in an HIV-HVC coinfected patient].

[Article in French]

Merle De Boever C, Mura F, Brun M, Reynes J.

Service maladies infectieuses et tropicales, CHU de Montpellier, 80 avenue Augustin-Flèche, Montpellier, France. c-merle_de_boever@chu-montpellier.fr

Bartonella henselae is the etiologic agent of the cat scratch disease and in immunocompromised patients, of bacillary angiomatosis and peliosis hepatis. Less often, ocular complications associated with B. henselae infection have been reported in immunocompetent patients and five times in HIV-infected patients. We report the case of a 42-year-old woman, coinfected by HIV-HCV, presenting with cirrhosis, who owned a cat and was hospitalized for bilateral loss of visual acuity. Ophthalmologic examination revealed bilateral papillitis with hyalitis. Nuclear magnetic resonance revealed a retrobulbar neuritis. Confirmation was given by blood tests positive for B. henselae and the exclusion of other causes of neuroretinitis with biological data. Doxycycline cured the disease rapidly.

PMID: 18706780 [PubMed - indexed for MEDLINE]

193. Ophthalmologe. 2009 Apr;106(4):351-5.

[Bilateral panuveitis with serous retinal detachment].

[Article in German]

Ramharter A, Kremser B.

Universitäts-Augenklinik, Innsbruck, Osterreich. Anke.Ramharter@i-med.ac.at

HISTORY: A 45-year-old patient with cat scratch disease presented with bilateral panuveitis as well as bilateral serous detachment of the retina. The patient had suffered from influenza with swollen lymph nodes 2 weeks previously. DIAGNOSIS: The diagnosis could be made serologically: IgG and IgM antibodies against Bartonella henselae were highly positive in the immunofluorescence test and the values for inflammation were also strongly increased. THERAPY: A macular star developed during the course, more in the left eye than in the right eye. The patient was treated with a sulfonamide (Bactrim forte) and prednisolonacetate (Urbason), which was changed to doxyzycline (Doxybene) after an allergic reaction developed. Clinical findings were reduced significantly and visual acuity improved. CONCLUSIONS: Bartonella henselae should be excluded when panuveitis occurs with serous retinal detachment. A uveitis anterior could precede this occurrence.

PMID: 18696078 [PubMed - indexed for MEDLINE]

194. Eur J Clin Microbiol Infect Dis. 2009 Feb;28(2):147-52. Epub 2008 Aug 5.

Evaluation of an in-house cat scratch disease IgM ELISA to detect Bartonella henselae in a routine laboratory setting.

Herremans M, Bakker J, Vermeulen MJ, Schellekens JF, Koopmans MP.

Laboratory for Infectious Diseases and Perinatal Screening, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, The Netherlands. Tineke.Herremans@rivm.nl

Cat scratch disease (CSD) is caused by Bartonella henselae infection and is a common cause of regional lymphadenopathy. The diagnosis of CSD largely depends on serology, but detection of B. henselae in an affected lymph node by PCR is also an important diagnostic tool. We evaluated an IgM in-house ELISA protocol and analyzed its performance in routine CSD serology. Serum samples from PCR-positive patients (n = 126), PCR-negative patients (n = 123), and age-matched controls (n = 126) were used for evaluation. The sensitivity of the IgM ELISA was only 56%, showing that the performance of B. henselae serology under routine laboratory settings is low, probably caused by the wide variability in disease duration in patients suspected of CSD whose samples were submitted to our laboratory. Most patients (46%) with a positive IgM response were between 0 and 20 years of age. We conclude that the serodiagnosis of B. henselae is hampered by the low sensitivity and specificity of the assays when used in a routine laboratory setting. For this reason, a negative IgM or PCR result can never exclude CSD, especially with late sample collection.

PMID: 18679728 [PubMed - indexed for MEDLINE]

195. Transpl Infect Dis. 2008 Dec;10(6):431-3. Epub 2008 Jul 22.

Possible donor-recipient bartonellosis transmission in a pediatric liver transplant.

Scolfaro C, Mignone F, Gennari F, Alfarano A, Veltri A, Romagnoli R, Salizzoni M.

Divisione di Malattie Infettive e Immuno-Reumatologia, Dipartimento di Pediatria, Universitá di Torino, Torino, Italy. carlo.scolfaro@unito.it

Comment in Transpl Infect Dis. 2009 Oct;11(5):474.

Bartonella henselae is the causative agent of cat-scratch disease and other disorders, including hepatosplenic granulomatosis. This infection has only rarely been reported after solid organ transplantation, where it can mimic the more common post-transplant lymphoproliferative disease. Here we present a case of asymptomatic B. henselae hepatic and lymph nodal granulomatosis in a pediatric patient who had received orthotopic liver transplant 2 months before; we hypothesize that the causative agent was transmitted from the donor. This infection developed early in the post-transplant period; the disease involved only the graft liver and the regional lymph nodes, and the patient did not have a cat or any history of contact, scratches, or bites by a cat. In our patient this infection resolved successfully with a combination of 2 associated antibiotics and reduction of immunosuppressive therapy.

PMID: 18651873 [PubMed - indexed for MEDLINE]

196. Int Ophthalmol Clin. 2008 Summer;48(3):93-105.

Ocular bartonella infections.

Roe RH, Michael Jumper J, Fu AD, Johnson RN, Richard McDonald H, Cunningham ET.

San Francisco Retina Foundation, San Francisco, CA 94107, USA.

PMID: 18645403 [PubMed - indexed for MEDLINE]

197. Braz J Infect Dis. 2008 Apr;12(2):158-60.

Cat scratch disease complicated with aseptic meningitis and neuroretinitis.

Pinto Jr VL, Curi AL, Pinto Ada S, Nunes EP, Teixeira Mde L, Rozental T, Favacho AR, Castro EL, Bóia MN.

Evandro Chagas Clinical Research Institute, Fiocruz, Rio de Janeiro, RJ, Brazil. vitor.laerte@ipec.fiocruz.br

Cat scratch disease (CSD) is a self limited condition characterized by fever, lymph node enlargement and less often eye involvement. Central nervous system involvement by Bartonella henselae infection is possibly an important cause of morbidity; its role as an agent of aseptic meningitis is unknown. We report a case of a 40 years-old man with CSD accompanied by aseptic meningitis and neuroretinitis. Serum indirect immmunofluorescence (IFI) assays for B. henselae were positive and the cerebrospinal fluid (CSF) analysis showed mononuclear pleocytosis and increased level of protein. Serological tests for other etiologies were negative. The patient responded well to antibiotic therapy with oral doxycicline plus rifampin and in the 12th day of hospitalization evolved to total regression of the headache and partial regression of the visual loss. Clinicians should consider CSD as a differential diagnosis when assessing previously healthy patients with aseptic meningitis associated with regional lymphadenopathy and epidemiological history of feline contact.

PMID: 18641856 [PubMed - indexed for MEDLINE]

198. J Med Microbiol. 2008 Aug;57(Pt 8):1049-50.

Low sensitivity of Bartonella henselae PCR in serum samples of patients with cat-scratch disease lymphadenitis.

Vermeulen MJ, Diederen BM, Verbakel H, Peeters MF.

PMID: 18628513 [PubMed - indexed for MEDLINE]

199. Cell Microbiol. 2008 Nov;10(11):2223-34. Epub 2008 Jul 7.

The head of Bartonella adhesin A is crucial for host cell interaction of Bartonella henselae.

Kaiser PO, Riess T, Wagner CL, Linke D, Lupas AN, Schwarz H, Raddatz G, Schäfer A, Kempf VA.

Institut für Medizinische Mikrobiologie und Hygiene, Universitätsklinikum, Eberhard-Karls-Universität, Elfriede-Aulhorn-Str. 6, 72076 Tübingen, Germany.

Human pathogenic Bartonella henselae cause cat scratch disease and vasculoproliferative disorders (e.g. bacillary angiomatosis). Expression of Bartonella adhesin A (BadA) is crucial for bacterial autoagglutination, adhesion to host cells, binding to extracellular matrix proteins and proangiogenic reprogramming via activation of hypoxia inducible factor (HIF)-1. Like the prototypic Yersinia adhesin A, BadA belongs to the class of trimeric autotransporter adhesins and is constructed modularly consisting of a head, a long and repetitive neck-stalk module and a membrane anchor. Until now, the exact biological role of these domains is not known. Here, we analysed the function of the BadA head by truncating the repetitive neck-stalk module of BadA (B. henselae badA(-)/pHN23). Like B. henselae Marseille wild type, B. henselae badA(-)/pHN23 showed autoagglutination, adhesion to collagen and endothelial cells and activation of HIF-1 in host cells. Remarkably, B. henselae badA(-)/pHN23 did not bind to fibronectin (Fn) suggesting a crucial role of the deleted stalk domain in Fn binding. Additionally, the recombinantly expressed BadA head adhered to human umbilical vein endothelial cells and to a lesser degree to epithelial (HeLa 229) cells. Our data suggest that the head represents the major functional domain of BadA responsible for host adhesion and angiogenic reprogramming.

PMID: 18627378 [PubMed - indexed for MEDLINE]

200. Infez Med. 2008 Jun;16(2):99-102.

Immune thrombocytopenic purpura as a complication of Bartonella henselae infection.

Palumbo E, Sodini F, Boscarelli G, Nasca G, Branchi M, Pellegrini G.

Dipartimento di Pediatria, Ospedale di Sondrio, Sondrio, Italy.

Immune thrombocytopenic purpura is an infrequent yet well-recognized complication of viral infections, such as mumps, rubella, varicella, cytomegalovirus, parvovirus and infectious monunucleosis by Epstein-Barr virus. Some recent studies have described a possible association between Henoch-Schonlein purpura, a non-thrombocytopenic purpura, and seropositivity for Bartonella henselae, but in the literature only sporadic case reports have described a severe immune thrombocytopenic purpura as a complication of Bartonella henselae infection. We report a case of an immunocompetent child with clinical and serological evidence of Bartonella henselae infection presenting with purpura and cervical lymphoadenopathy and treated with intravenous immunoglobulin. The patient obtained a rapid and persistent increase in platelet count and a complete regression of purpura.

PMID: 18622151 [PubMed - indexed for MEDLINE]

201. Infez Med. 2008 Jun;16(2):91-3.

Inguinal lymphadenopathy due to Bartonella henselae.

Mancino P, Ucciferri C, Falasca K, Racciatti D, Di Girolamo A, Vecchiet J, Pizzigallo E.

Clinica di Malattie Infettive, Dipartimento di Scienze dell'Invecchiamento, Universita G d'Annunzio, Chieti, Italy.

The bacterium Bartonella henselae causes cat scratch disease, a self-limited zoonotic disease which is common among children and adolescents. The most typical clinical presentation is a regional lymphadenopathy that commonly involves only a single node of cervical and axillary lymph nodes. Inguinal localization is rarely described. We report a case of a 35-year-old Caucasian male complaining of a painless right inguinal mass and slight fever. A diagnosis of Bartonella henselae infection was made according to the histopathological exam of the excised mass, that showed an inflammatory state likely due to Bartonella, and to the titre of antibodies for this agent. Cat scratch disease can occur at any age and may also involve inguinal lymph nodes. Therefore it should always be included in the differential diagnosis of lymphadenopathy for adults. It is important that a meticulous personal history is obtained and that a specific serological test and pathological examination of the lesions are carried out. Often antibiotic treatment is not required because it is a benign disease and often resolves spontaneously.

PMID: 18622149 [PubMed - indexed for MEDLINE]

202. Int J Infect Dis. 2009 Jan;13(1):3-8. Epub 2008 Jul 14.

Bartonella: emerging pathogen or emerging awareness?

Mogollon-Pasapera E, Otvos L Jr, Giordano A, Cassone M.

Sbarro Health Research Organization, College of Science and Technology, Temple University, Philadelphia, PA 19122, USA.

The number of known Bartonella species is rapidly growing. Some of them are responsible for distinct infectious diseases and show different prevalence and antibiotic susceptibility profiles. Not only have some vectors of Bartonella not been fully characterized, but also intermediate hosts are actually much more numerous and diverse than previously thought. Among these, dogs differ from cats because they tend to suffer an overt disease similar to humans, thus providing the base for a useful animal indicator and research model. Among the debilitating conditions with an unclear impact on the course of these infections, specific conditions (e.g., homelessness, alcoholism) have been linked to a much higher prevalence and to high risk of unfavorable outcome. Due to the limited arsenal of antibiotics effective in vivo on this peculiar intracellular pathogen, the risk/benefit balance of antibiotic therapy is sometimes difficult to draw. In this evolving picture, the recent discoveries of new species highlights the importance of basic molecular biology resources that would bring major public health benefits if available in endemic areas, and specifically in many areas of Peru and Bolivia.

PMID: 18621561 [PubMed - indexed for MEDLINE]

203. Emerg Infect Dis. 2008 Jul;14(7):1074-80.

Transmission of Bartonella henselae by Ixodes ricinus.

Cotté V, Bonnet S, Le Rhun D, Le Naour E, Chauvin A, Boulouis HJ, Lecuelle B, Lilin T, Vayssier-Taussat M.

Institut National de la Recherche Agronomique, Maisons-Alfort, France.

Bartonella spp. are facultative intracellular bacteria associated with several emerging diseases in humans and animals. B. henselae causes cat-scratch disease and is increasingly associated with several other syndromes, particularly ocular infections and endocarditis. Cats are the main reservoir for B. henselae and the bacteria are transmitted to cats by cat fleas. However, new potential vectors are suspected of transmitting B. henselae, in particular, Ixodes ricinus, the most abundant ixodid tick that bites humans in western Europe. We used a membrane-feeding technique to infect I. ricinus with B. henselae and demonstrate transmission of B. henselae within I. ricinus across developmental stages, migration or multiplication of B. henselae in salivary glands after a second meal, and transmission of viable and infective B. henselae from ticks to blood. These results provide evidence that I. ricinus is a competent vector for B. henselae.

PMCID: PMC2600320 PMID: 18598628 [PubMed - indexed for MEDLINE]

204. Rev Med Suisse. 2008 Apr 9;4(152):901-7.

[Cat scratch disease and other human infections caused by Bartonella species].

[Article in French]

Boillat N, Greub G.

Centre des maladies infectieuses, Institut central des hôpitaux valaisans, 1950 Sion.

The different Bartonella species can cause various human infections such as cat scratch disease, chronic bacteremia (homeless patient with nonspecific symptom), endocarditis, bacillary angiomatosis, peliosis, and Carrion's disease. Diagnostic approaches include serology, culture and molecular approaches. PCR is especially useful on lymph nodes biopsies from patients with cat-scratch disease and on valvular samples taken from culture-negative endocarditis. Serology exhibits a very high sensitivity in the latter situation. The treatment should be chosen according to the clinical presentation.

PMID: 18578430 [PubMed - indexed for MEDLINE]

205. Rev Stomatol Chir Maxillofac. 2008 Jun;109(3):183-6. Epub 2008 Jun 3.

[Cat-scratch disease localisation in the parotid gland].

[Article in French]

Ben Slama L, Hasni W, Royer B.

Cabinet de stomatologie et chirurgie maxillofaciale, 69, rue de la Tour, 75116 Paris, France. lbenslama@mac.com

INTRODUCTION: Cat scratch disease is an infection due to Bartonella henselae. It is one of the principal causes of benign chronic adenopathy in children or young adults. CASE REPORT: A 36-year-old woman presented with a left parotid pre-auricular swelling suggesting a pleiomorphic adenoma. The history and complementary tests (ultra sonography, MRI, cytopuncture, B. henselae serology) led to a diagnosis of cat scratch disease. Doxycilline was efficient within 15 days. DISCUSSION: The parotid localization of cat scratch disease is very rare. When a patient presents with parotid swelling, the distinction between a tumor and lymph node is not easy. Performing complementary tests can be in balance with a quicker but sometimes inappropriate surgical indication. The diagnosis is made even more difficult because of delayed specific serologic tests as for B. henselae.

PMID: 18533210 [PubMed - indexed for MEDLINE]

206. Int J Med Microbiol. 2008 Oct;298(7-8):579-90. Epub 2008 May 22.

Use of Bartonella adhesin A (BadA) immunoblotting in the serodiagnosis of Bartonella henselae infections.

Wagner CL, Riess T, Linke D, Eberhardt C, Schäfer A, Reutter S, Maggi RG, Kempf VA.

Institut für Medizinische Mikrobiologie und Hygiene, University Hospital, Eberhard-Karls-Universität, Elfriede-Aulhorn-Street 6, 72076 Tübingen, Germany.

Bartonella henselae causes a variety of human diseases (e.g. cat scratch disease and the vasculoproliferative disorders, bacillary angiomatosis and peliosis hepatis). The laboratory diagnosis of B. henselae infections is usually based on the detection of anti-B. henselae antibodies by an indirect immunofluorescence assay (IFA) which, unfortunately, suffers from a significant amount of cross-reactivity and hence is prone to deliver false-positive results. In this pilot study, we evaluated the use of a potential two-step serodiagnosis of B. henselae infections by combining IFA and anti-Bartonella adhesin A (BadA) immunoblotting. Our data revealed that approximately 75% of the IFA-positive sera of patients with a suspected B. henselae infection reacted specifically with BadA but only approximately 25% of the IFA-negative sera of healthy blood donors. Although Yersinia adhesin A (YadA) is structurally closely related to BadA, no cross-reactivity of sera from patients suffering from a Yersinia enterocolitica or Y. pseudotuberculosis infection with BadA was detected in immunoblotting. Unfortunately, recombinantly expressed BadA domains (head, connector, stalk fragment) were not suitable for immunoblotting. Finally, the best resolution for full-length BadA immunoblotting was obtained when whole cell lysates of B. henselae were separated using continuous 4-15% sodium dodecyl sulfate polyacrylamide gels. In summary, our results show that BadA antibodies are detectable in the sera of B. henselae-infected patients and, therefore, this pilot study suggests to include BadA immunoblotting in the laboratory diagnosis of B. henselae infections.

PMID: 18501673 [PubMed - indexed for MEDLINE]

207. Wien Klin Wochenschr. 2008;120(7-8):246-9.

Native valve endocarditis due to Bartonella henselae in an immunocompetent man.

Lejko-Zupanc T, Slemenik-Pusnik C, Kozelj M, Klokocovnik T, Avsic-Zupanc T, Dolenc-Strazar Z, Benko D, Duh D, Rojko T.

Department of Infectious Diseases, University Medical Center, Ljubljana, Slovenia. lejkot@yahoo.com

Culture-negative endocarditis accounts for 2.5-31% of all endocarditis cases and remains a diagnostic and therapeutic challenge. Bartonella spp. has only recently been recognized as an important cause of culture-negative endocarditis. We report a case of Bartonella henselae endocarditis occurring in an immunocompetent man who owned a cat and had previously been diagnosed with valvulopathy. Diagnosis was made only after prolonged diagnostic work-up with serology and with PCR and subsequent sequencing to identify the microorganism in the excised valves. The duration of treatment in patients with bartonella endocarditis is not clearly defined, and we decided to treat our patient with a prolonged course of antibiotic. Surgical treatment is usually necessary and was also successful in our patient. To our knowledge, this is the first case of bartonella endocarditis occurring in our geographic area.

PMID: 18500601 [PubMed - indexed for MEDLINE]

208. Zoonoses Public Health. 2008 Oct;55(8-10):514-20. Epub 2008 May 16.

Molecular evidence for Bartonella spp. in cat and dog fleas from Germany and France.

Just FT, Gilles J, Pradel I, Pfalzer S, Lengauer H, Hellmann K, Pfister K.

Institute for Comparative Tropical Medicine and Parasitology, Veterinary Faculty, Ludwig-Maximilians-University Munich, Germany. frank.just@lgl.bayern.de

Nine hundred and fifty-two fleas were collected from 148 cats and 133 dogs at 18 widely distributed geographic locations in Germany and France and examined for the presence of six different Bartonella spp. (Bartonella bacilliformis, Bartonella clarridgeiae, Bartonella elizabethae, Bartonella henselae, Bartonella quintana, Bartonella vinsonii subsp. berkhoffii) by PCR. Thirty-five specimens (3.7%) tested positive for either B. henselae (14 positive fleas) or B. clarridgeiae (21 positive fleas). DNA of other Bartonella spp. were not detected. Bartonella clarridgeiae was the dominating species in samples from France (19 out of 22 positive fleas), whereas B. henselae was more frequent in Germany (11 out of 13 positive fleas). With 3.5% (22 out of 632 fleas) in France and 4.1% (13 out of 320 fleas) in Germany, the overall prevalences of pathogen did not vary significantly between the flea populations of both countries. 5.4% of cats in France versus 16.1% of cats from Germany were infested by fleas carrying Bartonella, whereas 9.5% of dogs in France but none of the examined dogs from Germany were infested by Bartonella positive fleas. The molecular evidence of Bartonella infections reveals that agents of zoonotic potential are established in flea populations in Germany and France and that the spectrum of species can vary significantly from country to country.

PMID: 18489542 [PubMed - indexed for MEDLINE]

209. Hautarzt. 2008 Jun;59(6):457-8.

[Cat scratch disease].

[Article in German]

von Felbert V, Meybehm M, Megahed M.

Klinik für Allergologie und Dermatologie, RWTH Aachen, Pauwelsstrabe 30, 52074, Aachen, Deutschland. vvonfelbert@ukaachen.de

PMID: 18470500 [PubMed - indexed for MEDLINE]

210. Eur J Ophthalmol. 2008 May-Jun;18(3):456-8.

Macular hole following Bartonella henselae neuroretinitis.

Donnio A, Jean-Charles A, Merle H.

Service d'Ophtalmologie, Centre Hospitalier Universitaire de Fort de France, Hopital Pierre Zobda-Quitman, Fort de France Cedex, Martinique - France (French West Indies).

PURPOSE: To report a case of macular hole secondary to Bartonella henselae neuroretinitis. METHODS: Observational case report. An 11 year-old boy presented urgently with a decrease of visual acuity in the left eye. Posterior segment examination revealed neuroretinitis attributed to Bartonella henselae. Treatment was initiated, resulting in the disappearance of symptoms. RESULTS: Follow-up consultations 7 months later showed a further decline in visual acuity secondary to a macular hole. CONCLUSIONS: Cat scratch disease is a rare pathology and is most often considered benign. Serious complications can nonetheless occur, such as neuroretinitis, choroidal nodules, and disciform keratitis. The authors report a case of sequellar macular hole. They found only one previous report of macular hole caused by B henselae, which, contrary to their case, appeared rapidly 12 days after presentation.

PMID: 18465733 [PubMed - indexed for MEDLINE]

211. Klin Monbl Augenheilkd. 2008 May;225(5):486-7.

Severe occlusive vasculitis as a complication of cat scratch disease.

Berguiga M, Abouzeid H, Bart PA, Guex-Crosier Y.

Jules Gonin Eye Hospital, University of Lausanne, Lausanne, Switzerland.

BACKGROUND: The purpose of this communication is to report a severe occlusive vasculitis as a complication of cat scratch. HISTORY AND SIGNS: A 34-year-old Hispanic woman presented with a sudden visual loss of the right eye associated with shivers, high fever and arthritis which developed 2 months after a cat's bite. Fundus examination showed papillitis and a palor of the paramacular zone of the retina. Fluorescein angiography revealed multiple arterial and venous vasculitic occlusions. THERAPY AND OUTCOME: Auto-immune disease and endocarditis were ruled out by an extensive medical work-up. The diagnosis of Bartonella henselae was confirmed by a positive serology. A systemic antibiotherapy with azithromycin, doxycyclin, rifampicin and steroid therapy resulted in a good clinical response, including a rapid visual recovery with a visual acuity of 20/20 and no relapse of the disease at 6 months follow-up. CONCLUSIONS: Ocular complications associated with cat scratch disease may include vasculitis with both arterial and venous occlusions causing severe visual loss.

PMID: 18454406 [PubMed - indexed for MEDLINE]

212. BMC Infect Dis. 2008 May 1;8:58.

Seroprevalence of Bartonella spp. infection in HIV patients in Catalonia, Spain.

Pons I, Sanfeliu I, Nogueras MM, Sala M, Cervantes M, Amengual MJ, Segura F.

Infectious Diseases Program, Hospital de Sabadell Institut Universitari Parc Taulí UAB, Sabadell, Spain. ipons@tauli.cat

BACKGROUND: Although the first clinical descriptions of Bartonella infection were associated with immunocompromised patient with bacillary angiomatosis, we currently know that this organism is directly involved in diseases affecting a large number of patients, regardless of their immune status. Cat scratch disease, hepatic peliosis, and some cases of bacteraemia and endocarditis, are directly caused by some species of the genus Bartonella. The purpose of this study was to determinate the prevalence of IgG antibodies against Bartonella henselae and B. quintana in HIV patients and to identify the epidemiological factors involved. METHODS: Serum samples were collected from HIV patients treated at Hospital de Sabadell. Antibodies to B. henselae and B. quintana from 340 patients were examined by indirect immunofluorescence assay (IFA). Significance levels for univariate statistical test were determined by the Mann-Whitney U test and chi2 test. RESULTS: Of 340 patients, 82 were women and 258 men, with a median age of 42.21 +/- 10.35 years (range 16-86 years). Seventy-six (22.3%) patients reacted with one or more Bartonella antigens. Of all the factors concerning the seroprevalence rate being studied (age, sex, intravenous drugs use, alcohol consumption, CD4 levels, AIDS, HCV, HBV, residential area), only age was statistically significant. CONCLUSION: A high percentage of HIV patients presents antibodies to Bartonella and is increasing with age.

PMCID: PMC2390557 PMID: 18452613 [PubMed - indexed for MEDLINE]

213. Mikrobiyol Bul. 2008 Jan;42(1):163-75.

[Bartonella henselae and its infections].

[Article in Turkish]

Celebi B.

Refik Saydam Hifzissihha Merkezi Başkanliği, Salgin Hastaliklar Araştirma Müdürlüğü, Bakteriyel Zoonozlar Araştirma Laboratuvari, Ankara. bekir.celebi@rshm.gov.tr

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 been discussed.

PMID: 18444576 [PubMed - indexed for MEDLINE]

214. Pediatrics. 2008 May;121(5):e1413-25. Epub 2008 Apr 28.

Beyond cat scratch disease: widening spectrum of Bartonella henselae infection.

Florin TA, Zaoutis TE, Zaoutis LB.

Division of General Pediatrics, Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, USA. florint@email.chop.edu

Bartonella henselae was discovered a quarter of a century ago as the causative agent of cat scratch disease, a clinical entity described in the literature for more than half a century. As diagnostic techniques improve, our knowledge of the spectrum of clinical disease resulting from infection with Bartonella is expanding. This review summarizes current knowledge regarding the microbiology, clinical manifestations, diagnostic techniques, and treatment of B. henselae infection.

PMID: 18443019 [PubMed - indexed for MEDLINE]

215. Neth J Med. 2008 Apr;66(4):160-2.

Visceral involvement in an immunocompetent male: a rare presentation of cat scratch disease.

van der Veer-Meerkerk M, van Zaanen HC.

Department of Internal Medicine, Sint Franciscus Gasthuis, Rotterdam, the Netherlands.

We report a case of an adult, immunocompetent male with lymphadenopathy of both groins, para-aortal lymph nodes and multiple lesions in the spleen. A neoplasm was excluded by histology of the largest lymph node from the left groin. The diagnosis of cat-scratch disease (CSD ) became apparent when serological testing for Bartonella henselae showed to be positive. A review of literature shows that disseminated (visceral) infection is a rare presentation of CSD.

PMID: 18424863 [PubMed - indexed for MEDLINE]

216. J Mol Diagn. 2008 May;10(3):185-97. Epub 2008 Apr 10.

Emerging pathogens: challenges and successes of molecular diagnostics.

Dong J, Olano JP, McBride JW, Walker DH.

Department of Pathology, University of Texas Medical Branch, Galveston, Texas, USA.

More than 50 emerging and reemerging pathogens have been identified during the last 40 years. Until 1992 when the Institute of Medicine issued a report that defined emerging infectious diseases, medicine had been complacent about such infectious diseases despite the alarm bells of infections with human immunodeficiency virus. Molecular tools have proven useful in discovering and characterizing emerging viruses and bacteria such as Sin Nombre virus (hantaviral pulmonary syndrome), hepatitis C virus, Bartonella henselae (cat scratch disease, bacillary angiomatosis), and Anaplasma phagocytophilum (human granulocytotropic anaplasmosis). The feasibility of applying molecular diagnostics to dangerous, fastidious, and uncultivated agents for which conventional tests do not yield timely diagnoses has achieved proof of concept for many agents, but widespread use of cost-effective, validated commercial assays has yet to occur. This review presents representative emerging viral respiratory infections, hemorrhagic fevers, and hepatitides, as well as bacterial and parasitic zoonotic, gastrointestinal, and pulmonary infections. Agent characteristics, epidemiology, clinical manifestations, and diagnostic methods are tabulated for another 22 emerging viruses and five emerging bacteria. The ongoing challenge to the field of molecular diagnostics is to apply contemporary knowledge to facilitate agent diagnosis as well as to further discoveries of novel pathogens.

PMCID: PMC2329782 PMID: 18403608 [PubMed - indexed for MEDLINE]

217. Bull Acad Natl Med. 2007 Jun;191(6):1037-44; discussion 1047-9.

[Persistent Bartonella infection: epidemiological and clinical implications].

[Article in French]

Boulouis HJ, Haddad N, Vayssier-Taussat M, Maillard R, Chomel B.

UMR BIPAR ENVA/AFSSA/INRA/UPVM Ecole Nationale Vétérinaire d'Alfort, 7 avenue du Gal de Gaulle, 94704, Maisons-Alfort. hjboulouis@vet-alfort.fr

Bartonella are Gram-negative hemotropic bacteria that infect a wide range of mammals. At least 14 Bartonella species or subspecies have been reported to be pathogenic for humans and animals. Wild and domestic animals represent a large reservoir. Reservoir species usually display chronic bacteremia. This explains some aspects of the epidemiology of these infections, and especially vector-borne transmission. The molecular mechanisms of persistent infection have clinical consequences both for occasional hosts and for human and animal reservoirs. An increasing number of clinical cases are being described in reservoir species that were previously considered to remain asymptomatic.

PMID: 18402163 [PubMed - indexed for MEDLINE]

218. J Feline Med Surg. 2008 Aug;10(4):332-7. Epub 2008 Apr 8.

Bartonella species antibodies and DNA in cerebral spinal fluid of cats with central nervous system disease.

Leibovitz K, Pearce L, Brewer M, Lappin MR.

Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 300 West Drake Road, Fort Collins, CO 80523, USA.

Bartonella species infection is associated with central nervous system (CNS) disease in some humans and cats but the diagnosis is difficult to confirm with blood or serum test results. In this retrospective study of 100 client-owned cats, serum and cerebral spinal fluid (CSF) were assayed for Bartonella species IgG antibodies and CSF was assayed for Bartonella species DNA. Bartonella species IgG antibodies were detected in serum of 36 cats, Bartonella species C-values>1 (suggesting antibody production by the CNS) were detected in CSF of 11 cats, and B henselae DNA was amplified from the CSF of 10 cats. While the clinical significance of these findings cannot be assessed without a control group, the development of neurological signs in some cats inoculated with B henselae and the results of this study warrant prospective evaluation of the association of Bartonella species with feline CNS disease.

PMID: 18400536 [PubMed - indexed for MEDLINE]

219. Ocul Immunol Inflamm. 2008 Jan-Feb;16(1):45-9.

Atypical Bartonella hensalae chorioretinitis in an immunocompromised patient.

Patel SJ, Petrarca R, Shah SM, Zimmer-Galler I, Janjua KA, Do DV, Nguyen QD.

School of Medicine, Wilmer Eye Institute, The Johns Hopkins University, Baltimore, Maryland, USA.

PURPOSE: To report an atypical case of chorioretinopathy in a patient with bilateral renal transplantations. METHODS: A 55-year-old female was referred for management of birdshot chorioretinopathy. Ophthalmologic examination revealed bilateral yellowish, chorioretinal lesions with adjacent hemorrhages. RESULTS: Angiography demonstrated lesions with hyperfluorescence, leakage, and diffuse macular edema. OCT showed intraretinal edema. Laboratory evaluation revealed IgG antibodies for Bartonella hensalae. Treatment with oral ciprofloxacin led to regression of lesions, resolution of macular edema, and improvement in visual acuity. CONCLUSION: Multifocal chorioretinal lesions associated with B. hensalae can be atypical ophthalmic manifestations of cat-scratch disease (CSD), which may occur in immunosuppressed patients. Recognition of underlying disease and appropriate therapy can lead to improved outcomes.

PMID: 18379943 [PubMed - indexed for MEDLINE]

220. Congenit Heart Dis. 2007 Jan-Feb;2(1):79-84.

Bartonella endocarditis in complex congenital heart disease.

Hoffman RM, AboulHosn J, Child JS, Pegues DA.

Division of Infectious Diseases, Department of Internal Medicine, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA. rhoffman@mednet.ucla.edu

Bartonella species are an important cause of culture-negative endocarditis, with recognized risk factors of alcoholism, homelessness, cat exposure, and pre-existing valvular disease. We report a case of Bartonella henselae endocarditis in a 36-year-old woman with complex congenital heart disease who presented with a 7-month history of hemolytic anemia, leukocytoclastic vasculitis, and recurrent fevers. Transesophageal echocardiogram revealed vegetations on the patient's native aortic valve and in the right ventricular to pulmonary artery conduit and associated bioprosthetic valve. Diagnosis of B. henselae was confirmed with serum antibody and polymerase chain reaction (PCR) testing and tissue stains. The patient was treated successfully with surgical resection and prolonged antimicrobial therapy with ceftriaxone, gentamicin, and doxycycline. A review of the literature suggests prosthetic valves and complex congenital heart disease are risk factors for Bartonella endocarditis, and a high index of suspicion with antibody and PCR testing can expedite diagnosis and improve outcomes.

PMID: 18377522 [PubMed - indexed for MEDLINE]

221. J Med Microbiol. 2008 Apr;57(Pt 4):519-24.

Abscess-forming lymphadenopathy and osteomyelitis in children with Bartonella henselae infection.

Ridder-Schröter R, Marx A, Beer M, Tappe D, Kreth HW, Girschick HJ.

Children's Hospital, University of Würzburg, 97080 Würzburg, Germany.

Bartonella henselae is the agent of cat-scratch disease (CSD), a chronic lymphadenopathy among children and adolescents. A systemic infection is very rare and most of these cases are found in patients with immunodeficiency. Here, cases involving four children of 6-12 years of age are reported. Three of the children had an abscess-forming lymphadenopathy and surrounding myositis in the clavicular region of the upper arm. The diagnosis was made serologically and, in one case, using eubacterial universal PCR. One child was treated with erythromycin for 10 days, the second received cefotaxime and flucloxacillin for 14 days and the third child was not treated with antibiotics. The fourth child had a different course: a significantly elevated signal intensity affecting the complete humerus was found in magnetic resonance imaging, consistent with osteomyelitis. A lymph node abscess was also found in the axilla. Diagnosis was established by indirect fluorescence assay and lymph node biopsy. Antibiotic therapy using clarithromycin, clindamycin and rifampicin was gradually successful. Immunodeficiency was excluded. All described lesions healed without residues. In immunocompetent patients, infection affects skin and draining lymph nodes; however, prolonged fever of unknown origin as in the fourth patient indicated a systemic complication of CSD.

PMID: 18349375 [PubMed - indexed for MEDLINE]

222. Braz J Infect Dis. 2007 Dec;11(6):591-4.

Bartonella native valve endocarditis: the first Brazilian case alive and well.

Lamas C, Favacho A, Ramos RG, Santos MS, Ferravoli GI, Weksler C, Rozental T, Bóia MN, Lemos ER.

National Institute of Cardiology, de Janeiro, Brazil. cristianelamas@gmail.com

Bartonella is an important cause of blood culture-negative endocarditis in recent studies. Seroprevalence studies in the States of Minas Gerais and Rio de Janeiro have shown Bartonella IgG positivity around 14% in healthy adults and 40% in HIV seropositive adults, respectively. A case report of a 46-year-old white male with moderate aortic regurgitation (AR) due to rheumatic heart disease (RHD), admitted due to worsening heart failure, is presented. Clinical features were apyrexia, anemia, polyclonal hypergammaglobulinemia, hematuria and splenomegaly. He was submitted to surgery due to worsening AR. Histopathology of the excised valve showed active bacterial endocarditis and underlying RHD. Routine blood cultures were negative. Indirect immunofluorescence (IFI) assays for Coxiella burnetii were non-reactive. Bartonella henselae IgG titer was 1:4096 prior to antibiotics and 1:512 14 months after treatment. History of close contact with a young cat during the months preceding his admission was elicited.

PMID: 18327472 [PubMed - indexed for MEDLINE]

223. Vet Immunol Immunopathol. 2008 May 15;123(1-2):167-71. Epub 2008 Jan 19.

Feline bartonellosis and cat scratch disease.

Breitschwerdt EB.

College of Veterinary Medicine, North Carolina State University, Dipl. ACVIM, 4700 Hillsborough Street, Raleigh, NC 27606, United States. ed_breitschwerdt@ncsu.edu

Bartonella species are important emerging zoonotic pathogens. Transmission of these organisms in nature may be much more complex than is currently appreciated. Cats can be infected with five Bartonella species, including, Bartonella henselae, Bartonella clarridgeae, Bartonella bovis, Bartonella koehlerae and Bartonella quintana. In addition to cats, numerous domestic and wild animals, including bovine, canine, human, and rodent species can serve as chronically infected reservoir hosts for various intra-erythrocytic Bartonella species. In addition, an increasing number of arthropod vectors, including biting flies, fleas, keds, lice, sandflys and potentially ticks have been implicated in the transmission of various Bartonella species to animals or human beings. In the reservoir host, Bartonella species cause chronic intra-erythrocytic and vascular endothelial infections, with a relapsing bacteremia documented in experimentally infected cats. Although the immunopathology induced by Bartonella infection requires additional study, the organisms can localize to the heart valve (endocarditis), cause granulomatous inflammation in lymph nodes, liver or spleen, induce central nervous system dysfunction with or without cerebrospinal fluid changes, and may contribute to inflammatory polyarthritis. Hematological abnormalities are infrequent, but thrombocytopenia, lymphocytosis, neutropenia, and eosinophilia have been reported in B. henselae-infected cats. Serology, PCR and culture can be used to support a diagnosis of feline bartonellosis, however, due to the high rate of sub-clinical infections among various cat populations, documenting causation in an individual cat is difficult, if not impossible. Response to treatment can be used in conjunction with serology or organism isolation to support a clinical diagnosis of feline bartonellosis. As fleas are involved in the transmission among cats, the use of acaracide products to eliminate fleas from the environment is of critical importance to decrease the risk of B. henselae transmission among cats and to humans.

PMID: 18295347 [PubMed - indexed for MEDLINE]

224. Epidemiol Infect. 2008 Dec;136(12):1712-6. Epub 2008 Feb 25.

Serological evidence of Bartonella henselae infection in healthy people in Catalonia, Spain.

Pons I, Sanfeliu I, Cardeñosa N, Nogueras MM, Font B, Segura F.

Infectious Diseases Program, Department of Internal Medicine, Hospital Universitari Parc Taulí, Sabadell, Barcelona, Spain. ipons@tauli.cat

Cat scratch disease (CSD), bacillary angiomatosis, hepatic peliosis and some cases of bacteraemia, endocarditis, and osteomyelitis are directly caused by some species of the genus Bartonella. The purpose of this study was to determine the prevalence of IgG antibodies against Bartonella henselae in healthy people and to identify the epidemiological factors involved. Serum samples from 218 patients were examined by indirect immunofluorescence assay (IFA). Significance levels for univariate statistical analysis were determined by the Mann-Whitney U test, chi2 test and Fisher's exact test. Of 218 patients, 99 were female and 119 male, with a median age of 34.36 years (range 0-91 years). Nineteen (8.7%) reacted with B. henselae antigens. Of all the factors concerning the seroprevalence rate being studied (age, sex, contact with animals, residential area), only age was statistically significant. Our serological data seems to indicate that B. henselae is present in Catalonia and could be transmitted to humans.

PMCID: PMC2870778 PMID: 18294428 [PubMed - indexed for MEDLINE]

225. Am J Pathol. 2008 Apr;172(4):1005-18. Epub 2008 Feb 21.

Lymphadenopathy in a novel mouse model of Bartonella-induced cat scratch disease results from lymphocyte immigration and proliferation and is regulated by interferon-alpha/beta.

Kunz S, Oberle K, Sander A, Bogdan C, Schleicher U.

Immunologie und Hygiene, Universitätsklinikum Erlangen, Wasserturmstrasse 3-5, Erlangen, Germany.

In immunocompetent humans, cat scratch disease (CSD) is elicited by the Gram-negative bacterium Bartonella henselae and is characterized by a benign regional lymphadenopathy, the pathogenesis of which is poorly understood. Here, we describe a novel mouse model of Bartonella-induced CSD-like disease that allowed us to investigate the mechanisms leading to lymphadenopathy in vivo. In wild-type mice, a subcutaneous inoculation of either viable or inactivated B. henselae led to a strong swelling of the draining lymph node, which was long-lasting despite the rapid elimination of the bacteria. Carboxyfluorescein- and bromodesoxyuridine-labeling experiments showed that lymph node enlargement resulted from modified immigration and enhanced proliferation of lymphocytes, preferentially of B cells. A comparative analysis of B. henselae and the rodent pathogen B. grahamii in wild-type versus interferon-alpha/beta-receptor I chain-deficient mice revealed that interferon-alpha/beta is not only differentially induced by these two Bartonella species but also exerts an inhibitory effect on the development of lymphadenopathy both in vitro and in vivo. These data demonstrate that the lymphadenopathy of human CSD can be reproduced and studied in a mouse model and provide the first insights into the underlying immunological mechanisms.

PMCID: PMC2276426 PMID: 18292236 [PubMed - indexed for MEDLINE]

226. J Vet Intern Med. 2008 Jan-Feb;22(1):60-5.

Infectious diseases of dogs and cats on Isabela Island, Galapagos.

Levy JK, Crawford PC, Lappin MR, Dubovi EJ, Levy MG, Alleman R, Tucker SJ, Clifford EL.

Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610, USA. levyj@vetmed.ufl.edu

BACKGROUND: Vaccination and importation of dogs and cats are prohibited in the Galapagos, resulting in a uniquely isolated population. The purpose of this study was to determine the prevalence of infectious diseases of dogs and cats that impact their health, could spill over to native wildlife, or sentinel diseases of concern to humans. HYPOTHESIS: The isolation of dogs and cats in the Galapagos protects them from diseases common in mainland populations. ANIMALS: Ninety-five dogs and 52 cats presented during a neutering campaign. METHODS: A prospective cross-sectional study was performed. Blood was collected for serological and DNA evaluation of a panel of infectious diseases. RESULTS: Antibodies against parvovirus (100%), parainfluenza virus (100%), adenovirus 1/2 (66-67%), and distemper virus (22%) were present in dogs. Dirofilaria immitis was also common in dogs (34%), with lower prevalences of Wolbachia pipiens (22%), Bartonella sp. (13%), Ehrlichia/Anaplasma spp. (1%), and Mycoplasma haemocanis (1%) observed. Antibodies against panleukopenia virus (67%), Toxoplasma gondii (63%), calicivirus (44%), and herpesvirus 1 (10%) were detected in cats. Feline leukemia virus antigen, feline immunodeficiency virus antibody, or coronavirus antibodies were not detected. Bartonella sp. (44%) infections were common in cats, but only one was infected with M. haemofelis. CONCLUSIONS AND CLINICAL IMPORTANCE: Despite their relative seclusion from the rest of the world, cats and dogs of Isabela were exposed to many pathogens found in mainland South America. Parasite prophylaxis, neutering, and strict enforcement of animal movement restrictions would control a majority of the diseases. In the absence of vaccination, a reservoir of susceptible animals remains vulnerable to new disease introductions.

PMID: 18289290 [PubMed - indexed for MEDLINE]

227. Rev Chilena Infectol. 2008 Feb;25(1):58-63. Epub 2008 Feb 8.

[Ocular bartonellosis: report of three clinical cases].

[Article in Spanish]

Täger F M, Jahnsen K J, Mediavilla R M, Burgos L R.

Instituto de Pediatría, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile.

The characteristic clinical presentation of cat scratch disease is subacute regional lymphadenopathy; nevertheless, 5-25% of Bartonella henselae infections may present an atypical or systemic form, with potential eye involvement. We describe three clinical cases of ocular bartonellosis in two adolescents and one young adult, who had close contact with cats; all of them presented persistent fever ranging from 15 to 21 days, and two of them developed a sudden unilateral loss of visual acuity associated with optic neuritis. The other patient presented retinal choroiditis and unilateral retinal microgranulomas, with normal visual acuity. Patients received macrolides as sole antimicrobial or in association with rifampin, and one patient was additionally treated with systemic corticoids. The outcome was favorable in two patients; one patient developed a permanent visual deficit. Ocular bartonellosis must be suspected in patients with close contact to cats or with cat scratches whom develop persistent fever and sudden loss of visual acuity.

PMID: 18273527 [PubMed - indexed for MEDLINE]

228. Emerg Infect Dis. 2008 Jan;14(1):152-4.

Prolonged Bartonella henselae bacteremia caused by reinfection in cats.

Arvand M, Viezens J, Berghoff J.

Institute for Medical Microbiology, Virology and Hygiene, University of Rostock, Schillingallee 70, Rostock, Germany. mardjan.arvand@med.uni-rostock.de

We analyzed the genetic relatedness of blood culture isolates of Bartonella henselae from 2 cats of patients with cat-scratch disease at admission and after 12 months. Isolates from each cat at different times were clonally unrelated, which suggested reinfection by a second strain.

PMCID: PMC2600141 PMID: 18258096 [PubMed - indexed for MEDLINE]

229. Lancet Infect Dis. 2008 Feb;8(2):140.

Hepatosplenic cat-scratch fever.

Laham FR, Kaplan SL.

Department of Pediatrics, Section of Infectious Diseases, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA. skaplan@bcm.edu

Comment in Lancet Infect Dis. 2008 Nov;8(11):663.

PMID: 18222165 [PubMed - indexed for MEDLINE]

230. Clin Infect Dis. 2007 Dec 15;45(12):1541-2.

From Cat scratch disease to Bartonella henselae infection.

Raoult D.

Comment on Clin Infect Dis. 2007 Dec 15;45(12):1535-40.

PMID: 18190313 [PubMed - indexed for MEDLINE]

231. Clin Infect Dis. 2007 Dec 15;45(12):1535-40.

Musculoskeletal manifestations of cat scratch disease.

Maman E, Bickels J, Ephros M, Paran D, Comaneshter D, Metzkor-Cotter E, Avidor B, Varon-Graidy M, Wientroub S, Giladi M.

Department of Pediatric Orthopaedics, Dana Children's Hospital.

Comment in Clin Infect Dis. 2007 Dec 15;45(12):1541-2.

BACKGROUND: Musculoskeletal manifestations (MMs) are considered to be rare in cat scratch disease (CSD) and are not well characterized. We aimed to study MMs of CSD. METHODS: A surveillance study performed over 11 years identified patients with CSD on the basis of compatible clinical presentation and confirmatory serological test or PCR results for Bartonella henselae. Patients with CSD who had MMs (i.e., myalgia, arthritis, arthralgia, tendinitis, osteomyelitis, and neuralgia) were compared with patients with CSD who did not have MMs (control subjects). RESULTS: Of 913 patients with CSD, 96 (10.5%) had MMs. Myalgia (in 53 patients [5.8%]) was often severe, with a median duration of 4 weeks (range, 1-26 weeks). Arthropathy (arthralgia and/or arthritis; in 50 patients [5.5%]) occurred mainly in the medium and large joints and was classified as moderate or severe in 26 patients, with a median duration of 5.5 weeks (range, 1-240 weeks). In 7 patients, symptoms persisted for >or=1 year; 5 developed chronic disease. Tendinitis, neuralgia, and osteomyelitis occurred in 7, 4, and 2 patients, respectively. Patients with MMs were significantly older than patients in the control group (median age, 31.5 years vs. 15.0 years). In multivariate analysis, age >20 years was associated with having any MM (relative risk [RR], 4.96; 95% confidence interval [CI], 2.79-8.8), myalgia (RR, 4.69; 95% CI, 2.22-9.88), and arthropathy (RR, 11.0; 95% CI, 4.3-28.2). Arthropathy was also associated with female sex (RR, 1.89; 95% CI, 1.01-3.52) and erythema nodosum (RR, 4.07; 95% CI, 1.38-12.02). CONCLUSIONS: MMs of CSD are more common than previously thought and affect one-tenth of patients with CSD. MMs occur mostly in patients aged >20 years and may be severe and prolonged. Osteomyelitis, the most well known MM of CSD is, in fact, the rarest.

PMID: 18190312 [PubMed - indexed for MEDLINE]

232. Mikrobiyol Bul. 2007 Oct;41(4):603-6.

[A case of cat scratch disease].

[Article in Turkish]

Eroğlu C, Candir N, Dervişoğlu A, Kefeli M.

Ondokuz Mayis Universitesi Tip FakOltesi, Klinik Mikrobiyoloji ve Infeksiyon Hastaliklan Anabilim Dali, Samsun. ceroglu@omu.edu.tr

Cat scratch disease (CSD) which is usually seen in children and young adults and characterized by self limited lymphadenopathy, is caused by Bartonella henselae. In this report, a 30-year-old male patient who was admitted to the outpatient clinic with the complaint of lymphadenopathy, was presented. Erythrocyte sedimentation rate and C reactive protein values of the patient were normal, and anti-HIV, Brucella agglutination and anti-toxoplasma IgM and IgG tests were negative. No bacterial growth was detected in the cultures of repetetive blood samples and biopsy specimens taken from the right axillar lymph node. This might probably be due to the prior antibiotic therapy (ciprofloxacin and cefazolin) given by another health center. Polymerase chain reaction performed with biopsy specimen by using 27f and 1525r primers, also yielded negative result. CSD was diagnosed depending on the history of direct contact with a cat (being scratched and bitten), together with the clinical features and histopathologic findings (necrotizing granulomatous inflammation concordant with CSD). Lymphadenopathies of patient had completely resolved after five-days oral azithromycin therapy. Since CSD is a rare infection of adults, it should be taken into consideration in the patients who suffer from silent lymphadenopathy and present with the history of direct contact with cats.

PMID: 18173081 [PubMed - indexed for MEDLINE]

233. Ultrastruct Pathol. 2007 Nov-Dec;31(6):369-72.

Bartonella henselae infects human erythrocytes.

Pitassi LH, Magalhães RF, Barjas-Castro ML, de Paula EV, Ferreira MR, Velho PE.

Department of Dermatology, Medical School, State University of Campinas (UNICAMP), Sao Paulo, Brazil. pitassi@yahoo.com

Bartonella henselae, a facultative intracellular bacterium, has been known as the agent of cat scratch disease, bacillary angiomatosis, peliosis hepatis, endocarditis, and bacteremic syndrome in humans. Bartonella species can cause intraerythrocytic infections and have been isolated from the bloodstream of patients by several methods. It was demonstrated that B. bacilliformis and B. quintana infect human endothelial cells and human erythrocytes and B. henselae infects erythrocytes of cats. The aim of this study was to investigate through transmission electron microscopy whether B. henselae infects mature human erythrocytes. One red blood cell (RBC) unit received an experimentally standard strain of B. henselae. Blood aliquots were collected from the infected unit immediately after inoculation, at 30 min and 1, 5, 10, and 72 h for ultrastructural evaluation. B. henselae was seen adhering to human erythrocytes 10 h after inoculation and inside the erythrocyte after 72 h. This study demonstrates that B. henselae adheres to and invades mature human erythrocytes. The results favor the possibility that erythrocytes can serve as a primary target in Bartonella spp. infections. From this observation, further studies are warranted to prevent Bartonella spp. transfusional transmission.

PMID: 18098053 [PubMed - indexed for MEDLINE]

234. PLoS One. 2007 Dec 19;2(12):e1346.

Multi-locus sequence typing of Bartonella henselae isolates from three continents reveals hypervirulent and feline-associated clones.

Arvand M, Feil EJ, Giladi M, Boulouis HJ, Viezens J.

Institut für Medizinische Mikrobiologie, Virologie und Hygiene, Universität Rostock, Rostock, Germany. mardjan.arvand@med.uni-rostock.de

Bartonella henselae is a zoonotic pathogen and the causative agent of cat scratch disease and a variety of other disease manifestations in humans. Previous investigations have suggested that a limited subset of B. henselae isolates may be associated with human disease. In the present study, 182 human and feline B. henselae isolates from Europe, North America and Australia were analysed by multi-locus sequence typing (MLST) to detect any associations between sequence type (ST), host species and geographical distribution of the isolates. A total of 14 sequence types were detected, but over 66% (16/24) of the isolates recovered from human disease corresponded to a single genotype, ST1, and this type was detected in all three continents. In contrast, 27.2% (43/158) of the feline isolates corresponded to ST7, but this ST was not recovered from humans and was restricted to Europe. The difference in host association of STs 1 (human) and 7 (feline) was statistically significant (P< or =0.001). eBURST analysis assigned the 14 STs to three clonal lineages, which contained two or more STs, and a singleton comprising ST7. These groups were broadly consistent with a neighbour-joining tree, although splits decomposition analysis was indicative of a history of recombination. These data indicate that B. henselae lineages differ in their virulence properties for humans and contribute to a better understanding of the population structure of B. henselae.

PMCID: PMC2147075 PMID: 18094753 [PubMed - indexed for MEDLINE]

235. Vet Parasitol. 2008 Feb 14;151(2-4):332-6. Epub 2007 Nov 9.

Vector-borne infections in cats: molecular study in Barcelona area (Spain).

Tabar MD, Altet L, Francino O, Sánchez A, Ferrer L, Roura X.

Department of Animal Medicine and Surgery, Autonomous University of Barcelona, Barcelona 08193, Spain. lolitavet@yahoo.es

Previous serological surveys have reported the presence of different organisms in cats from Spain but little reports exist about the exact identity of these organisms. The purpose of the study reported here was to assess the presence of DNA of several vector-borne infections in a population of cats from Barcelona area. One hundred blood samples obtained from cats admitted to the UAB-VTH were entered into the study and classified as healthy (n=48) or unhealthy (n=52). EDTA-blood samples were assayed for Leishmania infantum, Ehrlichia spp., Anaplasma spp., Rickettsia spp., Bartonella spp., Hepatozoon spp., Babesia spp. and Theileria spp. DNA by means of PCR amplification and amplicons obtained were sequenced. Prevalence of infectious agents found were Leishmania infantum (3%), Ehrlichia/Anaplasma sp. (1%), Hepatozoon felis (4%) and Bartonella clarridgeiae (1%). Cats being less than 5 years old had more probability of having at less one PCR positive result (P=0.028). The results of this study show a low prevalence of several vector-borne pathogens among cats from Barcelona area. Although higher feline seroprevalences are previously reported, they evidenced exposure and probably overestimate the real or active degree of infection. However, it is important to maintain a high index of suspicion on these infectious diseases, both in sick and asymptomatic cats, and molecular techniques could aid in the identification of these pathogens.

PMID: 18079064 [PubMed - indexed for MEDLINE]

236. Dev Med Child Neurol. 2007 Dec;49(12):931-4.

Encephalopathy with retinitis due to cat-scratch disease.

Smith RA, Scott B, Beverley DW, Lyon F, Taylor R.

Department of Paediatrics, York Hospital, York, UK. robert.a.smith@york.nhs.uk

Cat-scratch disease is one of several diseases known to be caused by Bartonella species. Some infections due to Bartonella resolve spontaneously without treatment with antibiotics, but in other cases the disease can be fatal without treatment. This case study reports a 7-year-old male who presented with an unexplained encephalopathy and unusual retinal findings associated with evidence supporting infection by B. henselae. The 7-year-old male presented with a 2-week history of general malaise and cervical lymphadenopathy progressing onto fever, headache, vomiting, and confusion associated with meningism. Lumbar puncture revealed a raised cerebrospinal fluid protein, low glucose, and raised white cell count. Abnormal retinal findings and raised antibodies titres to B. quintana indicated a diagnosis of cat-scratch disease. He was treated with azithromycin orally for 3 weeks and made a complete recovery.

PMID: 18039241 [PubMed - indexed for MEDLINE]

237. Zhonghua Er Ke Za Zhi. 2007 Aug;45(8):573.

[Cat scratch disease: report of a case].

[Article in Chinese]

Li CW, Yin J, Zhang XL.

PMID: 18021527 [PubMed - indexed for MEDLINE]

238. J Wildl Dis. 2007 Oct;43(4):609-17.

Phylogenetic analysis of Bartonella detected in rodent fleas in Yunnan, China.

Li DM, Liu QY, Yu DZ, Zhang JZ, Gong ZD, Song XP.

Department of Vector Biology and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention P.O. Box 5, Changping, Beijing 102206, China.

Previous studies have demonstrated a diversity of Bartonella spp. in rodent populations in Yunnan Province, China. Although Bartonella spp. have been isolated from cat fleas and cattle ticks collected from their animal hosts, little is known about Bartonella carried by rodent fleas. In this study, Bartonella DNA was detected by polymerase chain reaction (PCR) in two of five species of rodent fleas. These included Xenopsylla cheopis and Ctenophthalmus lushuiensis, which were collected from Rattus tanezumi flavipectus and from the nests of voles, respectively, during 1997 from two sites in western Yunnan Province, China. Sequence analysis of the Bartonella citrate synthase gene (gltA) amplicons obtained from six of 65 grouped flea samples showed that Bartonella genetic variants were clustered in four groups. One from Xenopsylla cheopis was identical to Bartonella tribocorum, whereas the other three genotypes from Ctenophthalmus lushuiensis were related to the vole-associated Bartonella isolates and cat-associated Bartonella clarridgeiae. This is the first detection of this Bartonella variant from fleas in China. Therefore, further investigations are needed to clarify the distribution of Bartonella in rodents and their ectoparasites in China to define the role of these arthropods in the transmission routes of Bartonella.

PMID: 17984255 [PubMed - indexed for MEDLINE]

239. J Infect Chemother. 2007 Oct;13(5):350-2. Epub 2007 Oct 30.

Multifocal osteomyelitis due to Bartonella henselae in a child without focal pain.

Kodama Y, Maeno N, Nishi J, Imuta N, Oda H, Tanaka S, Kono Y, Kawano Y.

Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan. yuichik@m.kufm.kagoshima-u.ac.jp

We describe a case of an 11-year-old girl who presented with osteomyelitis of the vertebrae and right femur due to Bartonella henselae. Her only symptom was prolonged fever without focal pain. Magnetic resonance imaging (MRI) and nested polymerase chain reaction (PCR) were useful for the diagnosis. Osteomyelitis due to B. henselae should be considered in cases of prolonged fever of unknown origin.

PMID: 17982727 [PubMed - indexed for MEDLINE]

240. Med Clin (Barc). 2007 Sep 8;129(8):320.

[Cat-scratch disease].

[Article in Spanish]

Campos Franco J, Mallo González N, López Rodríquez R, Pérez Pampín E.

Servicio de Medicina Interna, Complejo Hospitalario Universitario, Santiago de Compostela, A Coruña, España.

PMID: 17969956 [PubMed - indexed for MEDLINE]

241. Emerg Infect Dis. 2007 Aug;13(8):1178-83.

Genetic diversity of Bartonella henselae in human infection detected with multispacer typing.

Li W, Raoult D, Fournier PE.

Université de la Méditerraneé, Marseille, France.

We applied multispacer typing (MST) by incorporating 9 variable intergenic spacers to Bartonella henselae DNA detected in lymph node biopsy specimens from 70 patients with cat-scratch disease (CSD), in cardiac valve specimens from 2 patients with endocarditis, and in 3 human isolates from patients with bacillary angiomatosis, CSD, and endocarditis. Sixteen MST genotypes were found, 5 previously identified in cats and 11 new. Of the studied DNA, 78.7% belonged to 2 genotypes, which were phylogenetically organized into 4 lineages. Human strains were mostly grouped within 2 lineages, previously identified as Marseille and Houston-1. Our results suggest a greater genetic diversity in human-infecting B. henselae than what has previously been evaluated by using other genotyping methods. However, the diversity is not significantly different from that of cat strains. MST is thus a suitable genotyping tool for evaluating the genetic heterogeneity of B. henselae among isolates obtained from human patients.

PMCID: PMC2828084 PMID: 17953088 [PubMed - indexed for MEDLINE]

242. Arch Pathol Lab Med. 2007 Oct;131(10):1591-4.

A case of fatal disseminated Bartonella henselae infection (cat-scratch disease) with encephalitis.

Fouch B, Coventry S.

Department of Pediatrics, University of Louisville School of Medicine, Louisville, KY, USA.

Cat-scratch disease resulting from Bartonella henselae infection is usually a benign, self-limited process in immunocompetent children. Even the rare cases associated with neurologic manifestations are not generally fatal. We report a case of a previously healthy 6-year-old boy with cat-scratch disease, systemic dissemination, and encephalitis that led to his death. Autopsy revealed perivascular lymphocytic infiltrates and microglial nodules in the brain. To our knowledge, this finding has not been previously reported in B. henselae infection, possibly because of the paucity of material available for complete neuropathologic evaluation. This case illustrates the extreme severity of the spectrum with which cat-scratch disease can present and provides evidence of brain histopathology that may be representative of the disease.

PMID: 17922599 [PubMed - indexed for MEDLINE]

243. Vet Res Commun. 2007 Aug;31 Suppl 1:317-20.

Seroprevalence of Bartonella henselae in dogs and cats in Sassari.

Pinna Parpaglia ML, Masu G, Masala G, Porcu R, Zobba R, Pintori G, Cocco R.

Institute of Special Pathology and Veterinary Clinical Medicine, Faculty of Veterinary Medicine, Sassari, Italy. pinnapar@uniss.it

PMID: 17682904 [PubMed - indexed for MEDLINE]

244. J Microbiol Methods. 2007 Nov;71(2):107-13. Epub 2007 Sep 15.

The use of Bartonella henselae-specific age dependent IgG and IgM in diagnostic models to discriminate diseased from non-diseased in Cat Scratch Disease serology.

Herremans M, Vermeulen MJ, Van de Kassteele J, Bakker J, Schellekens JF, Koopmans MP.

National Institute for Public Health and the Environment (RIVM), Diagnostic Laboratory for infectious diseases and perinatal screening (LIS), Bilthoven, The Netherlands. Tineke.Herremans@rivm.nl

Cat Scratch Disease (CSD) is caused by Bartonella henselae infection and is a common cause of regional lymphadenopathy. The diagnosis of CSD largely depends on serology, but is hampered by both low sensitivity and specificity of the applied IgG and IgM assays. Using an in-house ELISA, we detected a significant age-dependent increase in the IgG levels in the general population compared to CSD patients. With this knowledge, we developed diagnostic models to differentiate diseased from non-diseased persons. Evaluation of these models using samples from PCR-positive patients (n=155) and age-matched controls (n=244) showed an important increase in the assay performance if the combination of the IgG and IgM results were taken into account. If the specificity was set at 98% the sensitivity was only 45% and 32% for the IgM and IgG ELISA, respectively but increased to 59% when these results were combined. Also the use of age-dependent factors further improved the clinical relevance of the outcome raising the sensitivity to 64%. Although the sensitivity of the ELISA remains low we conclude that the use of models using the combination of both IgM and IgG test results and age-depending factors can be a useful diagnostic tool in the serodiagnosis of CSD.

PMID: 17916395 [PubMed - indexed for MEDLINE]

245. Ear Nose Throat J. 2007 Aug;86(8):449-50.

Cat-scratch disease lymphadenitis.

Caponetti G, Pantanowitz L.

Department of Pathology, Baystate Medical Center, Tufts University School of Medicine, Springfield, Massachusetts, USA.

PMID: 17915663 [PubMed - indexed for MEDLINE]

246. Pathol Biol (Paris). 2007 Nov;55(8-9):441-5. Epub 2007 Oct 1.

[Evaluation of a in house serology reagent for the diagnosis of cat-scratch disease defined by PCR].

[Article in French]

Trombert-Paolantoni S, Clairet V, Gaulier E, Figarella P.

Laboratoire Pasteur-Cerba, ZI de l'équerre, rue des béthunes, 95066 Cergy-Pontoise cedex 09, France. strombert@pasteur-cerba.com

AIM OF THE STUDY: evaluate the sensitivity and the specificity of the cat scratch disease serology by indirect immunofluorescence assay, realized from an in-house antigenic suspension, with PCR defined cases. Describe the epidemiological characteristics of the cases. METHODS: the antigenic suspension is realized by culture of a Houston 1 ATCC 49882 B. henselae reference strain on horse blood agar suspended in egg formoled PBS. Real time PCR from clinical samples is performed by amplification of a 998-bp 16S rDNA sequence with Bart and r-BH primers. RESULTS: In 57 out of 92 (62%) positive patients in PCR, the serology is positive in IgG at low or significative level or positive in IgG with presence of IgM or shows a seroconversion. The specificity in serum samples from 40 control patients is 100%. The average age of the 165 positive patients in PCR is 27.6 years old (3-80). The localization of the lymph nodes is more often axillary (47%) than inguinal (32%) or cervical (16%). CONCLUSION: Our in-house indirect immunofluorescence assay for the cat scratch disease serology shows a sensitivity equivalent to other technics described in the literature, with an excellent specificity.

PMID: 17905531 [PubMed - indexed for MEDLINE]

247. Infect Immun. 2007 Nov;75(11):5255-63. Epub 2007 Sep 4.

Characterization of an immunogenic outer membrane autotransporter protein, Arp, of Bartonella henselae.

Litwin CM, Rawlins ML, Swenson EM.

Section of Clinical Immunology, Microbiology and Virology, Department of Pathology, 50 N. Medical Drive, University of Utah, Salt Lake City, UT 84132, USA. Christine.Litwin@path.utah.edu

Bartonella henselae is a recently recognized pathogenic bacterium associated with cat scratch disease, bacillary angiomatosis, and bacillary peliosis. This study describes the cloning, sequencing, and characterization of an antigenic autotransporter gene from B. henselae. A cloned 6.0-kb BclI-EcoRI DNA fragment expresses a 120-kDa B. henselae protein immunoreactive with 21.2% of sera from patients positive for B. henselae immunoglobulin G antibodies by indirect immunofluorescence, with 97.3% specificity and no cross-reactivity with antibodies against various other organisms. DNA sequencing of the clone revealed one open reading frame of 4,320 bp with a deduced amino acid sequence that shows homology to the family of autotransporters. The autotransporters are a group of proteins that mediate their own export through the outer membrane and consist of a passenger region, the alpha-domain, and an outer membrane transporter region, the beta-domain. The passenger domain shows homology to a family of pertactin-like adhesion proteins and contains seven, nearly identical 48-amino-acid repeats not found in any other bacterial or Bartonella DNA sequences. The passenger alpha-domain has a calculated molecular mass of 117 kDa, and the transporter beta-domain has a calculated molecular mass of 36 kDa. The clone expresses a 120-kDa protein and a protein that migrates at approximately 38 kDa exclusively in the outer membrane protein fraction, suggesting that the 120-kDa passenger protein remains associated with the outer membrane after cleavage from the 36-kDa transporter.

PMCID: PMC2168282 PMID: 17785470 [PubMed - indexed for MEDLINE]

248. J Feline Med Surg. 2008 Feb;10(1):66-72. Epub 2007 Sep 4.

Evaluation of the association of Bartonella species, feline herpesvirus 1, feline calicivirus, feline leukemia virus and feline immunodeficiency virus with chronic feline gingivostomatitis.

Quimby JM, Elston T, Hawley J, Brewer M, Miller A, Lappin MR.

College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 300 West Drake Road, Fort Collins, CO 80523, USA. jquimby@colostate.edu

Gingivostomatitis (GS) is a significant condition in cats because of oral discomfort and associated periodontal disease. Several infectious agents have been associated with the presence of GS, but a causal relationship is unclear. The cats in this study were housed together, had a history of flea exposure, and were vaccinated with a modified live FVRCP product. There were nine cats with active GS and 36 unaffected cats at the time of sample collection. Serum was tested for feline leukemia virus (FeLV) antigen and antibodies against feline immunodeficiency virus, feline calicivirus (FCV), feline herpesvirus 1 (FHV-1), and Bartonella species (enzyme-linked immunosorbent assay and Western blot immunoassay). PCR assays for Bartonella species and FHV-1 and a reverse transcriptase PCR assay for FCV were performed on blood and throat swabs. All cats were negative for FeLV. Assay results failed to correlate to the presence of GS in the group of cats studied.

PMID: 17766156 [PubMed - indexed for MEDLINE]

249. J Feline Med Surg. 2008 Feb;10(1):41-6. Epub 2007 Aug 23.

Prevalence of serum antibodies against Bartonella species in the serum of cats with or without uveitis.

Fontenelle JP, Powell CC, Hill AE, Radecki SV, Lappin MR.

Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Veterinary Teaching Hospital, Colorado State University, 300 West Drake Road, Fort Collins, CO 80523, United States.

Bartonella henselae has been implicated as a causative agent of chronic uveitis in people and in some cats. The objective of this study was to determine whether Bartonella species seroprevalence or titer magnitude varies among cats with uveitis, cats without ocular diseases recorded and healthy cats, while controlling for age and risk of flea exposure based on state of residence. There was no difference in seroprevalence rates or titer magnitude between cats with uveitis and cats with non-ocular diseases. Healthy cats were more likely to be seropositive for Bartonella species than cats with uveitis. The median Bartonella species titer was 1:64 for all groups, although healthy cats were more likely to have higher titers than cats with uveitis and cats with non-ocular disease. The results suggest that serum antibody tests alone cannot be used to document clinical uveitis associated with Bartonella species infection.

PMID: 17719256 [PubMed - indexed for MEDLINE]

250. Klin Mikrobiol Infekc Lek. 2007 Jun;13(3):119-21.

[Abscessing lymphadenitis in a 1.5-year-old boy].

[Article in Czech]

Sedlácková L, Bartosová D, Vydrzalová P, Crhová K, Zarosská E, Holcíková A, Habanec T, Janecek D.

Clinic of Chilren's Infectious Diseases, Brno, Czech Republic. sedlaluc@centrum.cz

At present, Bartonella species are increasingly important as infectious agents in both animals and humans. Bartonella henselae, the most frequently diagnosed species, is known to cause numerous clinical syndromes in both immunocompetent and immunocompromised patients. In healthy individuals, the infection is most commonly manifested as the so-called cat scratch disease. The manifestations include erythema or papule at the point of entry of infection (site of injury) and regional lymphadenitis. The aim of the case report is to present the disease as one of possible causes of colliquative cervical lymphadenitis.

PMID: 17703405 [PubMed - indexed for MEDLINE]

251. Scand J Infect Dis. 2007;39(8):728-30.

Familial occurrence of cat-scratch disease, with varying clinical expression.

Song AT, Gory M, Roussi J, Salomon J, Cremieux AC, Perronne C, Bernard L.

Division of Infectious Diseases, Clinicas Hospital of the University of Sao Paulo, Sao Paulo, Brazil.

Cat-scratch disease, primarily caused by Bartonella henselae, typically presents with regional adenopathy, and the role of antibiotics in the treatment is debatable. We present a report of B. henselae infection transmitted by the same kitten to 4 different individuals, each with different clinical characteristics, treatment, and evolution.

PMID: 17654352 [PubMed - indexed for MEDLINE]

252. Clin Infect Dis. 2007 Aug 15;45(4):e42-5. Epub 2007 Jul 5.

Transverse myelitis in 2 patients with Bartonella henselae infection (cat scratch disease).

Baylor P, Garoufi A, Karpathios T, Lutz J, Mogelof J, Moseley D.

Department of Medicine, Veteran's Affairs Medical Center, Fresno, CA 93703, USA. Peter.Baylor@va.gov

Cat scratch disease is usually a benign, self-limiting condition. Neurological manifestations are uncommon and may consist of encephalopathy, seizures, and coma. This report describes 2 cases of transverse myelitis: 1 case in a 46-year-old man who had lymph node biopsy and serological testing results that were positive for Bartonella henselae and 1 case in a 13-year-old adolescent boy who had serological testing results that were positive for B. henselae. These are 2 of the only 3 cases of transverse myelitis associated with cat scratch disease that have been reported since the causative organism was first reported.

PMID: 17638185 [PubMed - indexed for MEDLINE]

253. J Paediatr Child Health. 2007 Jul-Aug;43(7-8):568-70.

Role of magnetic resonance imaging and scintigraphy in the diagnosis and follow-up of osteomyelitis in cat-scratch disease.

Rozmanic V, Banac S, Miletic D, Manestar K, Kamber S, Paparic S.

Department of Pediatrics, University of Rijeka, Rijeka, Croatia. vojko.rozmanic@medri.hr

Cat-scratch disease (CSD) is a self-limiting infectious disease characterised with lymphadenopathy in a patient with a history of cat contact. Cases of bone involvement in patients with CSD are rare. We reported a case of 11-year-old boy with prolonged intermittent fever, inguinal lymphadenopathy and osteomyelitis. He had a history of exposure to kittens. The physical examination revealed a febrile boy without an apparent site of infection except an enlarged inguinal lymph node. Its histopathology demonstrated granulomatous lesion with no presence of acid-fast bacilli. Serum titers for Bartonella henselae were positive. Multiple bone lesions were detected by skeletal scintigraphy. Magnetic resonance imaging (MRI) confirmed and characterised osteolytic masses. The oral combination of azithromycin and rifampicin were given for 6 weeks with a good clinical response. At follow-up, the boy was without symptoms or signs of the disease. Successive MRI controls showed gradual regression of the bone lesions together with significant decrease of acute-phase reactants. In conclusion, CSD should be considered in the differential diagnosis of osteomyelitis. MRI is more reliable for the characterisation, evaluation of soft-tissue extension and follow-up of the bone lesions than scintigraphy. However, the later method permits an overview of the multiple osseous lesions. Therefore, standard MRI equipment may not exclude bone scintigraphy. Both methods are required until whole-body MRI units become routine.

PMID: 17635689 [PubMed - indexed for MEDLINE]

254. Eur J Clin Microbiol Infect Dis. 2007 Sep;26(9):629-33.

Evaluation of an internally controlled real-time polymerase chain reaction assay targeting the groEL gene for the detection of Bartonella spp. DNA in patients with suspected cat-scratch disease.

Diederen BM, Vermeulen MJ, Verbakel H, van der Zee A, Bergmans A, Peeters MF.

Regional Laboratory of Public Health Haarlem, The Netherlands. bramdiederen@gmail.com

Bartonella (B.) henselae is the causative agent of cat-scratch disease (CSD), which usually presents as a self-limiting lymphadenopathy. This study reports the development and evaluation of an internally controlled real-time polymerase chain reaction targeting the groEL gene for detection of Bartonella spp. DNA was extracted using the MagNA Pure system. The lower detection limit was 10-100 fg DNA and the in vitro sensitivity of the assay was not affected by duplexing with an internal control PCR. The real-time PCR assay detected DNA from all five B. henselae strains tested, and from B. birtlesii, B. vinsonii subsp. vinsonii, B. vinsonii subsp. arupensis and B. doshiae. The assay generated negative results with a selection of other bacteria, including several Mycobacterium spp., Streptococcus pyogenes and Staphylococcus aureus. Results of real-time PCR in clinical samples were compared with those of a conventional 16S rDNA-based PCR assay. During the period described in the Material and methods section, real-time PCR and conventional 16S PCR were performed on 73 clinical samples. Of these samples, 29 (40%) were found to give positive results and 44 (60%) gave negative results, both by real-time PCR and by conventional PCR, with a 100% agreement between the two tests. The PCR developed in this study is a rapid, sensitive, and simple method for the detection of Bartonella spp. in CSD and is suitable for implementation in the diagnostic laboratory.

PMID: 17624560 [PubMed - indexed for MEDLINE]

255. Pediatr Radiol. 2007 Aug;37(8):840-3. Epub 2007 Jun 22.

Utility of MR imaging in cat-scratch neuroretinitis.

Reddy AK, Morriss MC, Ostrow GI, Stass-Isern M, Olitsky SE, Lowe LH.

School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA.

About 80% of cat-scratch disease (CSD) infections occur in children, and CSD neuroretinitis (optic neuropathy with retinal exudates in a "macular star" pattern) mostly occurs in children and young adults. A recent study suggested that CSD optic neuropathy has specific features on MR imaging. However, MR imaging findings in CSD neuroretinitis are not well described in the pediatric literature. We present a patient with CSD neuroretinitis in whom these specific MR imaging features preceded the macular star, a funduscopic finding strongly suggestive of neuroretinitis. This case demonstrates how knowledge of these features is important in the appropriate diagnostic work-up of optic neuropathy. MR imaging also incidentally revealed neuritis of another cranial nerve in the auditory canal-a rare manifestation of CSD.

PMID: 17583805 [PubMed - indexed for MEDLINE]

256. Ann Emerg Med. 2007 Jul;50(1):90, 97.

Images in emergency medicine. Bartonella henselae lymphadenitis.

Fisher W.

Bellevue Hospital Center, Emergency Medicine Department, New York, NY, USA.

PMID: 17572294 [PubMed - indexed for MEDLINE]

257. An Pediatr (Barc). 2007 Apr;66(4):419-20.

[Cat scratch disease].

[Article in Spanish]

Silveira Cancela M.

Comment on An Pediatr (Barc). 2006 Nov;65(5):506-8.

PMID: 17569180 [PubMed - indexed for MEDLINE]

258. Ter Arkh. 2007;79(4):58-62.

[Bartonella infection in hematological practice].

[Article in Russian]

Melikian AL, Mediannikov OIu, Kaplanskaia IB, Komarova AI, Tarasevich IV.

AIM: To characterize the clinical and histological features of Bartonella infection in patients asking for hematological advice and to assess the significance of serological and molecular methods for the diagnosis of this infection. MATERIALS AND METHODS: The case histories of 747 patients asking for advice at the Hematology Research Cancer, Russian Academy of Medical Sciences, for lymphadenopaphy were retrospectively studied. The study included 10 patients in whom Bartonella infection could be suspected. For verification of the diagnosis, the authors conducted a serological study of the patients' sera and a molecular study of archival paraffined lymph node biopsy specimens. RESULTS: The study showed it possible to make a retrospective diagnosis of cat-scratch disease (CSD) by polymerase chain reaction (PCR) used in the study of archival lymph node biopsy specimens and stained preparations. CONCLUSION: CSD should be suspected when a patient has sustained lymphadenopathy and a respective epidemiological history (feline contact). Bartonella infection should be diagnosed on the basis of a dynamic serological study and, if possible, PCR of cells from biopsy specimens of lymph nodes or the lesion developed at the site of Bartonella penetration into the human body (primary affect).

PMID: 17564022 [PubMed - indexed for MEDLINE]

259. N Z Med J. 2007 Jun 1;120(1255):U2558.

Two cases of endocarditis due to Bartonella henselae.

Fu J, Muttaiyah S, Pandey S, Thomas M.

Department of Infectious Diseases and Microbiology Laboratory, Auckland City Hospital, Auckland.

PMID: 17546106 [PubMed - indexed for MEDLINE]

260. Eur J Pediatr. 2008 Apr;167(4):471-3. Epub 2007 Jun 1.

Prolonged follow up of seven patients affected by hepatosplenic granulomata due to cat-scratch disease.

Scolfaro C, Leunga GG, Bezzio S, Chiapello N, Riva C, Balbo L, Bertaina C, Tovo PA.

Department of Pediatrics, University of Turin, Piazza Polonia, 94, 10126, Turin, Italy. stefaniabezzio@hotmail.com

This study is a retrospective analysis of seven patients with hypoechogenic lesions in the liver and/or spleen due to Bartonella henselae, who were followed from 1998 through to 2005 by the Department of Pediatrics, Turin University. In addition to showing constitutional symptoms, four children had skin lesions suggestive of injuries inflicted by cats, and one child had a history of exposure to cats. The origin of the infection remained undefined in the other two patients. Humoral tests enabled a precise diagnosis in all children. Treatment with macrolides or combinations of two active antibiotics for at least 2-3 weeks led to the definitive clearance of infection, although residual intraparenchymal lesions persisted in five patients for several months or years. Conclusion B. henselae serology allows an easy diagnosis of multiple hepatosplenic granulomata, a clinical picture that appears to be under-recognized. Macrolides or a combination of two active antibiotics for 2-3 weeks leads to a rapid clinical response and a definitive clearance of infection.

PMID: 17541640 [PubMed - indexed for MEDLINE]

261. J Formos Med Assoc. 2007 Feb;106(2 Suppl):S65-68.

Cat scratch disease from a domestic dog.

Chen TC, Lin WR, Lu PL, Lin CY, Chen YH.

Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

Cat scratch disease (CSD), caused by Bartonella henselae, is a zoonosis and characterized by self-limited lymphadenopathy. It is transmitted commonly by scratch or bite from cats or kitten. We report an unusual case of CSD caused by a domestic dog scratch that we believe is the first report in Taiwan. A 23-year-old healthy woman developed cervical lymphadenopathy, mild fever, headache, and malaise 3 days after dog scratch. Her symptoms improved after azithromycin treatment. Serology proved B. henselae infection. The owners of a domestic dog might be at risk of "cat" scratch disease.

PMID: 17493900 [PubMed - indexed for MEDLINE]

262. Br J Dermatol. 2007 Apr;156(4):705-8.

Idiopathic facial aseptic granuloma: a multicentre prospective study of 30 cases.

Boralevi F, Léauté-Labrèze C, Lepreux S, Barbarot S, Mazereeuw-Hautier J, Eschard C, Taïeb A; Groupe de Recherche Clinique en Dermatologie Pédiatrique.

Laboratory of Pathology, Hôpital Pellegrin-Enfant, Place Amélie Raba-Léon, 33076 Bordeaux cedex, France. franck.boralevi@chu-bordeaux.fr

BACKGROUND: Idiopathic facial aseptic granuloma (IFAG) was recently described in a single-centre retrospective study as a skin condition that occurs specifically in childhood. OBJECTIVES: To improve our epidemiological, clinical and pathological knowledge on IFAG, to search for an infectious aetiology, and to assess therapeutic recommendations. METHODS: Children presenting with one or several acquired nodules on the face, lasting for at least 1 month, with no evidence of any other recognizable clinical entity such as infantile acne, pilomatrixoma, furuncle, tumour or vascular malformation, were enrolled in a prospective multicentre study from June 2001 to June 2004, involving the main French paediatric dermatology outpatient units. We recorded clinical details about the nodule and its duration, ultrasound study pattern, cultures for bacteria and mycobacteria, and Bartonella henselae and Afipia felis antibody testing. RESULTS: Thirty children (17 boys and 13 girls, mean age 3.8 years) were enrolled. Ultrasound studies revealed a solid well-demarcated hypoechoic lesion without calcium deposit. Cultures for bacteria were negative in 70% of cases. Cultures for mycobacteria and cat scratch disease serologies were negative. Antibiotic therapy was ineffective; the lesion healed spontaneously with a mean duration of 11 months. Histological examination, performed in five cases, showed a chronic dermal lymphohistiocytic granuloma with numerous foreign body-type giant cells. CONCLUSIONS: IFAG is characterized by a painless facial nodule, presenting as a single lesion localized on the cheek, with a prolonged course but spontaneous healing. Oral or local antibiotics are usually ineffective. Regarding the pathophysiology, our study rules out a primary infectious disease, and allows considering IFAG either as a granulomatous process appearing around an embryological residue or as a manifestation to include in the spectrum of granulomatous rosacea in childhood.

PMID: 17493068 [PubMed - indexed for MEDLINE]

263. Klin Monbl Augenheilkd. 2007 Apr;224(4):311-3.

Bartonella henselae infection presenting as a unilateral acute maculopathy.

Wimmersberger Y, Baglivo E.

Clinique d'Ophtalmologie, Hôpitaux Universitaires de Genève, Geneva, Switzerland.

BACKGROUND: The purpose of this article is to report an unusual ocular manifestation of cat scratch disease (CSD) presenting as a unilateral acute maculopathy (UAM). We describe and review the clinical, laboratory, fluorescein angiography (FA), indocyanine green angiography (ICG) and optical coherence tomography (OCT) records of a patient with CSD. HISTORY AND SIGNS: A 30-year-old Chinese woman presented with a painless progressive visual loss affecting her left eye. Fundus examination of the left eye disclosed rare vitreous cells and a deep-creamy choroidal macular lesion with satellite foci of choroiditis. THERAPY AND OUTCOME: FA revealed an early hypofluorescence of the lesion, becoming progressively hyperfluorescent with a leakage on the late phase. The ICG disclosed an early hypofluorescence of the macular lesion with a mild staining of its periphery on the late frames. Hypofluorescent satellite lesions were visible both on the early and late frames. The OCT disclosed a serous retinal detachment at the level of the whitish lesion. Serologies for Bartonella henselae (BH) became positive (IgG 1: 512, IgM < 1:20) confirming an active or recent infection. CONCLUSIONS: Ocular manifestations of CSD can appear as a UAM with satellite lesions. CSD should be ruled out in patients manifesting such clinical features.

PMID: 17458800 [PubMed - indexed for MEDLINE]

264. Kansenshogaku Zasshi. 2007 Mar;81(2):206-9.

[Pediatric pneumonia, pleural effusion, and pericarditis following cat scratch disease and serological cross-reactions among Bartonella henselae and Rickettsia japonica determined by indirect fluorescence antibodies].

[Article in Japanese]

Takeda N, Ishiwada N, Fukasawa C, Furuya Y, Tsuneoka H, Tsukahara M, Kohno Y.

Department of Pediatrics, Graduate School of Medicine, Chiba University.

Cat scratch disease is associated with a variety of systemic manifestations. We report a pediatric case associated with pneumonia, pleural effusion, and pericarditis. A 3-year-old boy developed prolonged fever unresponsive to antibiotic treatment, including azithromycin and minocycline. Although the fever resolved with corticosteroid treatment, Bartonella henselae IgG titer was positive in indirect fluorescence antibodies, as was Rickettsia japonica IgG titer. Both titers were significantly reduced by serum absorption with B. henselae antigens, and we observed a serological cross-reaction between B. henselae and R. japonica.

PMID: 17447481 [PubMed - indexed for MEDLINE]

265. Chirurg. 2008 Mar;79(3):249-51.

[Painful soft-tissue swelling of the upper arm].

[Article in German]

Eichhorn-Sens J, Bund T, Vogt PM.

Plastische Gesichtschirurgie, Marienhospital Stuttgart, Böheimstrabe 37, 70199, Stuttgart. eichhorn-sens@web.de

Cat-scratch disease is an infection by Bartonella henselea and resolves spontaneously. We present a case of untypical Bartonella infection which was misinterpreted by MRI as a soft-tissue sarcoma of the upper arm. The histological findings of an incision biopsy were unspecific, without signs of malignancy. The tumor was excised completely and the final histology, however, showed no evidence of malignant changes. The Bartonella henselae infection could be confirmed by polymerase chain reaction. The untypical presentation of cat-scratch disease should be considered in the differential diagnosis of clinically suspected soft tissue sarcoma.

PMID: 17443304 [PubMed - indexed for MEDLINE]

266. BMC Infect Dis. 2007 Apr 18;7:30.

From cat scratch disease to endocarditis, the possible natural history of Bartonella henselae infection.

Gouriet F, Lepidi H, Habib G, Collart F, Raoult D.

Unité des Rickettsies, CNRS UMR 6020, IFR 48, Faculté de Médecine, Université de la Méditerranée, Marseille cedex 05, France. frederique.gouriet@medecine.univ-mrs.fr

BACKGROUND: Most patients with infectious endocarditis (IE) due to Bartonella henselae have a history of exposure to cats and pre-existing heart valve lesions. To date, none of the reported patients have had a history of typical cat scratch disease (CSD) which is also a manifestation of infection with B. henselae. CASE PRESENTATION: Here we report the case of a patient who had CSD and six months later developed IE of the mitral valve caused by B. henselae. CONCLUSION: Based on this unique case, we speculate that CSD represents the primary-infection of B. henselae and that IE follows in patients with heart valve lesions.

PMCID: PMC1868026 PMID: 17442105 [PubMed - indexed for MEDLINE]

267. An Pediatr (Barc). 2007 Apr;66(4):418-9.

[Atypical cat scratch disease in an immunocompetent school-aged child].

[Article in Spanish]

Dorado Moles MJ, López-Ibor B, Figueredo MA, González Laguillo A.

PMID: 17430722 [PubMed - indexed for MEDLINE]

268. Braz J Infect Dis. 2006 Dec;10(6):411-5.

Bartonellosis: suggestive case reports in adult and pediatric patients and therapeutic issues.

Manfredi R, Sabbatani S.

Department of Clinical and Experimental Medicine, Division of Infectious Diseases, University of Bologna Alma Mater Studiorum, S Orsola Hospital, Bologna, Italy. Roberto.manfredi@unibo.it

Cat-scratch disease warrants extensive investigation, from an epidemiological, a diagnostic, but especially a therapeutic point of view. Two suggestive episodes of Bartonella henselae-caused cat-scratch disease are reported, and discussed in the light of the most recent literature evidence. The first case occurred in a 60-year-old man, thus suggesting that it is important to maintain an elevated level of suspicion for this disease in adults as well. Both episodes were characterized by a very prolonged and complicated disease course (with the involvement of three lymph node sets in the first case), a need for lymph-node drainage, and apparently negligible activity of many antimicrobial courses, with a very slow local cure. While specific culture and molecular biology techniques proved negative (probably due to late availability of appropriate clinical specimens), indirect immunofluorescence antibody assay was positive since the first weeks of disease, and elevated levels were also fond many months after disease onset. When clinicians face patients with prominent swelling of lymph nodes draining from the upper limbs, cat-scratch disease may be suspected on the grounds of epidemiological and clinical features, with a limited systemic involvement contrasting with a prominent local disease. The significance of specific antibody temporal kinetics in the subacute disease course is still unknown. Although biomolecular assays are now available, the time elapsed from disease onset to clinical diagnosis usually hampers diagnosis, while the roles of surgical debridement and of the unpredictable activity of antimicrobial chemotherapy warrant careful investigation.

PMID: 17420917 [PubMed - indexed for MEDLINE]

269. Infection. 2007 Apr;35(2):107-9.

Chronic vasculitis and polyneuropathy due to infection with Bartonella henselae.

Stockmeyer B, Schoerner C, Frangou P, Moriabadi T, Heuss D, Harrer T.

Dept. of Medicine III, University Hospital Erlangen, Krankenhausstr. 12, 91054, Erlangen, Germany. Thomas.Harrer@med3.imed.uni-erlangen.de

Bartonella henselae, the causative agent of cat scratch disease and bacillary angiomatosis, is associated with an expanding spectrum of diseases. Here, we report on a 40-year-old patient suffering from chronic recurrent painful ulcers of the toes, distal axonal sensomotor polyneuropathy and Raynaud's phenomenon. Biopsy of the sural nerve demonstrated an axonal neuropathy with a neurogenic muscular atrophy. Treatment with high dose corticosteroids had no beneficial effect. A biopsy taken from a recurring ulcer 7 years after the beginning of the disease revealed superficial ulcerated hyperkeratosis with subepithelial proliferation of small vessels compatible with a diagnosis of verruca peruana, however, without detection of microorganism. Serologic analysis revealed an elevated IFT titer of 1:1,024 against B. henselae. Treatment with erythromycin induced healing of the ulcer, remission of the vasculitis and the polyneuropathy, and a decline of the IFT titer. This case illustrates that B. henselae infection should be considered in patients with vasculitis and polyneuropathic syndromes.

PMID: 17401716 [PubMed - indexed for MEDLINE]

270. Clin Microbiol Infect. 2007 Jun;13(6):627-34. Epub 2007 Mar 22.

Serological testing for Bartonella henselae infections in The Netherlands: clinical evaluation of immunofluorescence assay and ELISA.

Vermeulen MJ, Herremans M, Verbakel H, Bergmans AM, Roord JJ, van Dijken PJ, Peeters MF.

Department of Pediatrics, VU University Medical Center, Amsterdam, The Netherlands. m.vermeulen@vumc.nl

Cat-scratch disease (CSD), caused by Bartonella henselae infection, can mimic malignancy and can manifest atypically. Reliable serological testing is therefore of great clinical importance. The diagnostic performance of immunofluorescence assay (IFA) and ELISA was evaluated in a group of Dutch patients with proven CSD (clinical diagnosis confirmed by PCR). Sera of 51 CSD patients and 56 controls (patients with similar symptoms, but who were B. henselae PCR-negative and had an alternative confirmed diagnosis) were tested for anti-B. henselae IgM and IgG by IFA and ELISA. A commercially available IFA test for IgM had a sensitivity of 6%. In-house assays for IgM showed specificities of 93% (IFA) and 91% (ELISA), but with low sensitivities (53% and 65%, respectively). With a specificity of 82% (IFA) and 91% (ELISA), in-house IgG testing showed a significantly higher sensitivity in IFA (67%) than in ELISA (28%, p <0.01). Sensitivity was higher for genotype I (38-75%) than for genotype II (7-67%) infections, but this was only statistically significant for IgG ELISA (p <0.05). In conclusion, detection of IgM against B. henselae by in-house ELISA and IFA was highly specific for the diagnosis of CSD. The high seroprevalence in healthy individuals limits the clinical value of IgG detection for diagnosing CSD. Given the low sensitivity of the serological assays, negative serology does not rule out CSD and warrants further investigation, including PCR. Adding locally isolated (e.g., genotype II) B. henselae strains to future tests might improve the sensitivity.

PMID: 17378931 [PubMed - indexed for MEDLINE]

271. Ocul Immunol Inflamm. 2007 Jan-Feb;15(1):41-3.

Presumed oculoglandular syndrome from Bartonella quintana.

Borboli S, Afshari NA, Watkins L, Foster CS.

The Center for Eye Care, Beloxi, MS , USA.

BACKGROUND: To describe a case of clinically diagnosed oculoglandular syndrome in a 17-year-old patient that was presumed to be due to Bartonella quintana, as suggested by a positive serologic titer. METHODS: The patient presented to the Massachusetts Eye and Ear Infirmary emergency room with signs and symptoms suggestive of oculoglandular syndrome. He had a follicular conjunctivitis with a conjunctival granuloma of the right eye and an ipsilateral large, tender submandibular lymph node. He had recently acquired a kitten and a clinical diagnosis of cat-scratch disease was made. A laboratory workup was initiated to determine the cause of this clinical presentation and empirical treatment with antibiotics was started. RESULTS: All laboratory results were negative or normal except for the IgM titer to Bartonella quintana, which was elevated. The patient responded well to treatment and his symptoms resolved within a few weeks. DISCUSSION: Bartonella quintana infection, a pathogen prevalent in HIV-infected, homeless, or alcoholic patients, is a possible etiologic agent of cat-scratch disease and the associated condition of oculoglandular syndrome.

PMID: 17365807 [PubMed - indexed for MEDLINE]

272. Clin Experiment Ophthalmol. 2007 Mar;35(2):131-4.

Seropositivity rates for Bartonella henselae, Toxocara canis and Toxoplasma gondii in New Zealand blood donors.

Zarkovic A, McMurray C, Deva N, Ghosh S, Whitley D, Guest S.

Waikato Hospital, Hamilton, New Zealand.

Erratum in Clin Experiment Ophthalmol. 2007 Jul;35(5):500. MacMurray, Catherine [corrected to McMurray, Catherine].

BACKGROUND: Bartonella henselae, Toxocara canis and Toxoplasma gondii organisms can all cause vision-threatening posterior segment disease. Diagnosis relies heavily on clinical findings, but detection of antibodies in the patient's serum may be helpful in some cases. The significance of a positive serology result depends on the seroprevalence in the general population. Seroprevalence rates for these organisms vary widely around the world and this study aimed to determine the rates for a New Zealand population. METHODS: One hundred and forty healthy blood donors from the Waikato region in the North Island of New Zealand had their serum tested using an indirect latex agglutination test for detection of T. gondii antibodies, an indirect immunofluorescent assay for B. henselae antibodies and an enzyme-linked immunosorbent assay test for T. canis antibodies. RESULTS: Seropositivity rates for T. canis, T. gondii and B. henselae in this New Zealand population were 0.7 +/- 1.65%, 42.9 +/- 8.12% and 5 +/- 3.61%, respectively. CONCLUSION: Seropositivity rates for T. gondii and B. henselae in New Zealand are similar to rates reported in some other countries; however, T. canis seroprevalence may be lower than reported elsewhere in the world.

PMID: 17362453 [PubMed - indexed for MEDLINE]

273. Int J Clin Pract. 2008 Dec;62(12):1956-7. Epub 2007 Mar 1.

Bartonella henselae lymphadenitis progressing to hepatosplenic disease with slow clinical response despite early diagnosis and treatment.

Pasticci MB, Di Candilo F, Egidi MA, Lapalorcia LM, Marroni M, Tinca E, Sfara C, Stagni G.

PMID: 17343673 [PubMed - indexed for MEDLINE]

274. Pediatr Neurosurg. 2007;43(2):164-6.

Cat scratch disease with epidural extension while on antimicrobial treatment.

Hussain S, Rathore MH.

Pediatric Infectious Diseases and Immunology, University of Florida, USA.

We report the first case of a child with an epidural abscess caused by Bartonella henselae. This case is unique in that the diagnosis was confirmed by polymerase chain reaction (PCR) of the abscess fluid. A 3-year-old male was admitted with a 1-week history of fever and lower back pain. Magnetic resonance imaging (MRI) of the lumbar spine revealed a paraspinal soft tissue abnormality extending from the T(12) to the L(4) level, and a computed tomography (CT) scan of the lumbar spine showed osteomyelitis at the T(12) level with soft tissue changes. B. henselae serology showed an IgG titer of 1:256 and IgM of <1:16.

Copyright (c) 2007 S. Karger AG, Basel.

PMID: 17337934 [PubMed - indexed for MEDLINE]

275. Joint Bone Spine. 2007 Mar;74(2):184-6. Epub 2007 Feb 5.

Cat scratch disease during etanercept therapy.

Mathieu S, Vellin JF, Poujol D, Ristori JM, Soubrier M.

Clermont-Ferrand Teaching Hospital, Rheumatology Department, G. Montpied Hospital, Clermont-Ferrand, France. smathieu11@yahoo.fr

Lymphadenopathy in a patient taking TNFalpha antagonist therapy may indicate lymph node tuberculosis or a hematological malignancy. Although histological evidence of granuloma suggests tuberculosis, many other infections responsible for granulomatous reactions have been reported in patients on TNFalpha antagonist therapy. We report a case of granulomatous lymphadenopathy due to Bartonella henselae in a patient taking etanercept to treat ankylosing spondylitis.

PMID: 17337229 [PubMed - indexed for MEDLINE]

276. Pediatrics. 2007 Mar;119(3):e760-3.

Recurrent expressive aphasia as a presentation of cat-scratch encephalopathy.

Fox JW, Studley JK, Cohen DM.

Children's Hospital of Akron, Division of Emergency Medicine, One Perkins Square, Akron, OH 44308, USA. jfox@chmca.org

Cat-scratch disease is a common disease, occurring in an estimated 24,000 patients annually in the United States, and is one of the most common causes of chronic lymphadenitis in children. A wide array of neurologic complications occurs as a result of cat-scratch disease. However, there have been no reports of acute-onset, self-resolving, recurrent, expressive aphasia, as we report here in an adolescent boy. In our case, establishing the diagnosis of cat-scratch encephalopathy saved time and resources and afforded the family a benign diagnosis. Cat-scratch encephalopathy must be considered in the differential diagnoses when pediatric patients present with unusual neurologic symptoms.

PMID: 17332191 [PubMed - indexed for MEDLINE]

277. J Am Vet Med Assoc. 2007 Mar 1;230(5):681-5.

Detection of Bartonella henselae DNA in two dogs with pyogranulomatous lymphadenitis.

Morales SC, Breitschwerdt EB, Washabau RJ, Matise I, Maggi RG, Duncan AW.

Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108, USA.

CASE DESCRIPTION: 1 dog evaluated because of inappetence and lameness of the left hind limb of 1 day's duration and 1 dog evaluated because of inappetence, fever, and lymphadenopathy of 2 weeks' duration. CLINICAL FINDINGS: Histologic examination of excisional biopsy specimens from lymph nodes revealed pyogranulomatous lymphadenitis in both dogs. Quantitative real-time PCR assays detected Bartonella henselae DNA in blood samples and affected lymph node specimens from both dogs. Antibodies against B. henselae were not detected via immunofluorescent antibody testing during active disease in either dog. TREATMENT AND OUTCOME: 1 dog recovered after 6 weeks of treatment with doxycycline (5 mg/kg [2.3 mg/lb], p.o., q 12 h), whereas the other dog recovered after receiving a combination of azithromycin (14.5 mg/kg [6.6 mg/lb], p.o., q 24 h for 21 days), doxycycline (17.3 mg/kg [7.9 mg/lb], p.o., q 24 h for 4 weeks), and immunosuppressive corticosteroid (prednisone [3 mg/kg {1.4 mg/lb}, p.o., q 24 h], tapered by decreasing the daily dose by 25% every 2 weeks) treatment. CLINICAL RELEVANCE: B. henselae is implicated as a possible cause or a cofactor in the development of pyogranulomatous lymphadenitis in dogs. In dogs with pyogranulomatous lymphadenitis, immunofluorescent assays may not detect antibodies against B. henselae. Molecular testing, including PCR assay of affected tissues, may provide an alternative diagnostic method for detection of B. henselae DNA in pyogranulomatous lymph nodes.

PMID: 17331050 [PubMed - indexed for MEDLINE]

278. Vet Microbiol. 2007 Jun 21;122(3-4):290-7. Epub 2007 Jan 31.

Experimental infection of domestic cats with passaged genotype I Bartonella henselae.

Werner JA, Kasten RW, Feng S, Sykes JE, Hodzic E, Salemi MR, Barthold SW, Chomel BB.

Center for Comparative Medicine, Schools of Medicine and Veterinary Medicine, University of California, Davis, CA 95616, USA.

The influence of in vitro passage on Bartonella henselae pathogenesis in cats has not been thoroughly evaluated. Our objective was to examine the bacterial kinetics and humoral immune responses in cats experimentally infected with three different in vitro passages of B. henselae F1, a genotype I strain of feline origin. The F1 strain was in vitro passaged 20 and 40 times, and each was inoculated into a group of 5 cats. The kinetics of bacteremia and the feline humoral immune response to bacterial antigens were compared to a previous study involving a group of six cats inoculated with the original F1 strain. Among the three groups of cats, the kinetics of bacteremia profiles and the humoral immune responses to B. henselae lysates were similar. The influence of passage on bacterial membrane proteins was examined. In vitro passage altered the expression of 4/17 (23.5%) bacterial membrane proteins and 6/15 (40%) bacterial membrane antigens. An association between poor seroreactivity to three lysate antigens (15-, 18- and 45kDa), prolonged bacteremia and decreased serum bactericidal activity was noted. Our data show that in vitro passage of B. henselae did not alter the kinetics of bacteremia, including the occurrence of relapsing bacteremia, in experimentally infected cats. This suggests that highly passaged strains may not be suitable for future vaccination studies. Furthermore, in vitro passage results in phenotypic and antigenic changes in the bacterial membrane protein profile, which warrants caution in the interpretation of studies involving passaged B. henselae strains.

PMID: 17321078 [PubMed - indexed for MEDLINE]

279. BMC Infect Dis. 2007 Feb 23;7:8.

Adult systemic cat scratch disease associated with therapy for hepatitis C.

Bhatti Z, Berenson CS.

Infectious Disease Division, VA Western New York Healthcare System, State University of New York at Buffalo School of Medicine, Buffalo, New York 14215, USA. zbhatti@hotmail.com

BACKGROUND: We describe the first case of systemic cat scratch disease in a patient receiving peginterferon alpha-2a and ribavirin for treatment of hepatitis C. Cases of adult systemic CSD are extremely infrequent and immunomodulatory treatment for hepatitis C has been associated with aberrant host responses to common pathogens. CASE PRESENTATION: A 52 year old man being treated for hepatitis C presented with diffuse lymphadenopathy, weight loss, fevers and splenic lesions. Symptoms were initially confused with adverse effects of his regimen, delaying recognition of his infection. Diagnostic investigation, including histopathology, microbiology and serologic parameters, confirmed that his illness was due to disseminated cat scratch disease with Bartonella henselae. CONCLUSION: Disseminated CSD is exceptionally rare in adults. We describe the first case of disseminated cat scratch disease associated with peginterferon alpha and ribavirin to alert clinicians of the need to be aware of unusual manifestations of common infections in this population.

PMCID: PMC1810538 PMID: 17319959 [PubMed - indexed for MEDLINE]

280. J Med Entomol. 2007 Jan;44(1):158-62.

Detection of Rickettsia rickettsii and Bartonella henselae in Rhipicephalus sanguineus ticks from California.

Wikswo ME, Hu R, Metzger ME, Eremeeva ME.

Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.

Sixty-two questing adult Rhipicephalus sanguineus (Latreille) ticks were collected by direct removal from blades of turfgrass and adjacent concrete walkways at a suburban home in Riverside County, CA, and tested for the presence of Rickettsia, Bartonella, and Ehrlichia DNA. Polymerase chain reaction (PCR) was used to amplify fragments of the 17-kDa antigen gene and the rOmpA gene of the spotted fever group rickettsiae. One male tick contained R. rickettsii DNA; its genotype differed from R. rickettsii isolates found in Montana and Arizona that cause Rocky Mountain spotted fever and from Hlp#2 and 364D serotypes. One male tick and one female tick contained B. henselae DNA. No Ehrlichia platys or Ehrlichia canis DNAs were detected using nested PCR for their 16S rRNA genes. These findings extend the area where Rickettsia rickettsii may be vectored by Rh. sanguineus. Rh. sanguineus also may be infected with Bartonella henselae, a human pathogen that is typically associated with fleas and causes cat scratch disease.

PMID: 17294935 [PubMed - indexed for MEDLINE]

281. Vet Immunol Immunopathol. 2007 Mar 15;116(1-2):104-8. Epub 2006 Dec 22.

Bartonella henselae infection in splenectomized domestic cats previously infected with hemotropic Mycoplasma species.

Sykes JE, Henn JB, Kasten RW, Allen C, Chomel BB.

Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.

Cat scratch disease is caused by Bartonella henselae and the domestic cat represents its main reservoir. In immunocompromised patients, infection with B. henselae is characterized by more severe clinical forms than in non-immunocompromised individuals. The objective of the present study was to investigate the characteristics of B. henselae (Houston-I strain) infection in four splenectomized and three non-splenectomized cats, five of which were chronically infected with 'Candidatus Mycoplasma haemominutum'. No major clinical signs were observed in either group of cats. Cats in both splenectomized and non-splenectomized groups became bacteremic within a week post-inoculation. Although bacteremia was on average 10 days longer in the splenectomized cats, that difference was not statistically significant (P=0.72). In both groups, the level of bacteremia peaked within the same time frame; however, the level of bacteremia was about 10-fold higher in the splenectomized cats (P=0.007). Such a difference could be associated with a reduced immune response to the infection, especially a reduced ability to phagocytize Bartonella organisms in the splenectomized cats. Concurrent infection with 'Candidatus M. haemominutum' did not appear to alter the course of infection.

PMID: 17254639 [PubMed - indexed for MEDLINE]

282. Folia Parasitol (Praha). 2006 Dec;53(4):313-6.

Bartonella infections in fleas (Siphonaptera: Pulicidae) and lack of bartonellae in ticks (Acari: Ixodidae) from Hungary.

Sréter-Lancz Z, Tornyai K, Széll Z, Sréter T, Márialigeti K.

Department of Microbiology, National Institute for Food Investigations, Mester u. 81, H-1095 Budapest, Hungary.

Fleas (95 Pulex irritans, 50 Ctenocephalides felis, 45 Ctenocephalides canis) and ixodid ticks (223 ixodes ricinus, 231 Dermacentor reticulatus, 204 Haemaphysalis concinna) were collected in Hungary and tested, in assays based on PCR, for Bartonella infection. Low percentages of P. irritans (4.2%) and C. felis (4.0%) were found to be infected. The groEL sequences of the four isolates from P. irritans were different from all the homologous sequences for bartonellae previously stored in GenBank but closest to those of Bartonella sp. SE-Bart-B (sharing 96% identities). The groEL sequences of the two isolates from C. felis were identical with those of the causative agents of cat scratch disease, Bartonella henselae and Bartonella clarridgeiae, respectively. The pap31 sequences of B. henselae amplified from Hungarian fleas were identical with that of Marseille strain. No Bartonella-specific amplification products were detected in C. canis, I. ricinus, D. reticulatus and H. concinna pools.

PMID: 17252927 [PubMed - indexed for MEDLINE]

283. 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]

284. Pediatr Transplant. 2007 Feb;11(1):105-9.

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]

285. Acta Med Croatica. 2006 Dec;60(5):483-6.

[Rash and purulent lymphadenitis in cat scratch disease].

[Article in Croatian]

Dzelalija B, Medić A, Rode OD, Mazzi A.

Opća bolnica Zadar, Zavod za javno zdravstvo Zadarske zupanije, Zadar, Hrvatska. boris.dzelalija@zd.t-com.hr

We present a case of a cat-scratch disease (CSD) presenting with typical (primary lesion and regional lymphadenitis) and rare (purulent lymphadenitis and maculopapular rash) symptoms and positive epidemiological data. Laboratory blood test showed normal values for routine parameters, except for mild leukocytosis (L 12.4 x 10(9)), elevated erythrocyte sedimentation rate (SE 65/h) and moderately elevated asparta e-aminotransferase and alanine-aminotransferase values (AST/ALT 48/90), fibrinogen (5.3 g/L) and C-reactive protein (CRP 85 mg/L). Cytological analysis of lymph node content revealed granulomatous inflammation in the first sample, and purulent inflammation in the second sample. In paired serum samples, collected on the 15th and 29th day from the onset of disease, antibodies IgG (titre 4096/8192) and IgM (titre 80/40) to Bartonella henselae were detected by using an indirect immunofluorescence assay (IFA). Antibiotic therapy with azithromycin (1 x 500 mg per os/5 days) was administered. Purulent lymphadenitis and rash, although a rare clinical manifestation in CSD, are significant clinical findings in differentiating CSD from other febrile illnesses accompanied with rash and lymphadenitis.

PMID: 17217106 [PubMed - indexed for MEDLINE]

286. Arch Soc Esp Oftalmol. 2006 Dec;81(12):717-9.

[Serous macular detachment as an atypical sign in cat scratch disease].

[Article in Spanish]

Asensio-Sánchez VM, Rodríguez-Delgado B, García-Herrero E, Cabo-Vaquera V, García-Loygorri C.

Hospital General, Medina del Campo, Valladolid, España. vasensio@hmdc.sacyl.es

CASE REPORT: A 58-year-old woman presented with 0.1 visual acuity in the left eye associated with a serous retinal detachment of the macula as the only ocular manifestation of cat scratch disease. This diagnosis was made by serum antibody titers and the clinical course. DISCUSSION: Although uncommon, cat scratch disease should be considered in patients with a serous detachment in the macula region of the retina.

PMID: 17199167 [PubMed - indexed for MEDLINE]

287. Vet Pathol. 2007 Jan;44(1):80-3.

An immunohistochemical and polymerase chain reaction evaluation of feline plasmacytic pododermatitis.

Bettenay SV, Lappin MR, Mueller RS.

Tierdermatologie Oberhaching, Oberhaching, Germany.

Sections of 14 skin biopsies of cats with plasmacytic pododermatitis and a clinical follow-up of 12-36 months were stained with a polyclonal anti-Mycobacterium bovis (Bacille Calmette-Guerin = BCG) antibody cross-reactive to a broad spectrum of fungi and bacteria. All sections were negative for organisms within the actual footpad tissue with the anti-BCG antibody stains. Polymerase chain reaction (PCR) assays that amplify the DNA of Bartonella spp., Ehrlichia spp., Anaplasma phagocytophilum, Chlamydophila felis, Mycoplasma spp., Toxoplasma gondii, and feline herpesvirus 1 (FHV-1) were applied to tissue digests. DNA of those pathogens assessed was not amplified from tissue.

PMID: 17197627 [PubMed - indexed for MEDLINE]

288. Eur J Pediatr. 2007 Dec;166(12):1289-91. Epub 2006 Dec 22.

Pyogenic splenic abscess in an infant with serological evidence of cat scratch disease.

Kusuhara K, Nakao F, Saito M, Nakamura K, Ieiri S, Taguchi T, Hara T.

Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. kkusuhar@pediatr.med.kyushu-u.ac.jp

PMID: 17186270 [PubMed - indexed for MEDLINE]

289. Rev Med Chil. 2006 Oct;134(10):1243-8. Epub 2006 Dec 13.

[Cat-scratch disease. Review of eight adult patients hospitalized for fever or adenopathy].

[Article in Spanish]

Eymin G, Zapata A, Andrade M, Aizman A, Rojas L, Rabagliati R.

Departamento de Medicina Interna, Hospital Clínico, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. geymin@med.puc.cl

BACKGROUND: Cat-scratch disease is common among children. Among adults the disease is less often considered in the differential diagnosis of enlarged lymph nodes and fever. AIM: To report the clinical and laboratory features of eight patients with cat-scratch disease. MATERIAL AND METHODS: Review of the medical records of eight patients (aged 22 to 57 years, six males) with a serological diagnosis of cat-scratch disease (an IgG titer over 1:256, by immunofluorescence). RESULTS: Only five patients recalled having had contact with cats. Seven had fever and weight loss. Six had excessive sweating and five had chills. Seven had painfully enlarged lymph nodes mainly in submandibular and axillary regions. All had an increased C reactive protein and six had elevated erythrocyte sedimentation rate. Five had leukocytosis and four an elevated serum lactate dehydrogenase. The disease subsided in all, even in one patient that did not receive antimicrobials. CONCLUSIONS: Cat-scratch disease should be considered in the differential diagnosis of adult patients with lymph adenitis and fever.

PMID: 17186093 [PubMed - indexed for MEDLINE]

290. Clin Exp Dermatol. 2007 Mar;32(2):219-20. Epub 2006 Dec 14.

An unusual cutaneous presentation of cat-scratch disease.

Mehmi M, Lim SP, Tan CY.

PMID: 17176268 [PubMed - indexed for MEDLINE]

291. Brain Dev. 2007 Jul;29(6):377-9. Epub 2006 Dec 15.

Effect of high-dose methyl-prednisolone on brainstem encephalopathy and basal ganglia impairment complicating cat scratch disease.

Genizi J, Kasis I, Schif A, Shahar E.

Child Neurology Unit & Epilepsy Service, Meyer Children Hospital, Rambam Medical Center, Rappaport School of Medicine, Haifa, Israel.

Cat scratch disease (CSD) is a zoonotic illness caused by the Gram negative bacillus Bartonella henselae characterized by a small skin lesion at the site of a bite, lick or scratch by a cat, commonly followed by regional lymphadenopathy 1 or 2 weeks later. We report herein on severe neurological complications of CSD combining brainstem encephalopathy and basal ganglia impairment. This 12-year-old female acutely presented to a local hospital with profound coma and a prolonged tonic posturing of extremities. On the neurological examination she was deeply comatose with pin-point pupils and lack of vestibulo-ocular responses, suggestive of brainstem encephalopathy, along with marked rigid hypertonicity suggestive also of basal ganglia impairment. Initially suspecting Herpes simplex encephalitis or acute disseminated encephalomyelitis she was promptly started with high-dose methyl-prednisolone and acyclovir. Her parents apparently reported that she was scratched by a kitten some 4 weeks prior to her present admission and as such, suspecting CSD, she was begun with doxycycline and rifampicin. Her serology had proven positive for IgM antibodies to Bartonella henselae establishing the diagnosis. She regained consciousness after 4 days and the signs of brainstem and extra-pyramidal impairment also gradually abated and disappeared after 10 days. A follow-up exam after a month disclosed mild extra-pyramidal abnormalities which disappeared after 3 months. Although extremely rare, CSD should be also considered in a patient presenting with a severe encephalopathy and associated basal ganglia impairment. The prompt administration of high-dose methyl-prednisolone upon admission may have contributed to the favorable outcome in our patient and therefore should be advocated in any patient presenting with profound encephalopathy regardless the underlying etiology recovered later.

PMID: 17174500 [PubMed - indexed for MEDLINE]

292. Vojnosanit Pregl. 2006 Nov;63(11):971-4.

[Bartonella henselae as a cause of optical nerve neuritis].

[Article in Serbian]

Veselinović D.

Klinicki centar, Klinika za ocne bolesti, Nis, Srbija. veselinovicdr@Yahoo.com

INTRODUCTION: Bartonella henselae is included into the group of gram-negative bacteria that can cause not so rare disease known as cat-scratch disease (CSD). This disease is characterized by the specific general symptoms, and the complications in the eyes can be manifested in the form of neuroretinitis, follicular conjunctivitis and focal chorioretinitis. In this paper clinical and epidemiological characteristics of a patient with ophthalmologic complications caused by Bartonella henselae are described. We indicate diagnostic possibilities and the criteria for making the diagnosis. CASE REPORT: We presented a 42-year-old female patient with CSD symptoms, and with a registered neuritis as an ophthalmologic complication. Two weeks after the occurrence of a scratch on the hand after the contact with a cat, there was a slight lymphadenopathy of the axial area of the left side, accompanied by light febrility and weakness. A week after these symptoms occuring, the patient complained of a reduction of the visual acuity in her left eye. The established visual acuity in the left eye was 0.1 with ophthalmological findings of a light edema of the optical disk and a partial star-like edema in the nasal half of the macula. Central scotoma was present, with the extension of the blind spot and the constriction of central isopter of the left eye visual field. Fluorescein biomicroscopy revealed an intensive leaking of fluoresceins at the level of optical disk and macular region in an early arterial phase, without the appearance of pathological phenomena at the level of retinal blood vessels. With the application of doxycyline 100 mg two times a day, and systemic application of prednisolone (at the initial doses of 120 mg), after a two-week period, there was a full recovery of the visual acuity, out the optical disk edema, and the presence of light edema in the left eye macula receded. The complete disappearance of the edema in the macula was registered four weeks following the application of the therapy. CONCLUSION: Cat-scratch disease can be recognized by means of characteristic general symptoms, and it must be considered in persons with ophthalmologic picture of neuroretinitis. In spite of the good prognosis for the general condition of a patient, it is advised to apply antibiotic therapy in the cases where ophthalmologic complications appear. We recommend the application of doxycyline 100 mg two times a day, for a month. When pronounced edema of the optical disk and edema in the macula are present, a systematic application of corticosteroids is necessary.

PMID: 17144434 [PubMed - indexed for MEDLINE]

293. J Infect. 2007 May;54(5):417-21. Epub 2006 Nov 29.

Bone infection in cat-scratch disease: a review of the literature.

Hajjaji N, Hocqueloux L, Kerdraon R, Bret L.

Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Régional-La Source, BP 86709, 45067 Orléans Cedex 2, France.

OBJECTIVE: To describe the main features of bone infection associated with Cat-scratch disease (CSD). METHODS: We searched for articles indexed in the international literature databases by using the following key words: "Bartonella", "bone", "cat-scratch", "osteomyelitis" and "osteolytic". RESULTS: Cases of 47 patients were reviewed. The median age was 9 years, with an equal sex distribution. Bone pain and fever were the main symptoms. The presence of fever and increased age were more common in patients with bone infection than classically reported in uncomplicated (i.e. nodal) CSD. The vertebral column and pelvic girdle were the most common sites of infection. Radiological examination typically confirmed bone osteolysis. All patients recovered without complications or chronic infection, although they received a various combination antibiotic regimen and duration therapy. The mechanism by which infection might spread to the bone is via the haematogenous route, accounting for most of the disseminated cases and via the lymphatic route, for those with regional limited extension. CONCLUSIONS: Bone infection is rare but should be considered when bone pain and fever are present in a patient with nodal CSD. The prognosis is good, whatever treatment is given. Thus bone biopsy should be recommended only in a difficult diagnostic setting, when other bacteria or malignant disease are suspected.

PMID: 17140668 [PubMed - indexed for MEDLINE]

294. Wien Klin Wochenschr. 2006 Oct;118(19-20):615-8.

An unusual outcome in a child with hepatosplenic cat-scratch disease.

Vukelić D, Benić B, Bozinović D, Vuković B, Dakovic Rode O, Culig Z, Vuković J, Batinica S, Visnjić S, Puljiz I.

University Hospital for Infectious Diseases Dr. Fran Mihaljević, Zagreb, Croatia. bfm@bfm.hr

Typical cat-scratch disease (Bartonella henselae infection) in an immunocompetent child is usually associated with a history of scratch, bite or intimate contact with a cat. Most patients develop a non-tender papule in the scratch line after three to ten days. This may persist for only a few days or as long as two to three weeks. During the next two weeks or more, regional lymph nodes that drain the area gradually enlarge and then slowly resolve in more than 10% of patients. The nodes develop overlying erythema and may suppurate. Atypical forms of cat-scratch disease occur in a minority of cases and are characterized by ocular or neurological manifestations, hepatosplenic involvement, vertebral osteomyelitis, endocarditis etc. Immunocompromised individuals with B. henselae infection may develop bacillary angiomatosis, bacillary peliosis, and relapsing bacteremia. There have been several reports of hepatosplenic granulomas caused by B. henselae in immunocompetent children. We report a case of a 6-year-old boy with the hepatosplenic form of cat-scratch disease. Despite early diagnosis and long-term antimicrobial treatment, splenectomy could not be avoided.

PMID: 17136337 [PubMed - indexed for MEDLINE]

295. Pediatr Infect Dis J. 2006 Dec;25(12):1177-81.

Transient paresis associated with cat-scratch disease: case report and literature review of vertebral osteomyelitis caused by Bartonella henselae.

Vermeulen MJ, Rutten GJ, Verhagen I, Peeters MF, van Dijken PJ.

Department of Pediatrics, St. Elisabeth Hospital, Tilburg, The Netherlands. m.vermeulen@vumc.nl

Cat-scratch disease (CSD) rarely presents as vertebral osteomyelitis. We describe a case with paresis of the arm with total recovery after antibiotic and neurosurgical therapy. We reviewed 20 other cases of CSD vertebral osteomyelitis in the literature. This diagnosis should be considered in patients with systemic symptoms, back pain, and cat contact. The prognosis is generally good.

PMID: 17133166 [PubMed - indexed for MEDLINE]

296. Rev Med Chil. 2006 Jul;134(7):863-7. Epub 2006 Aug 29.

[Prevalence of Bartonella henselae antibodies in Chilean children, adolescents and veterinary workers].

[Article in Spanish]

Ferrés G M, Abarca V K, Prado D P, Montecinos P L, Navarrete C M, Vial C PA.

Laboratorio de Infectología y Virología Molecular, Pontificia Universidad Católica de Chile, Santiago, Chile. mferres@med.puc.cl

BACKGROUND: Bartonella henselae is the causative agent of cat-scratch disease. AIM: To study the seroepidemiology of Bartonella henselae in healthy Chilean children and in a population with occupational risk. MATERIAL AND METHODS: Serum IgG antibodies were determined by indirect fluorescence technique in 181 children and adolescents and in 107 technical and professional workers involved in the care of cats. Samples with titers equal to or greater than 64 were considered positive. RESULTS: Twenty four (13.3%) children and 11 (10.3%) occupational risk subjects were seropositive. No significant differences by age and gender were observed. CONCLUSIONS: Assuming that seroprevalence indicates level of exposure to Bartonella henselae, these results suggest that this infection is endemic in Chile and, for this reason, the best antibody titer to diagnose acute cat-scratch disease should be higher than the figure recommended by the Centers for Disease Control in the in United States.

PMID: 17130969 [PubMed - indexed for MEDLINE]

297. Ann N Y Acad Sci. 2006 Oct;1078:410-5.

Bartonella infection in domestic cats and wild felids.

Chomel BB, Kasten RW, Henn JB, Molia S.

D.V.M., Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA 95616, USA. bbchomel@ucdavis.edu

Bartonella are vector-borne, fastidious Gram-negative bacteria causing persistent bacteremia in their reservoir hosts. Felids represent a major reservoir for several Bartonella species. Domestic cats are the main reservoir of B. henselae, the agent of cat-scratch disease. Prevalence of infection is highest in warm and humid climates that are optimal for the survival of cat fleas, as fleas are essential for the transmission of the infection. Flea feces are the likely infectious substrate. Prevalence of B. henselae genotypes among cat populations varies worldwide. Genotype Houston I is more prevalent in the Far East and genotype Marseille is dominant in western Europe, Australia, and the western United States. Cats are usually asymptomatic, but uveitis, endocarditis, neurological signs, fever, necrotic lesions at the inoculation site, lymphadenopathy, and reproductive disorders have been reported in naturally or experimentally infected cats. Domestic cats are also the reservoir of B. clarridgeiae and co-infection has been demonstrated. B. koehlerae has been isolated from domestic cats, and was identified in cat fleas and associated with a human endocarditis case. B. bovis was isolated from a few cats in the United States and B. quintana DNA was recently identified in a cat tooth. Bartonella spp. have also been isolated from free-ranging and captive wild felids from North America and Africa. Whereas, B. henselae was identified in African lions and a cheetah, some strains specific to these wild cats have also been identified, leading to the concept of a B. henselae group including various subspecies, as previously described for B. vinsonii.

PMID: 17114749 [PubMed - indexed for MEDLINE]

298. Ann N Y Acad Sci. 2006 Oct;1078:223-35.

Arthropod-borne diseases in homeless.

Brouqui P, Raoult D.

Unité des rickettsies, CNRS UMR 6020, IFR 48, Faculté de médecine, 27 bd, J Moulin, 13385 Marseille, cedex 5, France. philippe.brouqui@medecine.univ-mrs.fr

Homeless people are particularly exposed to ectoparasite. The living conditions and the crowded shelters provide ideal conditions for the spread of lice, fleas, ticks, and mites. Body lice have long been recognized as human parasites and although typically prevalent in rural communities in upland areas of countries close to the equator, it is now increasingly encountered in developed countries especially in homeless people or inner city economically deprived population. Fleas are widespread but are not adapted to a specific host and may occasionally bite humans. Most common fleas that parasite humans are the cat, the rat, and the human fleas, Ctenocephalides felis, Xenopsylla cheopis, and Pulex irritans, respectively. Ticks belonging to the family Ixodidae, in particular, the genera Dermacentor, Rhipicephalus, and Ixodes, are frequent parasites in humans. Sarcoptes scabiei var. hominis is a mite (Arachnida class) responsible for scabies. It is an obligate parasite of human skin. The hematophagic-biting mite, Liponyssoides sanguineus, is a mite of the rat, mouse, and other domestic rodents but can also bite humans. Finally, the incidence of skin disease secondary to infestation with the human bedbug, Cimex lectularius, has increased recently. Bacteria, such as Wolbacchia spp. have been detected in bedbug. The threat posed by the ectoparasite in homeless is not the ectoparasite themselves but the associated infectious diseases that they may transmit to humans. Except for scabies all these ectoparasites are potential vectors for infectious agents. Three louse-borne diseases are known at this time. Trench fever caused by Bartonella quintana (B. quintana), epidemic typhus caused by Rickettsia prowazekii, and relapsing fever caused by the spirochete Borrelia recurrentis. Fleas transmit plague (Xenopsylla cheopis and Pulex irritans), murine typhus (Xenopsylla cheopis), flea-borne spotted rickettsiosis on account of the recently described species Rickettsia felis (C. felis), and occasionally cat scratch disease on account of Bartonella henselae (C. felis). The role of fleas as potential vector of B. quintana has recently been suggested. Among the hematophagic-biting mites, L. sanguineus, is responsible for the transmission of Rickettsia akari, the etiologic agent of rickettsialpox. Virtually, no data are available on tick-borne disease in this population. This article will deal with epidemiology, diagnosis, prevention, and treatment of these ectoparasite and the infectious diseases they transmit to the homeless people.

PMID: 17114713 [PubMed - indexed for MEDLINE]

299. J Formos Med Assoc. 2006 Nov;105(11):911-7.

Immunohistochemical study of lymph nodes in patients with cat scratch disease.

Lin YY, Hsiao CH, Hsu YH, Lee CC, Tsai HJ, Pan MJ.

Graduate Institute of Veterinary Medicine, National Taiwan University, Taipei, Taiwan.

BACKGROUND/PURPOSE: Bartonella henselaeis the causative agent of cat scratch disease (CSD), manifesting as fever and acute regional lymphadenopathy. Although serologic testing is the reference method for diagnosis, successful use of immunohistochemical (IHC) stain of regional lymph nodes for the diagnosis of CSD has been reported. To determine the characterization and diagnostic potential of IHC in lymphadenopathy of CSD, lymph nodes were excised from patients with suspected CSD for further evaluation. METHODS: Polyclonal antibody-based IHC studies were performed for the detection of B. henselae. Between January 2001 and December 2004, the reference laboratory of the Center for Disease Control, Taiwan, received a total of 377 sera from 352 reported suspected CSD cases. Twenty-three formalin-fixed paraffin-embedded lymph nodes from 16 patients and two skin biopsies from two patients suspected of having CSD were included in this study. Nine of them were serologically confirmed to have CSD and the others were seronegative but suspected to have CSD by the attending physicians. Seven lymph node specimens were obtained from tuberculosis patients for comparison. RESULTS: We demonstrated that the microorganisms existed in the cytoplasm of histiocytes within the granulomatous lesions in nine lymph nodes and one skin biopsy. Among the nine lymph nodes with IHC (+) stains, three were seronegative. On the other hand, three cases were IHC (+) and six cases were IHC (-) among nine seronegative patients. In addition, two seronegative patients with skin biopsy showed one IHC (+) and one IHC (-). CONCLUSION: IHC can contribute to the etiologic diagnosis of B. henselaelymphadenopathy when serology and molecular techniques are not available.

PMID: 17098692 [PubMed - indexed for MEDLINE]

300. J Clin Microbiol. 2007 Jan;45(1):270-2. Epub 2006 Nov 8.

Isolation of Bartonella quintana from a woman and a cat following putative bite transmission.

Breitschwerdt EB, Maggi RG, Sigmon B, Nicholson WL.

Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA. ed_breitschwerdt@ncsu.edu

We report here the detection of Bartonella quintana, after putative bite transmission, in pre-enrichment blood cultures from a woman and from two feral barn cats. Prospective molecular epidemiological studies are necessary to characterize the risk of human Bartonella quintana infection following cat bites.

PMCID: PMC1828989 PMID: 17093037 [PubMed - indexed for MEDLINE]

301. Emerg Infect Dis. 2006 Sep;12(9):1338-44.

Lymph node biopsy specimens and diagnosis of cat-scratch disease.

Rolain JM, Lepidi H, Zanaret M, Triglia JM, Michel G, Thomas PA, Texereau M, Stein A, Romaru A, Eb F, Raoult D.

Université de la Méditerranée, Marseille, France.

We report microbiologic analysis of 786 lymph node biopsy specimens from patients with suspected cat-scratch disease (CSD). The specimens were examined by standard, cell culture, and molecular methods. Infectious agents were found in samples from 391 (49.7%) of 786 patients. The most commonly identified infectious agent was Bartonella henselae (245 patients, 31.2%), the agent of CSD. Mycobacteriosis was diagnosed in 54 patients (6.9%) by culture and retrospectively confirmed by using a specific real-time PCR assay. Neoplasm was diagnosed in 181 specimens suitable for histologic analysis (26.0%) from 47 patients. Moreover, 13 patients with confirmed Bartonella infections had concurrent mycobacteriosis (10 cases) or neoplasm (3 cases). A diagnosis of CSD does not eliminate a diagnosis of mycobacteriosis or neoplasm. Histologic analysis of lymph node biopsy specimens should be routinely performed because some patients might have a concurrent malignant disease or mycobacteriosis.

PMID: 17073081 [PubMed - indexed for MEDLINE]

302. Infect Immun. 2007 Jan;75(1):35-43. Epub 2006 Oct 23.

Analysis of Bartonella adhesin A expression reveals differences between various B. henselae strains.

Riess T, Raddatz G, Linke D, Schäfer A, Kempf VA.

Institut für Medizinische Mikrobiologie und Hygiene, Elfriede-Aulhorn-Str. 6, D-72076 Tübingen, Germany.

Bartonella henselae causes cat scratch disease and the vasculoproliferative disorders bacillary angiomatosis and peliosis hepatis in humans. One of the best known pathogenicity factors of B. henselae is Bartonella adhesin A (BadA), which is modularly constructed, consisting of head, neck/stalk, and membrane anchor domains. BadA is important for the adhesion of B. henselae to extracellular-matrix proteins and endothelial cells (ECs). In this study, we analyzed different B. henselae strains for BadA expression, autoagglutination, fibronectin (Fn) binding, and adhesion to ECs. We found that the B. henselae strains Marseille, ATCC 49882, Freiburg 96BK3 (FR96BK3), FR96BK38, and G-5436 express BadA. Remarkably, BadA expression was lacking in a B. henselae ATCC 49882 variant, in strains ATCC 49793 and Berlin-1, and in the majority of bacteria of strain Berlin-2. Adherence of B. henselae to ECs and Fn reliably correlated with BadA expression. badA was present in all tested strains, although the length of the gene varied significantly due to length variations of the stalk region. Sequencing of the promoter, head, and membrane anchor regions revealed only minor differences that did not correlate with BadA expression, apart from strain Berlin-1, in which a 1-bp deletion led to a frameshift in the head region of BadA. Our data suggest that, apart from the identified genetic modifications (frameshift deletion and recombination), other so-far-unknown regulatory mechanisms influence BadA expression. Because of variations between and within different B. henselae isolates, BadA expression should be analyzed before performing infection experiments with B. henselae.

PMCID: PMC1828432 PMID: 17060468 [PubMed - indexed for MEDLINE]

303. Int J Surg Pathol. 2006 Oct;14(4):349-54.

Isolated hepatic involvement of cat scratch disease in immunocompetent adults: Enhanced magnetic resonance imaging, pathological findings, and molecular analysis--two cases.

Marsilia GM, La Mura A, Galdiero R, Galdiero E, Aloj G, Ragozzino A.

Department of Pathology, Cardarelli Hospital, Naples, Italy. gmarinomars@tiscali.it

Visceral involvement in absence of lymphadenopathy is a rare manifestation in cat scratch disease; hepatic granulomas are rare, representing 0.3% of systemic manifestations of cat scratch disease, and gallbladder extension is a singular case. The present article refers to 2 rare cases of visceral cat scratch disease in immunocompetent adults with hepatic granulomatous inflammation, caused by Bartonella henselae infection, with gallbladder involvement in 1 case and no lymphadenopathy. Histological features demonstrated the presence of inflammatory necrotizing granulomatous nonneoplastic process. Molecular studies (polymerase chain reaction) were performed to confirm the infectious etiology.

PMID: 17041206 [PubMed - indexed for MEDLINE]

304. Curr Opin Infect Dis. 1998 Apr;11(2):189-93.

Bartonella infections: diagnostic and management issues.

Maurin M, Raoult D.

Unité des Rickettsies, CNRS UPRES A 6020, Université de la Méditerranée, Faculté de Médecine, Marseille, France.

Bartonella species are emerging pathogens. Renewed interest in this group of bacteria has been highlighted by the recent description of new species, which are pathogenic for humans (Bartonella elizabethae and Bartonella clarridgeae), and their association with an increasing number of clinical manifestations, the more prevalent being cat scratch disease, bacillary angiomatosis, and culture-negative endocarditis.

PMID: 17033388 [PubMed]

305. Przegl Epidemiol. 2006;60(2):307-13.

[Cat scratch disease--course, diagnosis].

[Article in Polish]

Sala E, Lipiec A, Zygmunt A, Burdzel Z, Ogórek M, Chyla M.

Oddział Pediatryczny Samodzielny Publiczny Zespół Zakładów Opieki Zdrowotnej w Staszowie. odd.ped_staszow@op.pl

Cat scratch disease is an infection which often causes regional lymphadenopathy. Bartenolloses present a growing health problem both in human and veterinary medicine. They may be etiological fevers of unknown etiology, endocarditis, pneumonia, meningitis. The mildest clinical form is the cat scratch disease which proceeds as a mild regional lymphadenopathy. It is caused by Bartonellosis henselae. Animals, especially cats, are the sourse of infections. Lymphadenitis may remain for many weeks and requires differentiation from other causes of regional lymphadenopathy. Three typical cases of the disease are presented. All sick persons had contact with cats. In none case a primary change was observed. In the case no 1 the possibility of occurrence of the disease was not considered and it was diagnosed only after histopathological examination of lymphnodes. In the two other cases diagnoses were established on the basis of serological examination after a few days of admittance for hospital treatment. Cat scratch disease is rarely diagnosed in Poland probably due to insufficient knowledge of the clinical form of this disease. Swollen lymph nodes together with patient contact with a cat or other animals established during a detailed interviewing, raise suspicion of CSD. Denial by a patient of the primary change does not rule out diagnosis. When regional lymphadenopathy of cat scratch disease is taken into consideration in differential diagnosis and serological tests are carried out, it may be possible in many cases to eliminate any further diagnostics burdening a sick person.

PMID: 16964683 [PubMed - indexed for MEDLINE]

306. Nuklearmedizin. 2006;45(4):160-2.

Somatostatin receptor scintigraphy in patients with cat-scratch disease.

Krause R, Piswanger-Soelkner C, Lipp RW, Daxböck F, Schnedl WJ, Hoier S, Reisinger EC.

Department of Medicine, University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria. robert.krause@meduni-graz.at

Erratum in Nuklearmedizin. 2006;45(5):234.

AIM: Somatostatin receptor scintigraphy images various neoplastic, granulomatous, and auto-immune diseases. Cat-scratch disease in an infectious granulomatous disease usually affecting the lymphnodes. It is not known whether cat-scratch disease provides positive somatostatin receptor scintigrams. PATIENTS, METHODS: Twelve patients with lymphadenitis and suspected cat-scratch disease were investigated by immunofluorescence antibody testing and somatostatin receptor scintigraphy. Suppurated lymphnodes were extracted or drained and Bartonella henselae specific PCR was then performed. RESULTS: Eleven of 12 patients showed IgG antibodies against B. henselae. SRS showed positive scintigraphic results in 6 of 11 patients with CSD. B. henselae DNA was detected in tissue of lymphnodes from 4 of 5 patients with lymphnode extraction or lymphnode drainage. SRS demonstrated positive scintigrams in all patients with a positive PCR. In one patient with suspected CSD SRS was negative as well as antibody testing. CONCLUSION: Somatostatin receptor scintigraphy correlated with positive Bartonella henselae specific PCR tests and positive Bartonella henselae specific antibody tests in patients with CSD.

PMID: 16964341 [PubMed - indexed for MEDLINE]

307. Rev Med Interne. 2006 Oct;27(10):772-5. Epub 2006 Jul 7.

[Hepatosplenic localization of cat scratch disease: two cases in immunocompetent adult patients].

[Article in French]

Family-Pigné D, Mouchet B, Lousteau V, Borie MF, Deforges L, Lesprit P, Godeau B.

Service de médecine interne, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94000 Créteil, France. delphinepigne@hotmail.com

INTRODUCTION: Cat-Scratch Disease (CSD) is a well-recognized benign cause of localized lymphadenopathy, which often recovers spontaneously. However systemic clinical presentations are described in immunodeficient adults (bacillary angiomatosis, bacillary splenitis) and are less common in immunocompetent ones. EXEGESIS: We report two cases of disseminated CSD in immunocompetent patients, presenting hepatosplenic nodules, associated in the second case with an endocarditis. CONCLUSION: Bartonella serology must be achieved in case of hepatosplenic nodules with fever. Treatment of disseminated CSD in immunocompetent adults is still empirical and recovery can occur without antibiotherapy when endocarditis is not associated.

PMID: 16959382 [PubMed - indexed for MEDLINE]

308. Nihon Shokakibyo Gakkai Zasshi. 2006 Sep;103(9):1050-4.

[A case of hepatosplenic cat scratch disease].

[Article in Japanese]

Ishikawa T, Suzuki T, Shinoda M, Takashi H, Yamaguchi H, Suzuki T, Miyake N, Kamiya T.

Department of Gastroenterology, Toyota Memorial Hospital.

A 43-year-old man was admitted with idiopathic fever. Abdominal ultrasonogram demonstrated multiple hypoechoic lesions in the spleen. Abdominal CT scan showed multiple hypodense lesions in the liver and spleen. The patient had a cat in his house, and the presence of a very high serous antibody titer for Bartonella henselae led to the diagnosis of hepatosplenic cat scratch disease. It is important to consider this disease in the differential diagnosis of idiopathic fever when multiple lesions are detected in the liver and spleen.

PMID: 16953102 [PubMed - indexed for MEDLINE]

309. J Feline Med Surg. 2006 Oct;8(5):315-20. Epub 2006 Sep 1.

Prevalence of Bartonella henselae antibodies in serum of cats with and without clinical signs of central nervous system disease.

Pearce LK, Radecki SV, Brewer M, Lappin MR.

Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado 80523, USA. lpearce@lamar.colostate.edu

Bartonella henselae is occasionally associated with neurological dysfunction in people and some experimentally infected cats. The purpose of this study was to determine whether B henselae seroprevalence or titer magnitude varies among cats with neurological disease, cats with non-neurological diseases, and healthy cats while controlling for age and flea exposure. There was no difference in B henselae seroprevalence rates between cats with seizures and cats with other neurological diseases. Cats with non-neurological disease and healthy cats were more likely than cats with neurological disease to be seropositive. While the median B henselae antibody titer was greater in cats with seizures than in cats with other neurological disease, the median B henselae antibody titer was also greater in healthy cats than cats with seizures. The results suggest that titer magnitude cannot be used alone to document clinical disease associated with B henselae infection and that presence of B henselae antibodies in serum of cats with neurological disease does not prove the clinical signs are related to B henselae.

PMID: 16949848 [PubMed - indexed for MEDLINE]

310. J Am Vet Med Assoc. 2006 Sep 1;229(5):700-5.

Prevalence of DNA of Mycoplasma haemofelis, 'Candidatus Mycoplasma haemominutum,' Anaplasma phagocytophilum, and species of Bartonella, Neorickettsia, and Ehrlichia in cats used as blood donors in the United States.

Hackett TB, Jensen WA, Lehman TL, Hohenhaus AE, Crawford PC, Giger U, Lappin MR.

Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, 80523, USA.

OBJECTIVE: To identify the prevalence of DNA of Mycoplasma haemofelis; 'Candidatus Mycoplasma haemominutum'; Anaplasma phagocytophilum; and species of Bartonella, Neorickettsia, and Ehrlichia in blood of cats used as blood donors in the United States. DESIGN: Prospective study. ANIMALS: 146 cats that were active blood donors. PROCEDURES: Environmental history was requested for each blood-donor cat from which a blood sample (mixed with EDTA) was available. Polymerase chain reaction assays capable of amplifying the DNA of the microorganisms of interest following DNA extraction from blood were performed. RESULTS: Overall, DNA of one or more of the infectious agents was detected in blood samples from 16 of 146 (11%) feline blood donors. Twenty-eight laboratory-reared cats housed in a teaching hospital had negative results for DNA of all organisms investigated. The DNA of at least 1 infectious agent was amplified from blood samples collected from 16 of 118 (13.6%) community-source cats; assay results were positive for 'Candidatus M haemominutum,' M haemofelis, or Bartonella henselae alone or in various combinations. Of the community-source cats allowed outdoors (n = 61) or with known flea exposure (44), DNA for a hemoplasma or B henselae was detected in 21.3% and 22.7%, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: When community-source cats, cats allowed outdoors, or cats exposed to fleas are to be used as blood donors, they should be regularly assessed for infection with M haemofelis, 'Candidatus M haemominutum,' and Bartonella spp, and flea-control treatment should be regularly provided.

PMID: 16948578 [PubMed - indexed for MEDLINE]

311. J Infect Chemother. 2006 Aug;12(4):224-6.

Analysis of data in 30 patients with cat scratch disease without lymphadenopathy.

Tsuneoka H, Tsukahara M.

Faculty of Health Sciences, Yamaguchi University School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan. htsune@yamaguchi-u.ac.jp

The prominent clinical manifestation of cat scratch disease is regional lymphadenopathy at the site of the cat scratch or bite, associated with fever or general symptoms. A serological study of 540 patients with either lymphadenopathy, persistent fever, or pet ownership disclosed that 30 (16.1%) of the 186 patients with a serological diagnosis of cat scratch disease had no regional lymphadenopathy, and in these 30 patients, the absence of lymphadenopathy was closely related to the presence of persistent fever, fever of unknown origin, or systemic complications. Physicians should be alert to cat scratch disease that is not associated with lymphadenopathy to enable prompt diagnosis and treatment.

PMID: 16944264 [PubMed - indexed for MEDLINE]

312. Antimicrob Agents Chemother. 2006 Sep;50(9):3192-3.

Molecular characterization of resistance to macrolides in Bartonella henselae.

Biswas S, Raoult D, Rolain JM.

Unité des Rickettsies, CNRS UMR 6020, IFR 48, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, 13385 Marseille Cedex 05, France.

We selected in vitro erythromycin-resistant strains of Bartonella henselae. The mutants obtained had point mutations in domain V of 23S rRNA and/or in ribosomal protein L4. One lymph node of a patient with cat-scratch disease had such a mutation in 23S rRNA, suggesting that natural resistant strains may infect humans.

PMCID: PMC1563522 PMID: 16940128 [PubMed - indexed for MEDLINE]

313. J Bacteriol. 2006 Nov;188(21):7426-39. Epub 2006 Aug 25.

Genome rearrangements, deletions, and amplifications in the natural population of Bartonella henselae.

Lindroos H, Vinnere O, Mira A, Repsilber D, Näslund K, Andersson SG.

Department of Molecular Evolution, Evolutionary Biology Center, Uppsala University, Norbyvägen 18C, S-752 36 Uppsala, Sweden.

Cats are the natural host for Bartonella henselae, an opportunistic human pathogen and the agent of cat scratch disease. Here, we have analyzed the natural variation in gene content and genome structure of 38 Bartonella henselae strains isolated from cats and humans by comparative genome hybridizations to microarrays and probe hybridizations to pulsed-field gel electrophoresis (PFGE) blots. The variation in gene content was modest and confined to the prophage and the genomic islands, whereas the PFGE analyses indicated extensive rearrangements across the terminus of replication with breakpoints in areas of the genomic islands. We observed no difference in gene content or structure between feline and human strains. Rather, the results suggest multiple sources of human infection from feline B. henselae strains of diverse genotypes. Additionally, the microarray hybridizations revealed DNA amplification in some strains in the so-called chromosome II-like region. The amplified segments were centered at a position corresponding to a putative phage replication initiation site and increased in size with the duration of cultivation. We hypothesize that the variable gene pool in the B. henselae population plays an important role in the establishment of long-term persistent infection in the natural host by promoting antigenic variation and escape from the host immune response.

PMCID: PMC1636255 PMID: 16936024 [PubMed - indexed for MEDLINE]

314. J Formos Med Assoc. 2006 Aug;105(8):674-9.

Systemic cat scratch disease.

Liao HM, Huang FY, Chi H, Wang NL, Chen BF.

Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan.

Systemic cat scratch disease (CSD) is often associated with prolonged fever and microabscesses in the liver and/or spleen. We report a case of systemic CSD with hepatic, splenic and renal involvement in an aboriginal child in Taiwan. A previously healthy 9-year-old girl had an intermittent fever for about 17 days, and complained of abdominal pain, headache and weight loss. Abdominal computed tomography showed multiple tiny hypodense nodular lesions in the spleen and both kidneys. Laparotomy revealed multiple soft, whitish-tan lesions on the surface of the liver and spleen. Histopathologic examination of a biopsy specimen of the spleen showed necrotizing granulomatous inflammation with central necrosis surrounded by epithelioid cells and occasional Langhans' giant cells, strongly suggestive of Bartonella henselae infection. History revealed close contact with a cat. B. henselae DNA was detected by polymerase chain reaction in the tissue specimen, and the single antibody titer against B. henselae was greater than 1:2048. These results confirmed the diagnosis of visceral CSD caused by B. henselae. The patient's symptoms resolved after treatment with rifampin and tetracycline. This case illustrates the need for inclusion of systemic CSD in patients with fever of unknown origin and abdominal pain.

PMID: 16935770 [PubMed - indexed for MEDLINE]

315. Klin Med (Mosk). 2006;84(7):61-3.

[A case of cat scratch disease in a patient with diabetes mellitus and chronic renal failure].

[Article in Russian]

Mediannikov OIu, Melikian AL.

The article describes a case of cat scratch disease in a female patient with severe chronic pathology. This relatively rare disease was manifested by regional (in the site of microbial intrusion) lymphadenopathy, and general infectious syndrome. The presence of oncohematological process was excluded without biopsy; serologic examination with bartonella antibodies confirmed the diagnosis. Combined treatment with two antibiotics, rifampicin and doxycycline, was successful. The article stresses that general practitioners should be aware of this disease; timely diagnosis and specific treatment are of utter importance.

PMID: 16924805 [PubMed - indexed for MEDLINE]

316. Vet Microbiol. 2006 Dec 20;118(3-4):274-7. Epub 2006 Aug 17.

Serological and molecular evidence of exposure to arthropod-borne organisms in cats from northeastern Spain.

Solano-Gallego L, Hegarty B, Espada Y, Llull J, Breitschwerdt E.

Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA.

One hundred sixty-eight cat sera from Spain were tested for IgG antibodies to Rickettsia conorii (Rc), Ehrlichia canis (Ec), Anaplasma phagocytophilum (Ap) and Bartonella henselae (Bh) antigens using IFA and for FeLV antigen and FIV antibody by ELISA. For 47 whole blood samples, PCR testing was performed for Rickettsia, Ehrlichia and Bartonella. Seroprevalences were: Bh (71.4%), Rc (44%), Ec (11.3%), FeLV (8.5%), FIV (7.4%) and Ap (1.8%). Bh antibodies were associated with seroreactivity to both Ec and Rc antigens. FIV antibodies were associated with illness and cats older than 2 years. Bartonella henselae and B. clarridgeiae (Bcl) DNA was amplified from seven and one sample, respectively.

PMID: 16919405 [PubMed - indexed for MEDLINE]

317. J Paediatr Child Health. 2006 Jul-Aug;42(7-8):469-71.

Broad-range polymerase chain reaction for the diagnosis of Bartonella henselae endocarditis.

Walls T, Moshal K, Trounce J, Hartley J, Harris K, Davies G.

Department of Infectious Diseases, Great Ormond Street Hospital for Children, London, UK. wallst@gosh.nhs.uk

We present a case of subacute bacterial endocarditis in a 10-year-old girl with Di-George syndrome, congenital heart disease, and mild immunodeficiency. She was afebrile at initial presentation but was found to have massive splenomegaly, and signs of congestive heart failure. No causative organism could be identified on routine blood and tissue cultures. A detailed clinical history revealed a history that she had been scratched by a cat and developed intermittant fevers over 3 months. Bartonella henselae was identified by broad-range 16S r-DNA polymerase chain reaction on valvular tissue specimens.

PMID: 16898887 [PubMed - indexed for MEDLINE]

318. Clin Vaccine Immunol. 2006 Aug;13(8):830-6.

Cloning, characterization, and expression of Bartonella henselae p26.

Werner JA, Feng S, Kasten RW, Hodzic E, Chomel BB, Barthold SW.

Center for Comparative Medicine, Schools of Medicine and Veterinary Medicine, University of California at Davis, California 95616, USA.

In order to identify immunoreactive Bartonella henselae proteins, B. henselae antiserum from an experimentally infected cat was used to screen a B. henselae genomic DNA expression library. One immunoreactive phage clone contained a gene (p26) with significant nucleotide identity with orthologs in brucellae, bartonellae, and several plant-associated bacteria. p26 gene sequences from four B. henselae strains, one B. koehlerae strain, and one B. clarridgeiae strain were cloned. Comparative nucleotide sequence analysis showed that p26 is a potential marker for molecular diagnosis of infection, as well as for identification to species level and genotyping of Bartonella sp. isolates. Alignment of the predicted amino acid sequences illustrated conserved putative protein features including a hydrophobic transmembrane region, a peptide cleavage site, and four dominant antigenic sites. Expression of p26 in Escherichia coli produced two proteins (26 and 27.5 kDa), both of which were reactive with feline anti-B. henselae antisera. Furthermore, murine hyperimmune serum raised against either recombinant protein reacted with both proteins. No reactivity to either recombinant protein was detected in nonimmune serum, and reactivity persisted as long as 20 weeks for one cat. The p26 protein product is an immunodominant antigen that is expressed during infection in cats as a preprotein and is subsequently cleaved to form mature P26.

PMCID: PMC1539124 PMID: 16893981 [PubMed - indexed for MEDLINE]

319. J Wildl Dis. 2006 Apr;42(2):391-6.

Bartonella spp. in deer keds, Lipoptena mazamae (Diptera: Hippoboscidae), from Georgia and South Carolina, USA.

Reeves WK, Nelder MP, Cobb KD, Dasch GA.

Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, Mailstop G-13, Atlanta, Georgia 30333, USA. wreeves@alumni.clemson.edu

Deer keds, Lipoptena mazamae (Diptera: Hippoboscidae), were collected from white-tailed deer (Odocoileus virginianus) and humans in Georgia and South Carolina, USA (1 October 2001-6 January 2005) and screened for the presence of DNA from Bartonella spp. Forty deer keds were screened for Bartonella spp. by polymerase chain reaction using primers specific to the riboflavin synthase gene (ribC) of Bartonella. Bartonella species closely related to Bartonella schoenbuchensis and to the etiologic agent of cat-scratch disease (Bartonella henselae) were detected in 10 keds and one ked, respectively.

PMID: 16870863 [PubMed - indexed for MEDLINE]

320. J Feline Med Surg. 2006 Aug;8(4):213-26.

American Association of Feline Practitioners 2006 Panel report on diagnosis, treatment, and prevention of Bartonella spp. infections.

Brunt J, Guptill L, Kordick DL, Kudrak S, Lappin MR; American Association of Feline Practitioners; Academy of Feline Medicine Advisory Panel.

Cat Hospital At Towson (CHAT), 6701 York Road, Baltimore, MD 21212, USA.

PMID: 16846781 [PubMed - indexed for MEDLINE]

321. J Feline Med Surg. 2007 Feb;9(1):1-7. Epub 2006 Jul 17.

Prevalence of Mycoplasma haemofelis, 'Candidatus Mycoplasma haemominutum', Bartonella species, Ehrlichia species, and Anaplasma phagocytophilum DNA in the blood of cats with anemia.

Ishak AM, Radecki S, Lappin MR.

Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA. amishak@colostate.edu

Hemoplasmas are known causes of anemia in some cats and some Bartonella species have been associated with anemia in people and in dogs. In this retrospective study, we used polymerase chain reaction (PCR) assays to determine the prevalence rates of Mycoplasma haemofelis, 'Candidatus M haemominutum', A phagocytophilum, Ehrlichia species, and Bartonella species DNA in the blood of cats with anemia and a control group of healthy cats. DNA of the organisms was amplified from 22 of 89 cats with anemia (24.7%) and 20 of 87 healthy cats (23.0%). DNA of a hemoplasma was amplified from 18 of 89 cats with anemia (20.2%) and 13 of 87 healthy cats (14.9%); DNA of a Bartonella species was amplified from five of 89 cats with anemia (5.6%) and seven of 87 healthy cats (8.0%). There were no statistically significant differences detected between groups.

PMID: 16846745 [PubMed - indexed for MEDLINE]

322. Transpl Int. 2006 Aug;19(8):683-7.

Disseminated Bartonella infection following liver transplantation.

Bonatti H, Mendez J, Guerrero I, Krishna M, Ananda-Michel J, Yao J, Steers JL, Hellinger W, Dickson RC, Alvarez S.

Transplant Center, Mayo Clinic, Jacksonville, FL, USA.

Bartonella henselae has not only been identified as the causative agent of cat scratch disease, but it is also associated with other significant infectious syndromes in the immunocompromised population. We describe two cases of B. henselae associated diseases in liver transplant recipients who both had contact with cats. The first recipient developed localized skin manifestation of bacillary angiomatosis in association with granulomatous hepatitis. He tested positive for Immunoglobulin G (IgG) antibodies against B. henselae. The second patient developed axillary lymphadenopathy, with biopsy showing necrotizing granulomatous inflammation and polymerase chain reaction studies were positive for B. henselae DNA. Her serology for bartonellosis showed a fourfold rise in antibody titers during her hospitalization. Both patients responded to treatment with Azithromycin in combination with Doxycycline. These were the only cases within a series of 467 consecutive liver transplants performed in 402 patients performed during a 4-year period. Although bartonellosis is a rare infection in liver transplantation recipients, it should always be included in the differential diagnosis of patients presenting with fever, central nervous system (CNS) symptoms, skin lesions, lymphadenopathy, and hepatitis especially if prior contact with cats is reported.

PMID: 16827686 [PubMed - indexed for MEDLINE]

323. J Clin Microbiol. 2006 Jul;44(7):2499-506.

Multispacer typing to study the genotypic distribution of Bartonella henselae populations.

Li W, Chomel BB, Maruyama S, Guptil L, Sander A, Raoult D, Fournier PE.

Unité des Rickettsies, IFR 48, CNRS UMR 6020, Faculté de Médecine, Université de la Méditerranée, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 05, France.

Bartonella henselae, a worldwide fastidious bacterium, has a feline reservoir and is pathogenic for humans. However, the relationship between human and cat isolates of B. henselae, as well as its population dynamics and geographic heterogeneity, is not fully understood, in part because of the absence of appropriate typing methods. Multilocus sequence typing (MLST), the most discriminatory genotyping method for B. henselae, identified seven genotypes and suggested that human isolates arose from a limited number of cat isolates. Herein, we estimated the discriminatory power of multispacer typing (MST) by studying 126 B. henselae cat isolates from various areas of Europe, Asia, and the United States. We identified the nine most variable intergenic spacers conserved by both B. henselae and Bartonella quintana genomes. By comparing the sequences obtained from these nine spacers for each studied isolate, we identified 39 MST genotypes. The distribution of isolates into MST genotypes matched their phylogenetic organization into four clusters. MST showed that European and Asian isolates were different, in contrast with American isolates, but failed to identify pandemic strains. Our study demonstrated that MST is a powerful method for genotyping B. henselae at the strain level and may serve in studying the population dynamics of this bacterium and understanding the relationships between cat and human isolates. Finally, we provide a free-access MST-Rick online software program (http://ifr48.timone.univ-mrs.fr/MST_BHenselae/mst) that investigators may use to compare their own MST sequences to our database.

PMCID: PMC1489502 PMID: 16825371 [PubMed - indexed for MEDLINE]

324. Arthritis Rheum. 2006 Jul;54(7):2347-8.

Possible role of tick-borne infection in "cat-scratch disease": comment on the article by Giladi et al.

Stricker RB, Brewer JH, Burrascano JJ, Horowitz R, Johnson L, Phillips SE, Savely VR, Sherr VT.

Comment on Arthritis Rheum. 2005 Nov;52(11):3611-7.

PMID: 16802385 [PubMed - indexed for MEDLINE]

325. Enferm Infecc Microbiol Clin. 2006 May;24(5):297-301.

[Endocarditis due to Bartonella spp. Three new clinical cases and Spanish literature review].

[Article in Spanish]

Oteo JA, Castilla A, Arosey A, Blanco JR, Ibarra V, Morano LE.

Area de Enfermedades Infecciosas, Complejo Hospitalario San Millán-San Pedro de La Rioja, Hospital de La Rioja, Logroño, España. jaoteo@riojasalud.es

Comment in Enferm Infecc Microbiol Clin. 2006 May;24(5):295-6. Enferm Infecc Microbiol Clin. 2006 Nov;24(9):597.

INTRODUCTION: Infections by Bartonella spp. include a wide spectrum of emerging and re-emerging infectious diseases, such as culture-negative endocarditis. METHODS: Description of 3 cases of endocarditis due to Bartonella spp. and review of those previously reported in Spain. RESULTS: Including these 3 new cases of endocarditis due to Bartonella spp., a total of 6 cases have been reported in Spain. The median age of the patients was 51.6 years and 83.3% were men. There was history of contact with cats in 66.7%, and 50% were alcoholic. Only one patient had prior valvular disease. There were no clinical manifestations typical to any of the Bartonella species. The aortic valve was the one most commonly affected. In all cases, B. henselae was the agent implicated. The diagnosis was made by serology in 5 cases (83.3%). The outcome was favorable in all patients, although 4 of them (66.7%) required valve replacement. CONCLUSION: Endocarditis due to Bartonella spp. is present in Spain and is likely to be underestimated. We should suspect this pathogen in patients with negative blood cultures and a history of chronic alcoholism, homeless patients, and those who have had contact with cats or who have been bitten by fleas or lice, as well as patients with endocarditis and positive serology against Chlamydia spp.

PMID: 16762254 [PubMed - indexed for MEDLINE]

326. J Clin Microbiol. 2006 Jun;44(6):2288-90.

Isolation of Bartonella henselae DNA from the peripheral blood of a patient with cat scratch disease up to 4 months after the cat scratch injury.

Arvand M, Schäd SG.

Institut für Medizinische Mikrobiologie, Virologie, und Hygiene, Universität Rostock, Schillingallee 70, 18057 Rostock, Germany. mardjan.arvand@med.uni-rostock.de

We report the case of a girl with cervical lymphadenitis and a persistent primary lesion of cat scratch disease (CSD). Bartonella henselae DNA was isolated from plasma samples collected 3 and 4 months after the cat scratch, indicating that recurrent and long-term shedding of Bartonella DNA into peripheral blood may occur in typical CSD.

PMCID: PMC1489392 PMID: 16757642 [PubMed - indexed for MEDLINE]

327. An Pediatr (Barc). 2006 May;64(5):503-4.

[Submandibular tumor].

[Article in Spanish]

García Puga JM, Ramos Ramos MV, Muwaqued Rodríguez F, Santos Pérez JL, Vega Pérez S.

Centro Salud Salvador Caballero, Granada. jmgpuga@telefonica.net

PMID: 16756901 [PubMed - indexed for MEDLINE]

328. J Pediatr Orthop B. 2006 Jul;15(4):285-8.

Multifocal osteomyelitis in a child: a rare manifestation of cat scratch disease: a case report and systematic review of the literature.

de Kort JG, Robben SG, Schrander JJ, van Rhijn LW.

Department of Orthopaedic Surgery, University Hospital Maastricht, Maastricht, The Netherlands.

We present a case of a 9-year-old immunocompetent girl who presented with pain in her left elbow and a painful swelling at her left clavicle. She had no lymphadenopathy or fever. Four hot spots were seen at her left clavicle, proximal and distal left humerus and lumbo-sacral spine on a bone scan. A magnetic resonance imaging showed an inflammatory process with bone destruction at her clavicle. Serological testing and polymerase chain reaction performed on a bone biopsy identified a Bartonella henselae infection. She was treated with rifampin and trimethoprim-sulphamethoxazole. After a relapse half a year later, the patient recovered fully. Multifocal osteomyelitis is a rare manifestation of cat scratch disease in children.

PMID: 16751739 [PubMed - indexed for MEDLINE]

329. Microb Pathog. 2006 Jul;41(1):10-20. Epub 2006 May 24.

Binding of Bartonella henselae to extracellular molecules: identification of potential adhesins.

Dabo SM, Confer AW, Saliki JT, Anderson BE.

Department of Veterinary Pathobiology, Oklahoma State University, Stillwater, OK 74078-2007, USA. mady.dabo@okstate.edu

Bartonella henselae, the etiologic agent of cat scratch disease, bacillary angiomatosis and other clinical syndromes initiates infection through a trauma or wound to the skin suggesting involvement of extracellular matrix molecules. We have demonstrated in this study that B. henselae bound strongly fibronectin, collagen IX and X, but comparatively less laminin and collagen IV. B. henselae bound primarily the N- and C-terminal heparin (Hep-1 and Hep-2, respectively) and the gelatin-binding domains of fibronectin (Fn) but not the cell-binding domain. Binding to the Hep-binding domain was significantly inhibited by Hep suggesting common binding sites on the Fn molecule. Furthermore, glycosaminoglycans-mediated binding of B. henselae to soluble Fn showed that Hep but not dextran sulfate inhibited the bacterium binding to Fn. Unlike Fn, B. henselae bound strongly vitronectin only in the presence of Hep or dextran sulfate. Also, the binding of B. henselae to host cells could be inhibited by anti-B. henselae surface-reactive antibodies, the exogenous Fn or the anti-Fn polyclonal antibodies. Ligand blots, batch affinity purification and MALDI-TOF peptide fingerprinting identified B. henselae Pap31, Omp43 and Omp89 as the three major putative Fn-binding proteins (FnBPs) in B. henselae outer membrane proteins. We hypothesized that B. henselae wound associated infections involved interactions with extracellular matrix molecules. Taken together, the above data suggest that interactions between B. henselae and ECM molecules such as Fn may play an important role in the bacterium adherence to and invasion of host cells.

PMID: 16725305 [PubMed - indexed for MEDLINE]

330. Emerg Infect Dis. 2006 Mar;12(3):389-94.

Bartonella spp. in pets and effect on human health.

Chomel BB, Boulouis HJ, Maruyama S, Breitschwerdt EB.

Department of Population Health and Reproduction, University of California School of Veterinary Medicine, Davis, California 95616, USA. bbchomel@ucdavis.edu

Among the many mammals infected with Bartonella spp., pets represent a large reservoir for human infection because most Bartonella spp. infecting them are zoonotic. Cats are the main reservoir for Bartonella henselae, 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.

PMID: 16704774 [PubMed - indexed for MEDLINE]

331. Microbes Infect. 2006 Apr;8(5):1315-20. Epub 2006 Mar 15.

Emergence of distinct genetic variants in the population of primary Bartonella henselae isolates.

Arvand M, Schubert H, Viezens J.

Institut für Medizinische Mikrobiologie, Virologie und Hygiene, Universität Rostock, Schillingallee 70, D-18057 Rostock, Germany. mardjan.arvand@med.uni-rostock.de

Bartonella henselae isolates from different hosts display a marked genetic heterogeneity, as determined by pulsed-field gel electrophoresis (PFGE). The aim of the present study was to determine whether different genetic variants may coexist within the population of distinct B. henselae isolates and could be detected by PFGE. Three primary B. henselae isolates and the B. henselae reference strains ATCC 49793 and 49882 were subjected as single colony derived cultures in quadruplicate to PFGE analysis upon restriction with SmaI or NotI. Up to 4 fragment differences were found among the cultures obtained from each primary isolate, indicating the coexistence of genetic variants in the population of primary B. henselae isolates. The clonal relatedness of the genetic variants was confirmed by arbitrarily primed PCR and multi-locus sequence typing. In contrast to the primary isolates, no variants were detected among the single colony derived cultures of the high-passage ATCC strains. We hypothesized that the coexistence of different genetic variants may represent a feature that is restricted to primary or low-passage B. henselae isolates. The primary isolates were serially passed in vitro and then subjected as single colony derived cultures to PFGE analysis, which now revealed identical patterns among the quadruplicate cultures of each high-passage isolate. These results suggest that the population of a primary B. henselae isolate is composed of distinct genetic variants, which may disappear upon repeated passages on artificial culture media. Generation of genetic variants by B. henselae may represent an escape mechanism to circumvent the host specific immune responses.

PMID: 16697237 [PubMed - indexed for MEDLINE]

332. Int J Clin Pract. 2006 Dec;60(12):1679-80. Epub 2006 Mar 27.

Parotid mass due to cat scratch disease.

Petrogiannopoulos C, Valla K, Mikelis A, Kalogeropoulos SG, Karachalios G, Karachaliou I, Skandami I.

Second Department of Medicine, Red Cross Hospital, Athens, Greece.

Cat scratch disease (CSD), due to Bartonella henselae, is a self-limited chronic lymphadenopathy. A previously healthy 22-year-old woman presented with a palpable painful swelling in the right submandibular region accompanied by enlarged cervical lymph nodes. A diagnosis of B. henselae infection was made according to her personal history that divulged frequent contacts with cats and to a high titre of immunoglobulin G (IgG) and IgM antibodies for this agent. The patient improved within 1 month without the requirement of antibiotic treatment or surgery. The CSD should always be included in the differential diagnosis of all equivocal masses in the neck, especially in young individuals. In addition, it is important that a meticulous personal history is obtained.

PMID: 16669837 [PubMed - indexed for MEDLINE]

333. N Engl J Med. 2006 Apr 27;354(17):e17.

Images in clinical medicine. Cat scratch disease lymphadenopathy.

Eidlitz-Markus T, Zeharia A.

Schneider Children's Medical Center of Israel, Petah Tikva 4727, Israel.

PMID: 16641391 [PubMed - indexed for MEDLINE]

334. Vet Res. 2006 Jul-Aug;37(4):565-77. Epub 2006 Apr 28.

Cat-scratch disease in veterinary-associated populations and in its cat reservoir in Taiwan.

Chang CC, Lee CC, Maruyama S, Lin JW, Pan MJ.

Graduate Institute of Veterinary Public Health, School of Veterinary Medicine, National Chung Hsing University, Taichung 402, Taiwan.

In Taiwan, the first human case of cat-scratch disease (CSD) was diagnosed by a serologic test in 1998. Since then, no studies have been conducted to understand the epidemiology of the infection in Taiwan. Therefore, this study is the first epidemiologic survey of CSD in cats and humans in this country. Using veterinary-associated individuals as the study population, it was identified that 1.7% of them were seropositive for B. henselae, and residence was the only factor associated with seropositivity. Bartonella species were successfully isolated from 25 (19.1%) of the 131 cats tested. Only B. henselae and B. clarridgeiae were obtained from bacteremic cats. Furthermore, 9.2% of 131 cats were dually-infected with genotypes I and II of B. henselae. It is the highest prevalence of co-infection that has ever been reported worldwide. In cats, the seroprevalence was 23.7% by indirect immunofluorescence antibody assay with B. henselae Houston-1 (type I) as the antigen. When 12 bacteremic but seronegative cats were re-tested by IFA slides coated with B. henselae U-4 antigen (type II), 9 cats were identified to be seropositive. Our study further suggested that using only direct PCR of 16S-23S rRNA intergenic region or the combination of the PCR method and indirect immuno-fluorescence test will be useful to diagnose Bartonella-free cats.

PMID: 16641017 [PubMed - indexed for MEDLINE]

335. Jpn 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]

336. J Vector Ecol. 2005 Dec;30(2):310-5.

Bartonella and Rickettsia in fleas and lice from mammals in South Carolina, U.S.A.

Reeves WK, Nelder MP, Korecki JA.

Centers for Disease Control and Prevention, Viral and Rickettsial Zoonoses Branch, Mailstop G-13, 1600 Clifton Rd NE, Atlanta, GA 30333, USA.

Species in the genera Bartonella and Rickettsia are vector-borne pathogens of humans and domestic animals. The natural reservoirs and enzootic transmission cycles of these bacteria are poorly known in South Carolina. Thirteen species of lice and fleas were collected from urban animals and screened for the presence of Bartonella and Rickettsia by PCR amplification using genus-specific primers. Bartonella henselae was present in cat fleas (Ctenocephalides felis) from Virginia opossums (Didelphis virginiana) and a novel genotype of Bartonella was detected in Orchopeas howardi from an eastern gray squirrel (Sciurus carolinensis). We detected R. typhi and three novel genotypes Rickettsia in other species of fleas and lice. Rickettsia typhi, the causative agent of murine typhus, was detected in two pools of lice (Enderleinellus marmotae) from the woodchuck (Marmota monax). Cat fleas harbored one of two novel genotypes of Rickettsia. A third novel Rickettsia was detected in Orchopeas howardi from an eastern gray squirrel.

PMID: 16599169 [PubMed - indexed for MEDLINE]

337. Microbiol Immunol. 2006;50(3):171-8.

Predominant T helper 2 immune responses against Bartonella henselae in naturally infected cats.

Kabeya H, Sase M, Yamashita M, Maruyama S.

Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa 252-8510, Japan. kabeya@brs.nihon-u.ac.jp

This study was conducted to explicate the mechanism of long-term bacteremia in Bartonella henselae-infected cats by the examining host immune responses. Blood samples were collected from three naturally infected cats and the IgG antibody titers and the cytokine responses in peripheral blood mononuclear cells (PBMC) were examined by quantitative reverse transcriptase-polymerase chain reactions (RT-PCR). Relapsing bacteremia was found in two of the three cats during the examination period. The quantitative RT-PCR analyses demonstrated that increases of the mRNA expressions in interleukin-4 (IL-4) but not in gamma-interferon (IFN-gamma) were observed in PBMC from these infected cats after the bacteremia had peaked, showing that the T helper 2 (Th2) responses were specifically induced in the cats. Furthermore, the specific antibody titer increased, resulting in a decrease in the number of B. henselae to undetectable levels in these cats. However, the number of bacteria increased again in two of these cats at 90 and 45 days after the previous bacteremia, respectively. These results suggest that B. henselae predominantly induced IL-4 production from PBMC and resulted in stimulation of the humoral immune responses, including the secretion of specific antibodies in the cats. Furthermore, the specific antibody may play a role in eliminating the bacteria from cats partially but not completely, because relapsing bacteremia was found in these two cats.

PMID: 16547414 [PubMed - indexed for MEDLINE]

338. Ocul Immunol Inflamm. 2006 Feb;14(1):47-9.

Bartonella henselae bacilli detected in vitrectomy aspirates in a patient with massive vitreous opacity with total retinal detachment.

Matsuo T, Notohara K.

Department of Ophthalmology, Okayama University Graduate School of Medicine and Dentistry, Okayama City, Japan. matsuot@cc.okayama-u.ac.jp

PURPOSE: To present endophthalmitis-like massive vitreous opacity as a manifestation of cat-scratch disease. METHODS: Report of a case. RESULTS: A 47-year-old man developed massive vitreous opacity and total retinal detachment in his right eye after a four-month period of uveitis, which was controlled with oral prednisolone. During the diagnostic vitrectomy, a massive fluffy white opacity adhering to the detached retina was shaved using a vitreous cutter. Further surgical procedures to reattach the retina were not pursued because of the poor state of the infected retina. Pathological examination of the vitreous aspirates revealed pleomorphic bacilli. The serological testing done at referral revealed an IgG titer positive for Bartonella henselae and culture of the vitreous proved the infection a month later. With a mixture of oral sulfamethoxazole (1600 mg daily) and trimethoprim (320 mg daily), the intraocular inflammation subsided. CONCLUSION: Rapid progression of massive vitreous opacity with total retinal detachment, mimicking endophthalmitis, can occur in cat-scratch disease.

PMID: 16507491 [PubMed - indexed for MEDLINE]

339. J Antimicrob Chemother. 2006 Apr;57(4):761-3. Epub 2006 Feb 7.

Antimicrobial susceptibility of Bartonella henselae using Etest methodology.

Pendle S, Ginn A, Iredell J.

Centre for Infectious Diseases and Microbiology, University of Sydney, Westmead Hospital, NSW, Australia.

OBJECTIVES: Bartonella henselae is a fastidious slow growing pathogen which is seldom cultured in the laboratory. Previous descriptions of antimicrobial susceptibility have been largely limited to feline isolates and/or laboratory reference strains, with no accounting for genotypic or phenotypic diversity. METHODS: An optimal method of antimicrobial susceptibility testing by Etest was established to compare the antimicrobial susceptibilities of 12 different isolates of B. henselae, 5 human and 7 feline, which have previously been well characterized by 16S rRNA sequencing, multi-locus sequence typing (MLST), phase variation and passage number. RESULTS: No difference in susceptibility could be attributed to differences in genotype, source of the isolate or passage number. Where comparisons were drawn with previously published results, these were found to be concordant. CONCLUSIONS: We conclude that antibiotic susceptibility can be determined by a simple Etest method for B. henselae isolates. This method is reproducible among diverse strains, and is sufficiently predictable that generalizations can be confidently made about optimal antibiotic choices.

PMID: 16464897 [PubMed - indexed for MEDLINE]

340. Am J Ophthalmol. 2006 Feb;141(2):400-1.

Ocular manifestation of cat-scratch disease in HIV-positive patients.

Curi AL, Machado DO, Heringer G, Campos WR, Orefice F.

Department of Ophthalmology, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil. curiall@nitnet.com.br

PURPOSE: To characterize ocular manifestations of cat-scratch disease in HIV-positive patients. DESIGN: Retrospective case series study. METHODS: Records and photography of patients with the diagnosis of cat-scratch disease and HIV were reviewed. RESULTS: From 2001 and 2004 three patients with cat-scratch disease and HIV were identified. All patients presented with subretinal mass associated with an abnormal vascular network. Fluorescein angiography revealed this abnormal vascular network more clearly. All patients were treated with antibiotics alone with good response. CONCLUSIONS: Subretinal mass associated with abnormal vascular network is characteristic of cat-scratch disease in HIV-positive patients. Fluorescein angiography is important to characterize this vascular pattern, and patients may benefit from systemic treatment.

PMID: 16458711 [PubMed - indexed for MEDLINE]

341. Rev Med Chil. 2005 Dec;133(12):1465-71. Epub 2006 Jan 27.

[Presence of Bartonella henselae in cats: natural reservoir quantification and human exposition risk of this zoonoses in Chile].

[Article in Spanish]

Ferrés M, Abarca K, Godoy P, García P, Palavecino E, Méndez G, Valdés A, Ernst S, Thibaut J, Koberg J, Chanqueo L, Vial PA.

Departamento de Pediatría, Facultad de Medicina, Pontificia Universidad Católica de Chile. mferres@med.puc.cl

BACKGROUND: The availability of a serologic test for cat scratch disease in humans has allowed the diagnosis of an increasing number of cases of this disease in Chile. AIM: To perform a serological survey for Bartonella henselae among cats in Chile. MATERIAL AND METHODS: Blood samples from 187 cats living in three Chilean cities were obtained. IgG antibodies against Bartonella henselae were measured using indirect immunofluorescence. Blood cultures were done in 60 samples. The presence of Bartonella henselae in positive cultures was confirmed by restriction fragment length polymorphism polymerase chain reaction (RFLP-PCR). RESULTS: The general prevalence of IgG antibodies against Bartonella henselae was 85.6%. No differences in this prevalence were found among cats younger or older than 1 year, or those infested or not infested with fleas. However domestic cats had a lower prevalence when compared with stray cats (73 and 90% respectively, p <0.01). Bartonella henselae was isolated in 41% of blood cultures. All the isolated were confirmed as Bartonella henselae by RFLP-PCR. CONCLUSIONS: This study found an important reservoir of Bartonella henselae in Chilean cats and therefore a high risk of exposure in humans who have contact with them.

PMID: 16446874 [PubMed - indexed for MEDLINE]

342. J Feline Med Surg. 2006 Jun;8(3):164-8. Epub 2006 Jan 27.

Prevalence of selected infectious disease agents in cats from Arizona.

Eberhardt JM, Neal K, Shackelford T, Lappin MR.

Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 300 West Drake Road, Fort Collins, CO 80523, USA. Jason.Eberhardt@colostate.edu

The objective of this study was to use polymerase chain reaction (PCR) assays to determine the prevalence of Ehrlichia species, Anaplasma phagocytophilum, Mycoplasma haemofelis, 'Candidatus Mycoplasma haemominutum' and Bartonella species from feral and relinquished cats in Phoenix and Nogales, Arizona. DNA from one or more of the organisms was amplified from 31 of 112 blood samples (27.7%). DNA consistent with Bartonella clarridgeiae 15 (13.4%), Bartonella henselae 14 (12.5%), 'Candidatus M haemominutum' 9 (8.0%), and M haemofelis 5 (4.5%) were detected. DNA of Ehrlichia species, Neorickettsia risticii, or A phagocytophilum was not amplified. Failure to amplify DNA of A phagocytophilum may relate to the absence of appropriate tick vectors. Failure to amplify Ehrlichia species DNA suggests that cats were not exposed, exposed but not infected, or infected but the DNA was not detected by the PCR assay used in this study. The Bartonella species and hemoplasma results suggest flea control should be maintained.

PMID: 16443383 [PubMed - indexed for MEDLINE]

343. Ned Tijdschr Geneeskd. 2006 Jan 14;150(2):89.

[Diagnostic imaging (257). A boy with a swollen inguinal gland].

[Article in Dutch]

Winterberg DH.

Academisch Medisch Centrum/Universiteit van Amsterdam, locatie Emma Kinderziekenhuis, Postbus 22.660, 1100 DD Amsterdam. d.h.winterberg@amc.uva.nl

In a 4-year-old boy with left-sided inguinal lymphadenopathy and a papule on his left lower leg situated at the end of a scar of a probable cat scratch, cat scratch disease was confirmed serologically.

PMID: 16440563 [PubMed - indexed for MEDLINE]

344. Am J Surg Pathol. 2006 Feb;30(2):274-5.

Confirmation of diagnosis of cat scratch disease by immunohistochemistry.

Cheuk W, Chan AK, Wong MC, Chan JK.

PMID: 16434905 [PubMed - indexed for MEDLINE]

345. J Feline Med Surg. 2006 Apr;8(2):111-7. Epub 2006 Jan 23.

Serological survey of vector-borne zoonotic pathogens in pet cats and cats from animal shelters and feral colonies.

Case JB, Chomel B, Nicholson W, Foley JE.

Center for Vectorborne Diseases, School of Veterinary Medicine, University of California, Davis, 95616, USA.

Although cats and their arthropod parasites can sometimes be important sources of zoonotic diseases in humans, the extent of exposure among various cat populations to many potential zoonotic agents remains incompletely described. In this study, 170 domestic cats living in private homes, feral cat colonies, and animal shelters from California and Wisconsin were evaluated by serology to determine the levels of exposure to a group of zoonotic vector-borne pathogens. Serological positive test results were observed in 17.2% of cats for Rickettsia rickettsii, 14.9% for R akari, 4.9% for R typhi, 11.1% for R felis, and 14.7% for Bartonella henselae. Although vector-borne disease exposure has been documented previously in cats, the evaluation of multiple pathogens and diverse cat populations simultaneously performed here contributes to our understanding of feline exposure to these zoonotic pathogens.

PMID: 16434226 [PubMed - indexed for MEDLINE]

346. Clin Infect Dis. 2006 Feb 15;42(4):578-9; author reply 579-80.

Kikuchi's disease or Kikuchi's syndrome?

Angel-Moreno A, Hernández-Cabrera M, Pérez-Arellano JL.

Comment on Clin Infect Dis. 2005 Oct 15;41(8):e80-2.

PMID: 16421809 [PubMed - indexed for MEDLINE]

347. Int J Infect Dis. 2006 May;10(3):206-14. Epub 2006 Jan 18.

DNA examination of ancient dental pulp incriminates typhoid fever as a probable cause of the Plague of Athens.

Papagrigorakis MJ, Yapijakis C, Synodinos PN, Baziotopoulou-Valavani E.

Department of Orthodontics, Dental School, University of Athens, 2 Thivon str., 11527 Goudi/Athens, Greece. manjpap@dent.uoa.gr

Comment in Int J Infect Dis. 2006 Jul;10(4):334-5; author reply 335-6.

BACKGROUND: Until now, in the absence of direct microbiological evidence, the cause of the Plague of Athens has remained a matter of debate among scientists who have relied exclusively on Thucydides' narrations to introduce several possible diagnoses. A mass burial pit, unearthed in the Kerameikos ancient cemetery of Athens and dated back to the time of the plague outbreak (around 430 BC), has provided the required skeletal material for the investigation of ancient microbial DNA. OBJECTIVE: To determine the probable cause of the Plague of Athens. METHOD: Dental pulp was our material of choice, since it has been proved to be an ideal DNA source of ancient septicemic microorganisms through its good vascularization, durability and natural sterility. RESULTS: Six DNA amplifications targeted at genomic parts of the agents of plague (Yersinia pestis), typhus (Rickettsia prowazekii), anthrax (Bacillus anthracis), tuberculosis (Mycobacterium tuberculosis), cowpox (cowpox virus) and cat-scratch disease (Bartonella henselae) failed to yield any product in 'suicide' reactions of DNA samples isolated from three ancient teeth. On the seventh such attempt, DNA sequences of Salmonella enterica serovar Typhi were identified providing clear evidence for the presence of that microorganism in the dental pulp of teeth recovered from the Kerameikos mass grave. CONCLUSION: The results of this study clearly implicate typhoid fever as a probable cause of the Plague of Athens.

PMID: 16412683 [PubMed - indexed for MEDLINE]

348. J Fr Ophtalmol. 2005 Nov;28(9):968-75.

[Abrupt visual loss in children. Three case studies of ocular bartonellosis].

[Article in French]

Depeyre C, Mancel E, Besson-Leaud L, Goursaud R.

Service d'Ophtalmologie, CHT de Nouméa. oboulaba@voila.fr

PURPOSE: To evaluate the severity and progression of neuroretinitis in children caused by Bartonella. PATIENTS AND METHODS: Retrospective study of three consecutive cases. Patients underwent ophthalmological, medical, and radiological evaluations. Bartonella serology was positive. Intravenous treatment was started immediately with antibiotics and steroids. Patients were re-evaluated after visual acuity recovery. RESULTS: Progression was quickly positive with fosfomycin and fluoroquinolones in all cases. CONCLUSION: Bartonella induces neuroretinitis even without systemic signs of cat-scratch disease, with sometimes sudden bilateral blindness. Long-term progression is good but urgent medical treatment is necessary.

PMID: 16395224 [PubMed - indexed for MEDLINE]

349. J Fr Ophtalmol. 2005 Dec;28(10):e10.

[Multifocal chorioretinitis, papillitis, and recurrent optic neuritis in cat-scratch disease].

[Article in French]

Mennel S, Meyer CH, Schroeder FM.

Department of Ophthalmology, Philipps-University Marburg, Marburg, Germany. stefan.mennel@lycos.com

To evaluate the causative factor for multifocal chorioretinitis, papillitis, and recurrent optic neuritis. A 41-year-old patient presenting multifocal choroiditis, papillitis, and recurrent optic neuritis was evaluated with funduscopy, angiography (FA), optical coherence tomography (OCT), visual evoked potentials (VEP), and numerous blood laboratory tests. FA and OCT showed multifocal pigment epithelial detachments. VEP showed typical changes for optic neuritis and papillitis. Indirect fluorescent antibody assay disclosed Bartonella henselae. Although cat-scratch disease frequently presents with optic neuritis or neuroretinitis, additional multifocal chorioretinal lesions associated with serous pigment epithelial detachments may occur. In case of recurrent episodes, a detailed laboratory work-up is mandatory to define the appropriate diagnosis and treatment.

PMID: 16395190 [PubMed - indexed for MEDLINE]

350. Pediatr Infect Dis J. 2006 Jan;25(1):90-1.

Bartonella henselae infection associated with Guillain-Barre syndrome.

Massei F, Gori L, Taddeucci G, Macchia P, Maggiore G.

Dipartimento di Medicina della Procreazione e della Età Evolutiva, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy.

This is the first report of Guillain-Barré syndrome (GBS) related to Bartonella henselae infection. A 10-year-old girl had difficulty walking and marked myalgia. The search for all causes known to trigger GBS was negative. She was treated with intravenous immunoglobulins and recovered. Because she lived in a rural area and had a history of kitten contact, a specific serology for B. henselae infection was performed and confirmed an ongoing infection. She did not show any clinical typical feature of cat-scratch disease. B. henselae infection should be considered in the wide etiologic spectrum of GBS.

PMID: 16395116 [PubMed - indexed for MEDLINE]

351. Lin Chuang Er Bi Yan Hou Ke Za Zhi. 2005 Sep;19(18):820-2.

[Cat-scratch disease].

[Article in Chinese]

Jiang G, Guo M, Wen Z.

Department of Otolaryngology, the Second Affiliated Hospital, Nanfang Medical University, Guangzhou, 510282, China. jiangali6370@163.com

OBJECTIVE: To study the etiology, epidemiology, clinical and pathological features, diagnose and treatment of cat-scratch disease(CSD). METHOD: The clinical information of 1 case was reported and the literatures were also reviewed. RESULT: Bartonella henselae was the primary pathogen of CSD. Almost all patients with CSD were in contact with animals, especially cat or dog before the occurrence of the disease. All the patients had the self-limited swelling of local lymph nodes and commonly a fever. The pathological feature was necrotic granulation-like micro abscessation, and a pleomorphous argyrophil G- bacillus could be showed by Warthin-Starry or Brown-Hopp stainings in the swelling lymph nodes. CONCLUSION: CSD is a self-limited bacterial infectious disease. And its clinical features,biopsy and special stainings of swelling lymph nodes are helpful to the final diagnosis. Gentamicin, rifadin, ciprofloxacin, clarithromycin, bactrim, mitramycin, or resection of swelling lymph nodes had good effects on treating CSD.

PMID: 16375109 [PubMed - indexed for MEDLINE]

352. An Med Interna. 2005 Aug;22(8):400-1.

[Inguinal mass as presentation of cat-scratch disease].

[Article in Spanish]

Pinilla Moraza J, Labarga Echevarría P, Cachorro San Pedro I.

PMID: 16358433 [PubMed - indexed for MEDLINE]

353. Laryngorhinootologie. 2005 Dec;84(12):929-36; quiz 937-41.

[Cat-scratch disease as cause of Lymphadenitis colli].

[Article in German]

Wellinghausen N, Essig A.

Abteilung für Medizinische Mikrobiologie und Hygiene des Universitätsklinikums Ulm. nele.wellinghausen@medizin.uni-ulm.de

Cat-scratch Disease as Cause of Lymphadenitis colli. Cat-scratch disease is a frequent cause of lymphadenitis colli. It mainly affects children and adolescents younger than 21 years. Since the clinical picture is not characteristic, a history of contact to cats or kittens is highly valuable for diagnosing the disease. Major aspects of the disease concerning epidemiology, diagnostic procedures, clinical presentation and therapy are discussed.

PMID: 16358204 [PubMed - indexed for MEDLINE]

354. Pathol Res Pract. 2006;202(1):17-22. Epub 2005 Dec 13.

Plasmacytoid monocytes in cat scratch disease with special reference to the histological diversity of suppurative lesions.

Kojima M, Morita Y, Shimizu K, Itoh H, Masawa N, Nakamura S.

Department of Pathology and Clinical Laboratories, Gunma Cancer Center Hospital, Ohta, Japan. mkojima@gunma-cc.jp

It has been suggested that plasmacytoid monocytes (PMOs) play an essential role in T-cell-dependent immune response. Indeed, numerous PMOs are found in close topographical association with epithelioid cell granulomas in hypersensitivity-type granulomas, such as tuberculosis and sarcoidosis. The key pathologic process in cat scratch disease (CSD) usually involves a B-cell-associated granulomatous reaction. Histologically, CSD appears to exhibit a histopathologic diversity, including suppurative lesions without epithelioid cell granulomas (early lesion), in which the microabscesses were surrounded by monocytoid B-cells (MBCs), suppurative granulomas containing MBCs (intermediate lesion), and suppurative granulomas without MBCs (late lesion). However, the presence or absence of PMO in CSD has not been studied previously. We examined 14 cases of CSD. In early lesions, numerous clusters of PMO were detected in the MBCs. In intermediate lesions, both MBCs and PMOs were found to be decreased in number, while late lesions contained no or only a few MBCs and PMOs. Overall, these findings suggest that PMOs may play a role in MBC-associated granulomatous response and in hypersensitivity granulomatous response. Moreover, the association with MBCs and PMOs indicates a functional relationship of MBCs with PMOs in the formation of suppurative lesions in CSD.

PMID: 16352403 [PubMed - indexed for MEDLINE]

355. South Med J. 2005 Nov;98(11):1142-5.

Disseminated cat scratch disease with vertebral osteomyelitis and epidural abscess.

Abdel-Haq N, Abuhammour W, Al-Tatari H, Asmar B.

Children's Hospital of Michigan, 3901 Beaubien Blvd., Detroit, MI 48201, USA. nabdel@dmc.org

A 5-year-old boy with cat scratch disease presented with fever of unknown origin and osteomyelitis of the thoracic spine and epidural abscess. He did not have localizing signs or symptoms. Computed tomography of the abdomen, which was initially negative, showed hepatosplenic disease. Cat scratch disease has variable systemic presentations and should be included in the differential diagnosis of fever of unknown origin if an epidemiologic risk factor is present.

PMID: 16351038 [PubMed - indexed for MEDLINE]

356. Doc Ophthalmol. 2005 Mar-May;110(2-3):271-5.

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.

Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, Japan.

PURPOSE: To evaluate optic nerve function by pattern visual evoked potentials (VEPs) in eyes with optic disc swelling due to neuroretinitis associated with cat scratch disease (CSD). METHODS: Four eyes of four patients with marked optic disc swelling resembling optic neuritis but diagnosed serologically as CSD received systemic steroid treatment. VEPs elicited by black and white checkerboard stimuli created on a TV monitor were recorded before the treatment. RESULTS: The visual acuity (VA) in the affected eyes was decreased to 20/50 in two eyes and finger counting in two eyes at their initial visits. Ophthalmoscopic examination revealed neuroretinitis characterized by severe optic disc swelling, chorioretinal exudates, and macular edema in all eyes. Anti-Bartonella henselae serum antibody was markedly elevated in all patients confirming the diagnosis of CSD. The P100 of the transient VEPs was only mildly reduced without a delay in the implicit times in three eyes and only slightly delayed in the other eye. The steady-state VEPs were mildly reduced in two eyes and phase-reversed in other two eyes. The VA fully recovered after systemic steroid treatment in all patients. CONCLUSIONS: Although all examined patients showed marked swelling of the optic disc and visual decrease, the pattern VEPs were not affected as severely as in idiopathic optic neuritis. However, the degree of change of the pattern VEPs varied among patients.

PMID: 16328936 [PubMed - indexed for MEDLINE]

357. Eur J Intern Med. 2005 Dec;16(8):610-1.

Cat scratch disease encephalopathy in an immunocompetent patient.

Dyachenko P, Ziv M, Raz R, Chazan B, Lev A, Rozenman D.

Department of Dermatology, Ha'emek Medical Center, Afula, 18101, Israel. pavela4@hotmail.com

Cat scratch disease (CSD) is typically a self-limited regional lymphadenopathy in children and young adults that is caused by Bartonella henselae. The majority of CSD cases resolve spontaneously; however, many systemic complications have been described. We report an unusual case of CSD presenting as an epitrochlear arm mass and complicated by encephalopathy. Identification of B. henselae DNA in the affected lymph node and cerebrospinal fluid confirmed the diagnosis of CSD. Systemic antibiotic therapy was administered and the patient improved without any neurological deficit.

PMID: 16314249 [PubMed]

358. N Z Med J. 2005 Nov 25;118(1226):U1754.

Prevalence of human pathogens in cat and dog fleas in New Zealand.

Kelly P, Rolain JM, Raoult D.

Ross University School of Veterinary Medicine, Basseterre, St Kitts, West Indies. pkelly@rossvet.edu.kn

AIMS: To provide further information on the prevalence of Rickettsia felis, Bartonella hensela, and B. clarridgeiae in cat and dog fleas in New Zealand and their distribution in the country. METHODS: We used PCR and sequencing with primers for the its and pap 31 (for Bartonella spp.), and the gltA and OmpB (for Rickettsia spp.) genes on DNA from fleas collected from dogs and cats presenting to 3 widely separated veterinary practices on the North Island. RESULTS: DNA of R. felis (19%), B. henselae (11%), and B. clarridgeiae (7%) was found in the 114 cat fleas (Ctenocephalides felis) we studied. The DNA of both B. henselae and B. clarridgeiae was found in 3 fleas (from 2 animals); B. clarridgeiae and R. felis in 1 flea; B. henselae and R. felis in 5 fleas (from 3 animals); and R. felis, B. henselae, and B. clarridgeiae in 2 fleas (from 1 animal). No amplicons were obtained from 3 dog fleas (Ctenocephalides canis). CONCLUSIONS: The emerging human pathogens, R. felis, B. henselae, and B. clarridgeiae, are prevalent and widely distributed in cat fleas in the North Island of New Zealand.

PMID: 16311612 [PubMed - indexed for MEDLINE]

359. Kansenshogaku Zasshi. 2005 Oct;79(10):826-8.

[Determination of antibody titer to Bartonella henselae by indirect fluorescence antibody assay using B. henselae from domestic cats as antigen].

[Article in Japanese]

Tsuneoka H, Ishida C, Tsukahara M.

Department of Clinical Laboratory, Yamaguchi-Kouseiren Nagato Hospital.

PMID: 16296330 [PubMed - indexed for MEDLINE]

360. J Feline Med Surg. 2006 Apr;8(2):85-90. Epub 2005 Nov 14.

Prevalence of Bartonella species, haemoplasma species, Ehrlichia species, Anaplasma phagocytophilum, and Neorickettsia risticii DNA in the blood of cats and their fleas in the United States.

Lappin MR, Griffin B, Brunt J, Riley A, Burney D, Hawley J, Brewer MM, Jensen WA.

Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, 80523, USA. mlappin@lamar.colostate.edu

Ctenocephalides felis were killed and collected from 92 cats in Alabama, Maryland, and Texas. The fleas and blood from the corresponding cat were digested and assessed in polymerase chain reaction assays that amplify DNA of Ehrlichia species, Anaplasma phagocytophilum, Neorickettsia risticii, Mycoplasma haemofelis, 'Candidatus M haemominutum' and Bartonella species. DNA consistent with B henselae, B clarridgeiae, M haemofelis, or 'Candidatus M haemominutum' was commonly amplified from cats (60.9%) and their fleas (65.2%). Results of this study support the recommendation to maintain flea control on cats in endemic areas.

PMID: 16290092 [PubMed - indexed for MEDLINE]

361. Ann Emerg Med. 2005 Nov;46(5):406, 423. Epub 2005 Jul 22.

Images in emergency medicine. Parinaud's oculoglandular syndrome.

Lemme KA, Seupaul RA.

Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.

PMID: 16271667 [PubMed - indexed for MEDLINE]

362. Arthritis Rheum. 2005 Nov;52(11):3611-7.

Cat-scratch disease-associated arthropathy.

Giladi M, Maman E, Paran D, Bickels J, Comaneshter D, Avidor B, Varon-Graidy M, Ephros M, Wientroub S.

Pridan Laboratory for Molecular Biology of Infectious Diseases, Ichilov Hospital, Tel-Aviv Sourasky Medical Center, 6 Weizman Street, Tel-Aviv 64239, Israel. mgiladi@zahav.net.il

Comment in Arthritis Rheum. 2006 Jul;54(7):2347-8.

OBJECTIVE: To characterize the articular manifestations of cat-scratch disease (CSD) and to evaluate the long-term clinical outcome of those manifestations. METHODS: A community- and hospital-based surveillance study of CSD was conducted in Israel between 1991 and 2002. CSD was defined as present in a patient when a compatible clinical syndrome and a positive confirmatory finding of Bartonella henselae (by serology and/or polymerase chain reaction) were identified. CSD patients with arthropathy (arthritis/arthralgia) that limited or precluded usual activities of daily living constituted the study group. Patients were followed up until > or =6 weeks after resolution of symptoms, or if symptoms persisted, for >/=12 months. CSD patients without arthropathy served as controls. RESULTS: Among 841 CSD patients, 24 (2.9%) had rheumatoid factor-negative arthropathy that was often severe and disabling. Both univariate and multivariate analyses identified female sex (67% of arthropathy patients versus 40% of controls; relative risk [RR] 2.5, P = 0.047), age older than 20 years (100% of arthropathy patients versus 43% of controls; RR 4.9, P = 0.001), and erythema nodosum (21% of arthropathy patients versus 2% of controls; RR 7.9, P = 0.001) as variables significantly associated with arthropathy. Knee, wrist, ankle, and elbow joints were most frequently affected. Ten patients (42%) had severe arthropathy in the weight-bearing joints, which substantially limited their ability to walk, and 4 of these patients were hospitalized. All of the patients had regional lymphadenopathy, 37.5% had nocturnal joint pain, and 25% had morning stiffness. Nineteen patients (79.2%) recovered after a median duration of 6 weeks (range 1-24 weeks), whereas 5 patients (20.8%) developed chronic disease persisting 16-53 months (median 30 months) after the onset of arthropathy. CONCLUSION: This is the first comprehensive study of arthropathy in CSD. CSD-associated arthropathy is an uncommon syndrome affecting mostly young and middle-age women. It is often severe and disabling, and may take a chronic course.

PMID: 16255053 [PubMed - indexed for MEDLINE]

363. J Korean Med Sci. 2005 Oct;20(5):888-91.

Detection of bartonella henselae DNA by polymerase chain reaction in a patient with cat scratch disease: a case report.

Chung JY, Han TH, Kim BN, Yoo YS, Lim SJ.

Department of Pediatrics, Sanggyepaik Hospital, Inje University College of Medicine, Seoul, Korea. pedchung@sanggyepaik.ac.kr

We report a case of cat scratch disease caused by Bartonella henselae in Korea. A 25-yr-old woman developed left cervical lymphadenopathy with history of contact with a dog. The cervical lymphadenopathy persisted for 1 month and resolved gradually and spontaneously. Serologic test was not done during the acute stage of the disease. Immunofluorescent antibody test performed during the convalescent stage was positive for B. henselae. To confirm B. henselae infection, polymerase chain reaction (PCR) analysis using aspirates of cervical lymph node was performed and the presence of B. henselae DNA was demonstrated. This is the first reported case of cat scratch disease in Korea confirmed by PCR for B. henselae DNA.

PMCID: PMC2779292 PMID: 16224169 [PubMed - indexed for MEDLINE]

364. N Engl J Med. 2005 Sep 29;353(13):1387-94.

Case records of the Massachusetts General Hospital. Case 30-2005. A 56-year-old man with fever and axillary lymphadenopathy.

Koehler JE, Duncan LM.

Division of Infectious Diseases, University of California at San Francisco, San Francisco, USA.

PMID: 16192484 [PubMed - indexed for MEDLINE]

365. Scand J Infect Dis. 2005;37(10):723-30.

Bartonella spp. seroprevalence in healthy Swedish blood donors.

McGill S, Wesslén L, Hjelm E, Holmberg M, Auvinen MK, Berggren K, Grandin-Jarl B, Johnson U, Wikström S, Friman G.

Infectious Diseases, Uppsala University Hospital, Uppsala.

Serum samples were collected from healthy blood donors in 5 regions in Sweden in 1999, i.e. from the local Blood Centres (collecting facilities) in Boden, Jönköping, Lund, Skövde, and Uppsala. In total, 498 serum samples (63% males, 37% females) were received and tested by immunofluorescence assay for antibodies against B. elizabethae, B. grahamii, B. henselae (Houston-1), B. henselae (Marseille), B. quintana, and B. vinsonii subsp. vinsonii. An overall Bartonella spp. seroprevalence of 16.1% was found, with a predominance of immunoreactivity to B. elizabethae, at 14.1%; B. grahamii, 2.6%; B. henselae (Houston-1), 1.2%; B. henselae (Marseille), 1.8%; B. quintana, 0.2%; and B. vinsonii subsp. vinsonii, 0.0%. Univariate and multivariate analyses of epidemiological and demographical information revealed an increased rate of B. elizabethae seropositivity in blood donors working outdoors, being out in the wild a minimum of once a week, hunting moose, having cat contact, and travelling to Eastern Europe. Living in the southern region of Sweden (Lund area) was associated with decreased seropositivity to B. elizabethae.

PMID: 16191889 [PubMed - indexed for MEDLINE]

366. Blood. 2006 Jan 15;107(2):454-62. Epub 2005 Sep 27.

Role of dendritic cell-derived CXCL13 in the pathogenesis of Bartonella henselae B-rich granuloma.

Vermi W, Facchetti F, Riboldi E, Heine H, Scutera S, Stornello S, Ravarino D, Cappello P, Giovarelli M, Badolato R, Zucca M, Gentili F, Chilosi M, Doglioni C, Ponzi AN, Sozzani S, Musso T.

Department of Pathology and the Section of General Pathology and Immunology, University of Brescia, Italy.

Dendritic cells (DCs) initiate adaptive immunity and regulate the inflammatory response by producing inflammatory chemokines. This study was aimed to elucidate their role in the pathogenesis of the suppurative granuloma induced by Bartonella henselae infection, which characterizes cat scratch disease (CSD). In vitro DC infection by B. henselae results in internalization of bacteria, phenotypic maturation with increased expression of HLA-DR and CD86, and induction of CD83, CD208, and CCR7. In comparison to LPS-activated DCs, B henselae-infected DCs produce higher amounts of IL-10, whereas the production of IL-12p70 is reduced. Infected DCs also produce high levels of CXCL8 and CXCL13, 2 chemokines active respectively on neutrophils and B lymphocytes. These results provide the molecular basis for the morphogenesis of CSD granuloma, which typically contains high numbers of neutrophils and B cells. Remarkably, CSD granulomas in vivo contain CXCL13-producing DCs. We further demonstrate that the B cells in CSD granulomas are represented by monocytoid B cells and, worth noting, they express T-bet, a transcription factor able to induce a T-independent immunoglobulin (Ig) class switch in B lymphocytes. These findings suggest that the humoral immune response to B henselae initiates in the extrafollicular areas of infected lymph nodes and is regulated by DCs.

PMID: 16189275 [PubMed - indexed for MEDLINE]

367. Bull Acad Natl Med. 2005 Mar;189(3):465-77; discussion 477-80.

[Zoonotic diseases caused by bacteria of the genus Bartonella genus: new reservoirs ? New vectors?].

[Article in French]

Chomel BB, Boulouis HJ.

Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, California 95616, USA. bbchomel@ucdavis.edu

Domestic animals and wildlife represent a large reservoir for bartonellae, at least eight species or subspecies of which have been reported to cause zoonotic infections. In addition, numerous orphan clinical syndromes are now being attributed to Bartonella henselae infection. Many mammalian species, including cats, dogs, rodents and ruminants are the main bartonellae reservoirs. Cats are the main reservoir for B. henselae. It appears that domestic dogs, at least in non tropical regions, are more likely to be accidental hosts than reservoirs, and constitute excellent sentinels for human infections. Bartonellae are vector-borne bacteria. The mode of B. henselae transmission by cat fleas is now better understood, but new potential vectors have recently been identified, including ticks and biting flies. This articles summarizes current knowledge of the etiology, new clinical features and epidemiological characteristics of these emerging zoonoses.

PMID: 16149211 [PubMed - indexed for MEDLINE]

368. Clin Infect Dis. 2005 Oct 1;41(7):969-74. Epub 2005 Aug 30.

Cat-scratch disease in elderly patients.

Ben-Ami R, Ephros M, Avidor B, Katchman E, Varon M, Leibowitz C, Comaneshter D, Giladi M.

Infectious Disease Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. rbenami1@zahav.net.il

BACKGROUND: Cat-scratch disease (CSD) is mostly contracted by children and young adults. To our knowledge, CSD in elderly patients has never been characterized, and it may be underrecognized in this age group. METHODS: The study population included all patients with CSD diagnosed at our reference laboratory during 1991-2002. Demographic, clinical, and laboratory data for patients with CSD aged >or=60 years (elderly group) were compared with data for patients with CSD aged <60 years (nonelderly group). RESULTS: There were 846 immunocompetent patients with CSD included in this study. Fifty-two patients (6%) were >or=60 years old. Lymphadenopathy was less common in elderly patients than in nonelderly patients (76.5% vs. 94.4%; P<.001), and general malaise was more frequent in elderly patients (70.8% vs. 51.4%; P=.009). Atypical CSD was more common in elderly patients than in nonelderly patients (32.7% vs. 13.6%), including endocarditis (odds ratio [OR], 61.6; P<.001), encephalitis (OR, 6.3; P=.013), and fever of unknown origin (OR, 7.3; P<.001). The time period from onset of symptoms to diagnosis was >6 weeks for 29.5% of elderly patients versus 13.3% of nonelderly patients (P=.003). CONCLUSIONS: CSD affects elderly persons as well as nonelderly persons, but clinical features differ between the patient groups. Atypical CSD, including endocarditis, is more frequent in elderly than in nonelderly patients. Conversely, lymphadenitis, the hallmark of typical CSD, is often absent in elderly patients. Lack of awareness among clinicians may delay the diagnosis of CSD in elderly persons and result in unnecessary and often invasive diagnostic procedures.

PMID: 16142661 [PubMed - indexed for MEDLINE]

369. Nihon Rinsho. 2005 Jul;63 Suppl 7:237-40.

[Diagnostic tests: Cat-scratch disease].

[Article in Japanese]

Maruyama S.

Laboratory of Veterinary Public Health, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University.

PMID: 16111236 [PubMed - indexed for MEDLINE]

370. J Bacteriol. 2005 Sep;187(17):6155-65.

Characterization of the genome composition of Bartonella koehlerae by microarray comparative genomic hybridization profiling.

Lindroos HL, Mira A, Repsilber D, Vinnere O, Näslund K, Dehio M, Dehio C, Andersson SG.

Department of Molecular Evolution, Evolutionary Biology Center, Norbyvägen 18C, 752 36 Uppsala, Sweden.

Bartonella henselae is present in a wide range of wild and domestic feline hosts and causes cat-scratch disease and bacillary angiomatosis in humans. We have estimated here the gene content of Bartonella koehlerae, a novel species isolated from cats that was recently identified as an agent of human endocarditis. The investigation was accomplished by comparative genomic hybridization (CGH) to a microarray constructed from the sequenced 1.93-Mb genome of B. henselae. Control hybridizations of labeled DNA from the human pathogen Bartonella quintana with a reduced genome of 1.58 Mb were performed to evaluate the accuracy of the array for genes with known levels of sequence divergence. Genome size estimates of B. koehlerae by pulsed-field gel electrophoresis matched that calculated by the CGH, indicating a genome of 1.7 to 1.8 Mb with few unique genes. As in B. quintana, sequences in the prophage and the genomic islands were reported absent in B. koehlerae. In addition, sequence variability was recorded in the chromosome II-like region, where B. koehlerae showed an intermediate retention pattern of both coding and noncoding sequences. Although most of the genes missing in B. koehlerae are also absent from B. quintana, its phylogenetic placement near B. henselae suggests independent deletion events, indicating that host specificity is not solely attributed to genes in the genomic islands. Rather, the results underscore the instability of the genomic islands even within bacterial populations adapted to the same host-vector system, as in the case of B. henselae and B. koehlerae.

PMCID: PMC1196136 PMID: 16109957 [PubMed - indexed for MEDLINE]

371. Diagn Mol Pathol. 2005 Sep;14(3):146-51.

Diagnosis of cat scratch disease with Bartonella henselae infection in formalin-fixed paraffin-embedded tissues by two different PCR assays.

Qian X, Jin L, Hayden RT, Macon WR, Lloyd RV.

Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN, USA.

Cat scratch disease (CSD) is commonly caused by Bartonella henselae infection. Clinical history and histologic findings are often insufficient to establish a definitive diagnosis of CSD. We retrospectively studied formalin-fixed, paraffin-embedded (FFPE) lymph nodes from 35 patients with histologically suspected CSD by 2 different PCR assays and immunohistochemistry (IHC). The first primer pair amplified a 163-bp fragment of the 16S rRNA gene in 19 of the 35 cases (54%). The second primer pair amplified a 191-bp fragment of the henselae citrate synthase (gltA) gene in 17 of the 35 cases (49%). IHC identified the organisms in 8 of 33 cases (24%). Fresh cultures of various Bartonella species showed a specific PCR product with an analytical sensitivity of 0.5 to 5 pg bacterial DNA. Bartonella species were identified by the unique size of the amplified PCR product. Twenty-two lymph nodes without morphologic evidence or a history of CSD were negative by PCR and immunostaining. Tissues from a patient with Legionella pneumophila were also negative by PCR and immunostaining for CSD supporting the specificity of the PCR reaction. The specific PCR products of the B. henselae were confirmed by sequencing. Human beta-actin for each case was amplified to check the integrity of the DNA. Our data indicate that detection of Bartonella DNA by PCR is useful to confirm the diagnosis of CSD.

PMID: 16106195 [PubMed - indexed for MEDLINE]

372. Infect Dis Clin North Am. 2005 Sep;19(3):691-711.

The expanded spectrum of bartonellosis in children.

Massei F, Gori L, Macchia P, Maggiore G.

Department of Procreative Medicine and Child Development, Division of Pediatrics, University of Pisa Hospital, Italy. f.massei@clp.med.unipi.it

Bartonella spp cause various clinical syndromes immunocompetent and immunocompromised hosts. Domestic cats are the natural reservoir, and vectors of B henselae. B henselae infection usually occurs early in childhood, is generally asymptomatic, and in most cases revolves spontaneously. It may, however, produce a wide spectrum of clinical symptoms, the most frequent feature being cat-scratch disease. Disseminated atypical B. henselae infection may follow cat-scratch disease alter a symptom-free period or may present de novo mimicking a wide range of clinical disorders. A careful clinical history researching an intimate contact with a kitten associated with a specific serology and an abdominal ultrasound for typical hepatosplenic involvement may follow a rapid and accurate diagnosis.

PMID: 16102656 [PubMed - indexed for MEDLINE]

373. Emerg Infect Dis. 2005 Aug;11(8):1287-9.

Bartonella quintana in domestic cat.

La VD, Tran-Hung L, Aboudharam G, Raoult D, Drancourt M.

Université de la Méditerranée-Unité des Rickettsies, CNRS UMR 6020, IFR 48, Marseille, France.

We recovered Bartonella quintana DNA from dental pulp of a domestic cat. This study, the first to detect B. quintana in a nonhuman mammal, changes our understanding of the epidemiology of this infection and proposes that cats may be an emerging source of human infection.

PMID: 16102321 [PubMed - indexed for MEDLINE]

374. BMC Infect Dis. 2005 Aug 12;5:63.

A nested-PCR with an Internal Amplification Control for the detection and differentiation of Bartonella henselae and B. clarridgeiae: an examination of cats in Trinidad.

Rampersad JN, Watkins JD, Samlal MS, Deonanan R, Ramsubeik S, Ammons DR.

Dept. of Life Sciences, The University of the West Indies, St. Augustine, Trinidad, Trinidad and Tobago. uwimdl@hotmail.com

BACKGROUND: Bartonella species are bacterial blood parasites of animals capable of causing disease in both animals and man. Cat-Scratch Disease (CSD) in humans is caused mainly by Bartonella henselae and is acquired from the cat, which serves as a reservoir for the bacteria. A second species, B. clarridgeiae is also implicated in the disease. Diagnosis of Bartonellosis by culture requires a week or more of incubation on enriched media containing blood, and recovery is often complicated by faster growing contaminating bacteria and fungi. PCR has been explored as an alternative to culture for both the detection and species identification of Bartonella, however sensitivity problems have been reported and false negative reactions due to blood inhibitors have not generally been addressed in test design. METHODS: A novel, nested-PCR was designed for the detection of Bartonella henselae and B. clarridgeiae based on the strategy of targeting species-specific size differences in the 16S-23S rDNA intergenic regions. An Internal Amplification Control was used for detecting PCR inhibition. The nested-PCR was utilized in a study on 103 blood samples from pet and stray cats in Trinidad. RESULTS: None of the samples were positive by primary PCR, but the Nested-PCR detected Bartonella in 32/103 (31%) cats where 16 were infected with only B. henselae, 13 with only B. clarridgeiae and 3 with both species. Of 22 stray cats housed at an animal shelter, 13 (59%) were positive for either or both species, supporting the reported increased incidence of Bartonella among feral cats. CONCLUSION: The usefulness of a single PCR for the detection of Bartonella henselae and B. clarridgeiae in the blood of cats is questionable. A nested-PCR offers increased sensitivity over a primary PCR and should be evaluated with currently used methods for the routine detection and speciation of Bartonella henselae and B. clarridgeiae. In Trinidad, B. henselae and B. clarridgeiae are the predominant species in cats and infection appears highest with stray cats, however B. clarridgeiae may be present at levels similar to that of B. henselae in the pet population.

PMCID: PMC1208886 PMID: 16098227 [PubMed - indexed for MEDLINE]

375. Pediatr Infect Dis J. 2005 Aug;24(8):700-4.

Epidemiology of cat-scratch disease hospitalizations among children in the United States.

Reynolds MG, Holman RC, Curns AT, O'Reilly M, McQuiston JH, Steiner CA.

Viral and Rickettsial Zoonoses Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA 30333, USA. nzr6@cdc.gov

BACKGROUND: Cat-scratch disease (CSD), caused by infection with Bartonella henselae, affects both children and adults but is principally a pediatric disease. Typical CSD is generally benign and self-limited and is characterized by regional lymphadenopathy with fever. Infections can, however, be accompanied by focal or diffuse inflammatory responses (atypical CSD) involving neurologic, organ (liver/spleen), lymphatic or skeletal systems. METHODS: Pediatric hospitalizations with CSD listed as a diagnosis were examined using the Kids' Inpatient Database for the year 2000. National estimates of CSD-associated hospitalizations, hospitalization rates and various hospitalization statistics were examined for patients younger than 18 years of age. RESULTS: During 2000, an estimated 437 (SE 43) pediatric hospitalizations associated with CSD occurred among children younger than 18 years of age in the United States. The national CSD-associated hospitalization rate was 0.60/100,000 children younger than 18 years of age (95% confidence interval, 0.49-0.72) and 0.86/100,000 children younger than 5 years of age (95% CI 0.64-1.07). Accompanying diagnoses included neurologic complications (12%), organ (liver/spleen) involvement (7%) and "other" (5%). Atypical CSD accounted for approximately 24% of the CSD-associated hospitalizations. The median charge for a CSD-associated hospitalization was 6140 dollars with total annual hospital charges of approximately 3.5 million dollars among children in the United States. CONCLUSIONS: The CSD-associated hospitalization rate among children during 2000 appeared similar to those estimated for the 1980s in the United States, despite significant increases in cat ownership in the intervening time. Early serologic and molecular testing for CSD in children is suggested to minimize unnecessary interventions and promote optimally effective care when supportive measures are required.

PMID: 16094224 [PubMed - indexed for MEDLINE]

376. J Clin Microbiol. 2005 Aug;43(8):3800-6.

Diagnosis of cat scratch disease with detection of Bartonella henselae by PCR: a study of patients with lymph node enlargement.

Hansmann Y, DeMartino S, Piémont Y, Meyer N, Mariet P, Heller R, Christmann D, Jaulhac B.

Service des Maladies Infectieuses et Tropicales, Hôpitaux Universitaires de Strasbourg, 1, Place de l'Hôpital, 67091 Strasbourg Cedex, France. Yves.Hansmann@chru-strasbourg.fr

Cat scratch disease (CSD) is mostly due to Bartonella henselae after inoculation of the organism through a skin injury. Since the causative bacteria cannot be easily cultured from human lymph node samples, the diagnosis usually relies on epidemiological, clinical, histological, and serological criteria (classical criteria). A study was performed to determine the diagnostic value of PCR analysis for the detection of B. henselae for the diagnosis of CSD and its place in the diagnostic strategy alongside the classical criteria. Over a 7-year period, lymph node biopsy specimens or cytopunctures from 70 patients were systematically tested by PCR for the presence of B. henselae DNA (htrA gene) in the Bacteriology Laboratory of the Hôpitaux Universitaires de Strasbourg. Serological testing by an immunofluorescence assay for B. henselae antibodies was also performed for each patient, and clinical, epidemiological, and histological data were collected. The patients were then divided into two groups according to the number of positive diagnostic criteria for CSD: 29 patients with definite CSD (two or more classical criteria) and 15 patients with possible CSD (less than two classical criteria). The remaining 26 patients for whom another diagnosis was retained were used as a control group. Among all criteria, PCR analysis had the best specificity (100%). The PCR assay for B. henselae was positive for 22 (76%; 95% confidence interval [CI95], 56.5 to 89.7%) of the 29 definite CSD patients and 3 (20%; CI95, 4.3 to 48.1%) of the 15 possible CSD patients. We then studied combinations of diagnostic criteria, including B. henselae PCR analysis. The best diagnostic performance was observed if at least two criteria were present among serologic, epidemiologic, histological, and molecular criteria.

PMCID: PMC1233974 PMID: 16081914 [PubMed - indexed for MEDLINE]

377. Diagn Microbiol Infect Dis. 2005 Sep;53(1):75-7.

Rapid identification of Bartonella henselae by real-time polymerase chain reaction in a patient with cat scratch disease.

Ciervo A, Mastroianni CM, Ajassa C, Pinto A, Ciceroni L.

Department of Infectious, Parasitic, and Immune-Mediated Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy. ciervo@iss.it

We report a localized submandibular lymph node infection in a patient with cat scratch disease. Directly performing real-time polymerase chain reaction assay on the biopsy sample, Bartonella henselae DNA was simultaneously detected and identified.

PMID: 16054323 [PubMed - indexed for MEDLINE]

378. Arch Pathol Lab Med. 2005 Aug;129(8):1065-6.

A 16-year-old adolescent boy with unilateral cervical lymphadenopathy suspicious for malignancy.

Barr YR, Qiu S.

Institute of Pathology and Cancer Research, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.

PMID: 16048405 [PubMed - indexed for MEDLINE]

379. Am J Ophthalmol. 2005 Jul;140(1):149-51.

Macular hole in cat scratch disease.

Albini TA, Lakhanpal RR, Foroozan R, Holz ER.

Baylor College of Medicine, Department of Ophthalmology, Houston, TX 77030, USA.

PURPOSE: To report the development of a macular hole as a complication of cat scratch disease. DESIGN: Case report. METHODS: A 10-year-old girl was seen with unilateral neuroretinitis from serologically confirmed cat scratch disease. Twelve days later, she developed a macular hole in the involved eye. Fundus photography and optical coherence tomography (OCT) were obtained at presentation and after the development of a macular hole. RESULTS: Fundus photography and OCT on presentation revealed a nasal neurosensory detachment and multiple inflammatory foci throughout the macula, including a subfoveal lesion. Fundus photography and OCT 12 days later revealed the development of a partial posterior vitreous detachment and a full thickness macular hole. CONCLUSIONS: Macular hole should be included among posterior segment complications of cat scratch disease. In this case, the macular hole was associated with partial vitreous detachment and a preexisting subfoveal lesion, likely representing an inflammatory focus.

PMID: 16038666 [PubMed - indexed for MEDLINE]

380. Emerg Infect Dis. 2005 Jul;11(7):1146-7.

Bartonella henselae and domestic cats, Jamaica.

Messam LL, Kasten RW, Ritchie MJ, Chomel BB.

PMID: 16032793 [PubMed - indexed for MEDLINE]

381. N Z Vet J. 1997 Oct;45(5):185-7.

Bartonella henselae bacteraemia in domestic cats from Auckland.

Joseph AK, Wood CW, Robson JM, Paul SL, Morris AJ.

Epsom Central Veterinary Centre, Epsom, Auckland, New Zealand.

Bartonella henselae causes most cases of cat scratch disease, a self-limited localised lymphadenopathy illness of humans. Bartonella henselae also causes disseminated cutaneous and visceral disease in immunocompromised people. Cat blood (1-5 ml) collected from cats in the Auckland area was processed and plated on to 5% sheep blood brain heart infusion agar and incubated at 35 degrees C in 5% CO2 for 14 days. Bartonella henselae was identified by colony morphology, Gram's stain, twitching motility, biochemical tests and molecular methods. Eight of 48 cats (17%) had Bartonella bacteraemia. Species-specific probes and biochemical profiles identified all isolates as B. henselae. Infected cats pose a risk to humans they lick, scratch or bite. People should be made aware of the risk cats pose.

PMID: 16031983 [PubMed]

382. Clin Pediatr (Phila). 2005 Jul-Aug;44(6):553.

Persistent abdominal pain.

Wilson M.

Division of Pediatric Gastroenterology, Blair E. Batson Hospital for Children, University of Mississippi Medical Center, Jackson, 39216, USA.

PMID: 16015406 [PubMed - indexed for MEDLINE]

383. Med Parazitol (Mosk). 2005 Apr-Jun;(2):44-8.

[Bartonellosis and a possible role of Ixodes ticks (family Ixodidae, order Parasitiformes) in the transmission of pathogenic Bartonella bacteria].

[Article in Russian]

Vasil'eva IS.

The papers reviews the literature on bartonellosis and a role of Ixodes ticks, including the representatives of the genus Ixodes, in the circulation and transmission of Bartonella bacteria. It shows that man can be infected with pathogenic Bartonella bacteria by the bite of ticks. The paper also presents data on tick-transmitted human and animal mixed infections, including bartonellosis.

PMID: 15984622 [PubMed - indexed for MEDLINE]

384. J Clin Microbiol. 2005 Jun;43(6):2651-5.

Novel chemically modified liquid medium that will support the growth of seven bartonella species.

Maggi RG, Duncan AW, Breitschwerdt EB.

Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 4700 Hillsborough Street, Raleigh, NC 27606, USA.

Bacteria of the genus Bartonella, a member of the Alphaproteobacteria, are fastidious, gram-negative, aerobic bacilli that comprise numerous species, subspecies, and subtypes. In human and veterinary medicine, species isolation remains a vital component of the diagnostic and therapeutic management of Bartonella infection. We describe a novel, chemically modified, insect-based liquid culture medium that supports the growth of at least seven Bartonella species. This medium will also support cocultures consisting of different Bartonella species, and it facilitated the primary isolation of Bartonella henselae from blood and aqueous fluid of naturally infected cats. This liquid growth medium may provide an advantage over conventional direct blood agar plating for the diagnostic confirmation of bartonellosis.

PMCID: PMC1151927 PMID: 15956379 [PubMed - indexed for MEDLINE]

385. 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]

386. Lancet. 2005 Jun 11-17;365(9476):2062.

A man with chest pain and glomerulonephritis.

Turner JW, Pien BC, Ardoin SA, Anderson AM, Shieh WJ, Zaki SR, Bhatnagar J, Guarner J, Howell DN, Woods CW.

Durham Veterans Affairs Medical Center and Duke University Medical Center, Durham, North Carolina, USA.

PMID: 15950721 [PubMed - indexed for MEDLINE]

387. J Oral Maxillofac Surg. 2005 Jun;63(6):869-72.

Cat scratch disease: an unusual cause of facial palsy and partial ptosis: case report.

Ganesan K, Mizen K.

Department of Oral and Maxillofacial Surgery, Leeds Dental Institute, Leeds Teaching Hospital NHS Trust, England. kandy71@yahoo.com

PMID: 15944991 [PubMed - indexed for MEDLINE]

388. Pediatr Infect Dis J. 2005 May;24(5):472-4.

Multifocal bone marrow involvement in cat-scratch disease.

Hipp SJ, O'Shields A, Fordham LA, Blatt J, Hamrick HJ, Henderson FW.

Departments of Pediatrics, University of North Carolina, Chapel Hill, NC 27599-7593, USA. shipp@unch.unc.edu

We describe 2 children with prolonged fever of unknown origin and prominent skeletal pain who had multifocal bone disease caused by Bartonella infection. Initial radiologic studies, including plain films, radionuclide scintigraphy and computed tomography, yielded negative results. In both cases, magnetic resonance imaging revealed multiple enhancing bone marrow lesions consistent with clinical symptoms. Microbiologic diagnoses were established serologically.

PMID: 15876956 [PubMed - indexed for MEDLINE]

389. Am J Trop Med Hyg. 2005 Apr;72(4):453-7.

Prevalence of Bartonella henselae in cats in Catalonia, Spain.

Pons I, Sanfeliu I, Quesada M, Anton E, Sampere M, Font B, Pla J, Segura F.

Infectious Diseases Program, Parc Taulí Hospital, Corporació Sanitària Parc Taulí, Sabadell, Barcelona, Spain. ipons@cspt.es

Bartonella henselae, an emerging pathogen bacterium, is the main causative agent of the cat scratch disease. While the first clinical descriptions were associated with immunosupressed patients, it is now more frequently observed in patients with normal immune status (endocarditis and bacteremia). Cats were found to be the only known reservoir of B. henselae. In this paper, we report the results obtained in the first study made to investigate the prevalence of B. henselae bacteremia and antibodies in domestic cats in Catalonia, Spain. Serum samples from 115 cats were tested for antibodies to B. henselae by immunofluorescent antibody testing, and 29.6% had a titer >or= 1:64. Seven B. henselae strains were isolated using standard culture techniques and amplification by a polymerase chain reaction and subsequent sequencing was performed on the intergenic spacer region between the 16 and 23S ribosomal RNA genes. Of all factors concerning the studied bacteremia rate (age, sex, habitat, presence of antibodies, contact with animals, parasites), only the presence of antibodies to B. henselae was statistically significant.

PMID: 15827285 [PubMed - indexed for MEDLINE]

390. Pediatrics. 2005 Apr;115(4):1112.

Detection of the Bartonella henselae gene sequence in lymph nodes of children with Kikuchi's disease.

Chung JY, Kim SW, Han TH, Lim SJ.

PMID: 15805408 [PubMed - indexed for MEDLINE]

391. Presse Med. 2005 Feb 26;34(4):297-8.

[Bartonella hensalae encephalopathy].

[Article in French]

Angibaud G, Balagué JP, Lafontan JF.

Service de neurologie, Clinique du Pont de Chaume, 82 017 Montauban, France.

INTRODUCTION: Bartonella hensalae is a poorly known cause of encephalopathy in young subjects. OBSERVATION: A 17 year-old adolescent was admitted in a state of emergency because of frequent convulsive seizures and inter-critical drowsiness. The diagnosis of encephalopathy was made on the association of these clinical signs and electro-encephalographic abnormalities. The presence of a cat in his home, a right axillary lymph node that had appeared in a context of fever, and positive serological kinetics related this encephalopathy to a bartonellosis. The course was good. DISCUSSION: Diagnosis of a Bartonella hensalae encephalopathy is based on a range of anamnesic, clinical and microbiological arguments. The potential interest of antibiotic therapy and its modalities remains to be established.

PMID: 15798550 [PubMed - indexed for MEDLINE]

392. N Z Vet J. 2004 Dec;52(6):352-7.

A review of bacterial pathogens in Ctenocephalides felis in New Zealand.

Kelly PJ.

Institute of Veterinary Animal and Biomedical Sciences, Massey University, Private Bag 11222, Palmerston North, New Zealand.

The cat flea, Ctenocephalides felis, is the recognised vector of Bartonella henselae, B. clarridgeiae and Rickettsia felis. Although these Gram-negative bacteria were only described in the last decade, they are already known to cause a variety of diseases in people, particularly children and the immunosuppressed. Such diseases include cat-scratch disease, bacillary angiomatosis, endocarditis, bacteraemia, encephalopathy, neuroretinitis, osteomyelitis and peliosis hepatis. Although most infections in cats and dogs appear to be subclinical, recent studies have provided growing evidence that the bartonellas can also cause serious problems in pets, including hepatitis, endocarditis, central nervous system (CNS) signs, lymphadenopathy, uveitis, cataracts and reproductive failure. In 2004, DNA of B. henselae, B. clarridgeiae and R. felis was demonstrated in cat fleas from New Zealand and pets and their owners in the country are thus at risk of infection. While flea control programmes have traditionally been advocated by veterinarians to prevent pruritus and tapeworms in pets, they should now also be recommended to prevent infections with the new flea-borne bacterial pathogens. To raise awareness of the organisms amongst veterinarians and animal health workers, this review describes: the biology of the organisms; clinical and laboratory features of infections in cats, dogs and people; diagnosis; and possible treatments and control of infections with these organisms.

PMID: 15768135 [PubMed]

393. Otolaryngol Head Neck Surg. 2005 Mar;132(3):353-8.

Cat-scratch disease: Otolaryngologic manifestations and management.

Ridder GJ, Boedeker CC, Technau-Ihling K, Sander A.

Department of Otorhinolaryngology-Head and Neck Surgery, University of Freiburg, Freiburg, Germany. ridder@hno.ukl.uni-freiburg.de

OBJECTIVE: The bacteria Bartonella henselae has been known as the principal causative agent of cat-scratch disease (CSD) since 1992. It is an important cause of infectious lymphadenopathies in the head and neck. Nevertheless, CSD often remains unrecognized in cases of cervicofacial lymph node enlargement. STUDY DESIGN: Between January 1997 and May 2003, we conducted a prospective clinical study including 721 patients with primarily unclear masses in the head and neck. RESULTS: CSD was diagnosed by serology and molecular investigations in 99 patients (13.7%; median age 33 years). Cervicofacial lymphadenopathy was the most common manifestation. Atypical manifestation of CSD including Parinaud's oculoglandular syndrome, swelling of the parotid gland and erythema nodosum were diagnosed in 8.1%, 8.1%, and 2.0% of cases, respectively. CONCLUSIONS: Our results demonstrate that CSD is a major cause of enlarged cervicofacial lymph nodes and should therefore be included in the differential diagnosis of lymphadenopathy in the head and neck region.

PMID: 15746844 [PubMed - indexed for MEDLINE]

394. Arch Pediatr. 2005 Mar;12(3):295-7.

[Erythema nodosum and adenopathy in a 15-year-old boy: uncommon signs of cat scratch disease].

[Article in French]

Sarret C, Barbier C, Faucher R, Lacombe P, Meyer M, Labbé A.

Service des urgences médicochirurgicales pédiatriques, pédiatrie A, Hôtel-Dieu, CHU de Clermont-Ferrand, boulevard Charles-de-Gaulle, 63058 Clermont-Ferrand cedex 01, France.

Erythema nodosum rarely occurs in childhood and can be caused by cat scratch disease, as a result of agent Bartonella henselae. We report the case of a teenager who presented erythema nodosum and bilateral inguinal adenitis. Cat scratch disease diagnosis was confirmed by anti-Bartonella henselae serologies. Despite an appropriate antibiotic therapy, evolution was unfavourable with adenitis abcédation requiring surgical drainage. CONCLUSION: Erythema nodosum in children must let think to cat scratch disease among others etiologies.

PMID: 15734128 [PubMed - indexed for MEDLINE]

395. Clin Microbiol Infect. 2005 Mar;11(3):167-9.

Bartonellosis: light and shadows in diagnostic and therapeutic issues.

Manfredi R, Sabbatani S, Chiodo F.

Cat-scratch disease involves a prolonged and/or complicated course, and lymph node drainage is usually required. Culture and molecular techniques often yield negative results, but immunofluorescence assays may give early information, and elevated antibodies may persist for months. Cat-scratch disease should be suspected in patients with prominent swelling of lymph nodes draining from the upper limbs, limited systemic involvement, and typical epidemiological-clinical features. The temporal antibody response during the sub-acute course remains unknown. Although biomolecular assays are available, the time between onset and investigation is an obstacle to positive results. The role of surgical debridement and the unpredictable activity of antimicrobial agents warrant further investigation.

PMID: 15715712 [PubMed - indexed for MEDLINE]

396. Clin Infect Dis. 2005 Mar 1;40(5):e43-5. Epub 2005 Feb 1.

Cat-scratch disease (ocular bartonellosis) presenting as bilateral recurrent iridocyclitis.

Martínez-Osorio H, Calonge M, Torres J, González F.

Ocular Immunology and Uveitis Unit, Institute of Ophthalmobiology (IOBA), University of Valladolid, Valladolid, Spain. calonge@ioba.med.uva.es.

An otherwise healthy 9-year-old girl presented with bilateral recurrent anterior uveitis. Thirteen months later, the diagnosis of cat-scratch disease (ocular bartonellosis) was suspected when neuroretinitis appeared. Confirmation was based on serological test results positive for Bartonella henselae. Antibiotic treatment completely cured the disease, and there have been no further manifestations during a follow-up period of 6 years.

PMID: 15714406 [PubMed - indexed for MEDLINE]

397. Nihon Jibiinkoka Gakkai Kaiho. 2004 Nov;107(11):1016-9.

[Newly emerging infections: Catscratch disease].

[Article in Japanese]

Harada T.

PMID: 15700401 [PubMed - indexed for MEDLINE]

398. Med Mal Infect. 2005 Jan;35(1):46-7.

[Cat-scratch disease].

[Article in French]

Roblot F.

Maladies infectieuses et tropicales, centre hospitalier Jean-Bernard-Milétrie, 2, rue de la Milétrie, BP 577, 86021 Poitiers cedex, France. froblot@chu-poitiers.fr

PMID: 15695034 [PubMed - indexed for MEDLINE]

399. Rev Prat. 2004 Nov 30;54(18):1982-6.

[Bartonellosis: emerging infection].

[Article in French]

Boulouis HJ, Chomel B.

Microbiologie-immunologie, Ecole nationale vétérinaire d'Alfort, 94704 Maisons-Alfort. hjboulouis@vet-alfort.fr

The spectrum of Bartonella infections in humans shows a constant increase. The number of Bartonella species responsible of zoonoses has increased from one to 7 during the past ten years. In addition numerous orphan clinical manifestations are now associated to Bartonella henselae infections. Animals and particularly domestic cat are the main reservoirs of Bartonella. Cats are healthy carriers of B. henselae and B. clarridgeiae, and can be bacteremic for months to years. Cat-to-cat transmission of the bacteria involves the cat flea in ab-sence of transmission by direct contact. Present knowledge on the etiology, clinical features and epidemiological characteristics of these emerging infections are presented.

PMID: 15673067 [PubMed - indexed for MEDLINE]

400. Microb Pathog. 2005 Jan;38(1):47-51. Epub 2004 Dec 8.

Molecular detection of Bartonella spp. in the dental pulp of stray cats buried for a year.

Aboudharam G, Vu DL, Davoust B, Drancourt M, Raoult D.

Unité des Rickettsies, CNRS UMR 6020, IFR 48, Faculté de Médecine, Université de la Méditerranée, 27, Boulevard Jean Moulin, Marseille Cedex 05 13385, France.

Bartonella henselae causes chronic bacteremia in cats. To test if B. henselae DNA can be recovered from the dental pulp of cats buried a year previously, we used PCR with primers for a sequence of the conserved groEL to test 104 teeth from 11 cats. Seven of the cats were found positive; canine teeth were more frequently positive than molar teeth. Where PCR sequences could be determined, they were identical to those of B. henselae Marseille (four cats), B. henselae Houston (one cat) or similar to those of B. grahamii (one cat). Our study indicates that dental pulp from the teeth of cats, especially the canine teeth, may be used for the PCR detection of Bartonella in animals buried for a year.

PMID: 15652295 [PubMed - indexed for MEDLINE]

401. Br J Biomed Sci. 2004;61(4):190-3.

Culture-negative Bartonella endocarditis in a patient with renal failure: the value of molecular methods in diagnosis.

Todd S, Xu J, Millar BC, Moore JE, Crowe M, Raoult D, Harrison T, Hill C, Douglas J.

Directorate of Nephrology, Belfast City Hospital, Belfast, Northern Ireland.

Members of the genus Bartonella are increasingly recognised as a cause of culture-negative endocarditis, particularly in those patients with underlying risk factors (e.g., homelessness and alcoholism (B. quintana) or valvulopathy and cat ownership (B. henselae). The aortic and mitral-valves are most commonly involved. Here, a case is reported of culture-negative right-sided endocarditis, without any of the above risk factors, due to Bartonella sp. in a 69-year-old man who presented with acute renal failure. The diagnosis was made using a broad-range 16S rRNA polymerase chain reaction (PCR) technique and direct automated sequencing on a peripheral blood sample, which was subsequently confirmed serologically. A review of the literature on Bartonella endocarditis is also presented. Molecular laboratory methods using peripheral blood or blood cultures may be very useful in the diagnosis of causal agents in culture-negative endocarditis and add further support to the recently inclusion of molecular (PCR) diagnosis, as a major Duke's criterion, for the diagnosis of infective endocarditis.

PMID: 15649011 [PubMed - indexed for MEDLINE]

402. J R Soc Med. 2005 Jan;98(1):28-9.

Visual loss after cat scratch.

Hu V, Dong B, MacFarlane A.

Maidstone Hospital, Maidstone ME16 2QQ, UK. victorhu@doctors.org.uk

PMCID: PMC1079239 PMID: 15632237 [PubMed - indexed for MEDLINE]

403. Am J Ophthalmol. 2004 Dec;138(6):1063-5.

Bartonella henselae infection presenting as a unilateral panuveitis simulating Vogt-Koyanagi-Harada syndrome.

Khurana RN, Albini T, Green RL, Rao NA, Lim JI.

Doheny Eye Institute, University of Southern California Keck School of Medicine, Los Angeles, California, USA.

PURPOSE: To report an unusual ocular manifestation of cat scratch disease. DESIGN: Observational case report. METHODS: Review of the clinical, laboratory, photographic, and angiographic records of a patient with cat scratch disease. RESULTS: A 54-year-old woman presented with counting fingers visual acuity in the right eye associated with optic disk edema, diffuse choroidal thickening, and panuveitis. Fluorescein angiography showed disk leakage and hyperfluorescent spots with late leakage suggestive of Vogt-Koyanagi-Harada disease. She was diagnosed with cat scratch disease by serum antibody titers and clinical course. CONCLUSIONS: Ocular manifestations of cat scratch disease can include diffuse thickening of the choroid. Cat scratch disease may manifest with angiographic features suggestive of Vogt-Koyanagi-Harada disease.

PMID: 15629311 [PubMed - indexed for MEDLINE]

404. Ear Nose Throat J. 2004 Nov;83(11):781-3.

Neck abscess secondary to cat-scratch disease.

Dean RL, Eisenbeis JF.

Department of Otolaryngology, St. Louis (Mo.) University Hospital, USA. rldeano@yahoo.com

A 7-year-old boy was referred to us for evaluation of an enlarging neck mass. The results of his primary care physician's initial clinical examination suggested lymphadenopathy secondary to lymphadenitis, and the patient was treated over a 4-week period with two rounds of antibiotics. However, the mass did not resolve, and it subsequently became fluctuant. The patient was referred to our institution, where we diagnosed cat-scratch disease.

PMID: 15628637 [PubMed - indexed for MEDLINE]

405. Semin Ophthalmol. 2004 Sep-Dec;19(3-4):125-6.

Late onset of serologic positive titers in a patient with Parinaud's oculoglandular syndrome.

Kymionis GD, Siganos CS, Pallikaris IG.

Department of Ophthalmology, University of Crete, Medical School, Heraklion, Greece. kymionis@med.uoc.gr

PURPOSE: To report a case of Parinaud's oculoglandular syndrome (POS) in which, despite the initially negative, a late onset of serologic positive titers was observed. METHODS: Case report. RESULTS: A 65-year-old man was examined for a foreign body in the left eye associated with granulomatous nodule on the palpebral conjuctiva, chemosis and a swollen preauricular lymph node. Despite the initially negative serologic titers to Bartonella henselae, a clinical diagnosis of POS was made and treatment was instituted initially with oral ciprofloxacin (500 mg twice a day). Three weeks later, serologic positive titers were found which confirmed the diagnosis of POS. CONCLUSION: Even though the improvements in diagnostic testing such as indirect immunofluorescence antibody, negative titles could be initially observed, confusing the diagnostic process. Other techniques (such as polymerase chain reaction (PCR) testing) should be also taken into consideration in cases with increased clinical suspicious of B. henselae indections.

PMID: 15590554 [PubMed - indexed for MEDLINE]

406. J Med Microbiol. 2004 Dec;53(Pt 12):1221-7.

The Bartonella henselae sucB gene encodes a dihydrolipoamide succinyltransferase protein reactive with sera from patients with cat-scratch disease.

Litwin CM, Johnson JM, Martins TB.

Section of Clinical Immunology, Microbiology and Virology, Department of Pathology, University of Utah, 50 N. Medical Drive, Salt Lake City, UT 84132, USA. Christine.Litwin@path.utah.edu

Bartonella henselae is a recently recognized pathogenic bacterium associated with cat-scratch disease, bacillary angiomatosis and bacillary peliosis. A recombinant clone expressing an immunoreactive antigen of B. henselae was isolated by screening a genomic DNA cosmid library by Western blotting with sera pooled from patients positive for B. henselae IgG antibodies by indirect immunofluorescence (IFA). The deduced amino acid sequence of the 43.7 kDa encoded protein was found to be 76.3 % identical to the dihydrolipoamide succinyltransferase enzyme (SucB) of Brucella melitensis. SucB has been shown to be an immunogenic protein during infections by Brucella melitensis, Coxiella burnetii and Bartonella vinsonii. The agreement between reactivity with a recombinant SucB fusion protein on immunoblot analysis and the results obtained by IFA was 55 % for IFA-positive sera and 88 % for IFA-negative sera. Cross-reactivity was observed with sera from patients with antibodies against Brucella melitensis, Mycoplasma pneumoniae, Francisella tularensis, Coxiella burnetii and Rickettsia typhi.

PMID: 15585501 [PubMed - indexed for MEDLINE]

407. Saudi Med J. 2004 Nov;25(11):1664-9.

Seroprevalence of Bartonella henselae and Bartonella quintana infections in children from Central and Northern Jordan.

Al-Majali AM, Al-Qudah KM.

Section of Infectious Diseases and Zoonosis, Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Jordan University of Science and Technology, PO Box 3030, Irbid 22110, Jordan. almajali@just.edu.jo

OBJECTIVE: To investigate the prevalence of antibodies to Bartonella henselae (B.henselae) and Bartonella quintana (B.quintana) among children from central and northern Jordan. METHODS: Sera from 482 children were randomly collected from referenced governmental hospitals in the central and northern parts of Jordan during the period between January 2001 to March 2003. An indirect immunofluorescent assay was used to determine serum antibody titers to B.henselae and B.quintana. Sera that were reactive at a dilution >/-1:64 were considered positive. In addition, blood from 20 cats belonged to children with high B.henselae titers were tested using polymerase chain reaction. RESULTS: Out of the 482 serum samples examined, 53 (11%) and 20 (4.1%) had positive antibody titers for B. henselae and B.quintana. Bartonella henselae was isolated from 4 cats that belonged to 3 children with high antibody titers to B.henselae-IgG. The seroprevalence of IgG antibodies to B.henselae was significantly higher (P<0.05) in children aged 7-10-years than in younger or older ones. Having a cat in the household and having a history of cat scratches or bites were strongly associated (P<0.01) with seropositivity to B.henselae-specific IgG. Cats ownership and history of cat scratches or bites had no impact on the prevalence of B.quintana. Seropositivity to B.henselae-specific IgG was significantly higher (P<0.01) in children from northern Jordan than in children from central Jordan. CONCLUSION: This study substantiates the presence of B.henselae in Jordan, documents the seroreactivity to 2 Bartonella antigens, and suggests that cat ownership and history of cat scratches or bites are important epidemiological risk factors for B.henselae infection in Jordan.

PMID: 15573198 [PubMed - indexed for MEDLINE]

408. Acta Microbiol Immunol Hung. 2004;51(3):321-32.

Bacterial models for tumor development. Mini-review.

Gyémánt N, Molnár A, Spengler G, Mándi Y, Szabó M, Molnár J.

Department of Medical Microbiology and Immunobiology, Faculty of Medicine, Szent-Györgyi Albert Medical Centre, University of Szeged, Dóm tér 10, H-6720 Szeged, Hungary.

The tumor-inducing effects of Agrobacterium, Bartonella and Helicobacter bacterial species are compared step by step. An analogy for the existence of these individual steps is considered in connection with the development of cancer. The transformations of eukaryotic cells occur in particular in the type IV secretion system, i.e. involving the simultaneous transmission of DNA and protein from bacterial cells to eukaryotic cells. Thus, transfected cells facilitate the indefinite growth of tissue cells and additionally produce growth factors, triggering further bacterial multiplication. The higher numbers of bacteria then produce more transfection and the cycle repeats as long as the host lives. The main limiting factor is the frequency of bacterial infection, while the secondary rate-limiting factors are the levels of transforming growth factors and factors triggering bacteria growth. CONCLUSIONS: Analogous processes are probably responsible for the tumor induction by the three different bacterial species; however, the critical points for eradication are different. The early eradication or limitation of B. henselae or H. pylori can prevent hemangiomas, stomach cancer and malignant cell proliferation. The crown gall formation by A. tumefaciens can only be avoided by prevention of the transforming activity of a single bacterial infection. Questions arise as to what is common in the three processes, and the nature of the rate-limiting step in the three different models. The frequency of transformation is the rate-limiting step, but the co-transmission of the DNA-protein complex is common in the three systems.

PMID: 15571072 [PubMed - indexed for MEDLINE]

409. Klin Mikrobiol Infekc Lek. 2004 Oct;10(5):207-13.

[Bartonelloses].

[Article in Czech]

Medková Z.

Dept. of Immunology, BIO-PLUS, Polní 23/25, 639-00 Brno, Czech Republic. zm.bioplus@volny.cz

Bartonellae belong to less known causal agents of many human diseases. They are gram-negative bacteria growing slowly on culture media enriched with hemin or bovine serum. The genus Bartonella, which currently involves more than 15 species, is present worldwide. Bartonellae live in natural foci in dependence on the occurrence of natural host (rodents, felines, canidae, human) and insect vector (flea, tick, louse). By reservoir animals they usually cause permanent intraerythrocytic bacteraemia without system inflammation symptoms. A classical example of a human disease is cat scratch disease (CSD) caused by Bartonella henselae and characterised by regional lymphagoitis and lymphadenitis. Increasing interest is being devoted to the ability of Bartonella sp. (e.i. B. quintana) to cause the opportune infections with diverse clinical manifestation: bacillary angiomatosis, specific liver and spleen vasculitis (peliosis hepatis, splenis), endocarditis and others. The issue of Bartonella infections is relatively new and its importance is still growing with increasing knowledge in this field.

PMID: 15558448 [PubMed - indexed for MEDLINE]

410. J Am Vet Med Assoc. 2004 Nov 1;225(9):1394-8.

Seroprevalences of antibodies against Bartonella henselae and Toxoplasma gondii and fecal shedding of Cryptosporidium spp, Giardia spp, and Toxocara cati in feral and pet domestic cats.

Nutter FB, Dubey JP, Levine JF, Breitschwerdt EB, Ford RB, Stoskopf MK.

Environmental Medicine Consortium and Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA.

OBJECTIVE: To compare seroprevalences of antibodies against Bartonella henselae and Toxoplasma gondii and fecal shedding of Cryptosporidium spp, Giardia spp, and Toxocara cati in feral and pet domestic cats. DESIGN: Prospective cross-sectional serologic and coprologic survey. ANIMALS: 100 feral cats and 76 pet domestic cats from Randolph County, NC. PROCEDURE: Blood and fecal samples were collected and tested. RESULTS: Percentages of feral cats seropositive for antibodies against B. henselae and T. gondii (93% and 63%, respectively) were significantly higher than percentages of pet cats (75% and 34%). Percentages of feral and pet cats with Cryptosporidium spp (7% of feral cats; 6% of pet cats), Giardia spp (6% of feral cats; 5% of pet cats), and T. cati ova (21% of feral cats; 18% of pet cats) in their feces were not significantly different between populations. Results of CBCs and serum biochemical analyses were not significantly different between feral and pet cats, except that feral cats had a significantly lower median PCV and significantly higher median neutrophil count. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that feral and pet cats had similar baseline health status, as reflected by results of hematologic and serum biochemical testing and similar prevalences of infection with Cryptosporidium spp, Giardia spp, and T. cati. Feral cats did have higher seroprevalences of antibodies against B. henselae and T. gondii than did pet cats, but this likely was related to greater exposure to vectors of these organisms.

PMID: 15552314 [PubMed - indexed for MEDLINE]

411. APMIS. 2004 Jun;112(6):336-41.

Identification of Bartonella species in rodents, shrews and cats in Denmark: detection of two B. henselae variants, one in cats and the other in the long-tailed field mouse.

Engbaek K, Lawson PA.

Department of Clinical Microbiology, Herlev University Hospital, Herlev, Denmark.

Small mammals and stray cats were trapped in two areas of North Zealand, Denmark, and their blood cultured for hemotrophic bacteria. Bacterial isolates were recovered in pure culture and subjected to 16S rDNA gene sequencing. Bartonella species were isolated from five mammalian species: B. grahamii from Microtus agrestis (field vole) and Apodemus flavicollis (yellow-necked field mouse); B. taylorii from M. agrestis, A. flavicollis and A. sylvaticus (long-tailed field mouse); B. tribocorum from A. flavicollis; B. vinsonii subsp. vinsonii from M. agrestis and A. sylvaticus; and B. birtlesii from Sorex vulgaris (common shrew). In addition, two variant types of B. henselae were identified: variant I was recovered from three specimens of A. sylvaticus, and B. henselae variant II from 11 cats; in each case this was the only B. henselae variant found. No Bartonella species was isolated from Clethrionomys glareolus (bank vole) or Micromys minutus (harvest mouse). These results suggest that B. henselae occurs in two animal reservoirs in this region, one of variant I in A. sylvaticus, which may be transmitted between mice by the tick Ixodes ricinus, and another of variant II in cats, which may be transmitted by the cat flea (Ctenocephalides felis). To our knowledge, this is the first report of the occurrence of B. henselae and B. tribocorum in Apodemus mice.

PMID: 15511270 [PubMed - indexed for MEDLINE]

412. Zhonghua Bing Li Xue Za Zhi. 2004 Oct;33(5):475-7.

[Cat scrach disease].

[Article in Chinese]

Ding HJ.

PMID: 15498227 [PubMed - indexed for MEDLINE]

413. Berl Munch Tierarztl Wochenschr. 2004 Sep-Oct;117(9-10):404-9.

[Screening for antibodies against zoonotic agents among employees of the Zoological Garden of Vienna, Schönbrunn, Austria].

[Article in German]

Juncker-Voss M, Prosl H, Lussy H, Enzenberg U, Auer H, Lassnig H, Müller M, Nowotny N.

Institut für Parasitologie und Zoologie, Department für Pathobiologie, Veterinärmedizinische Universität Wien.

The aim of this study was to investigate the prevalence of antibodies against zoonotic agents in employees of the zoological garden of Vienna, Schönbrunn, Austria. Sixty out of 120 employees participated in the study. In 97% of them antibodies to at least one zoonotic agent were identified. Only two participants were free of antibodies to the zoonotic agents tested. The following seroprevalences (in brackets) were obtained: Viral zoonotic (and potentially zoonotic) agents: Influenzavirus A/H1N1 (58%), Influenzavirus A/H3N2 (85%), Lymphocytic choriomeningitis virus (13%), Encephalomyocarditis virus (5%), Orthopox- (Cowpox-) virus and Hantavirus type Puumala (3%). Hantavirus type Hantaan and Borna disease virus (all negative). Bacterial zoonotic agents: Bartonella henselae (65 %), Borrelia burgdorferi (10%), Leptospira interrogans serovar copenhageni and serovar icterohaemorrhagiae as well as Chlamydophila psittoci (2% each). Brucella spp., Coxiella bumetii, and Francisella tularensis (all negative). Parasitic zoonotic agents: Toxoplasma gondii (53%), Toxocara spp. (21%), Capillaria hepatica (2%), Fasciola hepatica, Schistosoma mansoni, E. multilocularis, and E. granulosus (all negative). The remarkably high seroprevalence to the causative agent of cat scratch disease, Bartonella henselae, is probably due to the private contact of the employees to cats. Regarding viral zoonotic agents it has to be mentioned that Influenzavirus vaccination and/or human-to-human transmission of especially A/H3N2 Influenzaviruses probably attributed significantly to the very high seroprevalence to both Influenzavirus types A/H1N1 and A/H3N2. When investigating parasitic zoonotic agents, high prevalence rates were found against Toxoplasma gondii and Toxocara spp., however, it was not possible to establish a causal link between seropositivity and the professional activity in the zoo. Interestingly, in the case of antibodies to T. gondii, the typical correlation with age was not found in this study, while in the case of the Toxocara spp. positive subjects a correlation was identified with both age and duration of employment in the zoo. Regarding the later two zoonotic parasites, employees of the zoological garden showed significantly higher seroprevalences than the average Austrian population. Antibodies to Capillaria hepatica, a hepatic-parasite in rodents which is diagnosed in humans rarely, were identified in one employee and another one showed a questionable positive result. Further investigations did not exhibit clinical infestations with the parasite in these two individuals so far.

PMID: 15495931 [PubMed - indexed for MEDLINE]

414. Clin Infect Dis. 2004 Nov 1;39(9):1391-4. Epub 2004 Oct 12.

Molecular detection of Bartonella henselae DNA in the dental pulp of 800-year-old French cats.

La VD, Clavel B, Lepetz S, Aboudharam G, Raoult D, Drancourt M.

Unité des Rickettsies, Faculté de Medecine, Université de la Méditerranée, Marseille, France.

Bartonella species are responsible for chronic bacteremia in domestic cats, which raises a question about the antiquity of the relationship between Bartonella species and cats that act as reservoirs for the organism. The sequencing of Bartonella pap31 and groEL genes from the dental pulp of cats dating from the 13th to 16th centuries identified the presence of B. henselae genotype Houston; the observation of a unique mutation in the results of PCR assays for Bartonella species ruled out modern DNA contamination of the dental pulp samples. We conclude that cats had bacteremia due to B. henselae 800 years ago.

PMID: 15494918 [PubMed - indexed for MEDLINE]

415. Annu Rev Microbiol. 2004;58:365-90.

Molecular and cellular basis of bartonella pathogenesis.

Dehio C.

Division of Molecular Microbiology, Biozentrum, University of Basel, 4056 Basel, Switzerland. christoph.dehio@unibas.ch.

The genus Bartonella comprises several important human pathogens that cause a wide range of clinical manifestations: cat-scratch disease, trench fever, Carrion's disease, bacteremia with fever, bacillary angiomatosis and peliosis, endocarditis, and neuroretinitis. Common features of bartonellae include transmission by blood-sucking arthropods and the specific interaction with endothelial cells and erythrocytes of their mammalian hosts. For each Bartonella species, the invasion and persistent intracellular colonization of erythrocytes are limited to a specific human or animal reservoir host. In contrast, endothelial cells are target host cells in probably all mammals, including humans. Bartonellae subvert multiple cellular functions of human endothelial cells, resulting in cell invasion, proinflammatory activation, suppression of apoptosis, and stimulation of proliferation, which may cumulate in vasoproliferative tumor growth. This review summarizes our understanding of Bartonella-host cell interactions and the molecular mechanisms of bacterial virulence and persistence. In addition, current controversies and unanswered questions in this area are highlighted.

PMID: 15487942 [PubMed - indexed for MEDLINE]

416. Braz J Infect Dis. 2004 Jun;8(3):263-6. Epub 2004 Sep 29.

Acute hemiplegia associated with cat-scratch disease.

Rocha JL, Pellegrino LN, Riella LV, Martins LT.

Department of Infectious Disease, Nossa Senhora das Graças Hospital, Curitiba, PR, Brazil. jaimeluis@b.com.br

Cat scratch disease (CSD) is an infectious illness caused by a Gram-negative rod named Bartonella henselae. Typical CSD is characterized by a small skin lesion at the site of a scratch or a bite, followed by regional lymphadenopathy, one to two weeks later. Atypical forms may present as ocular manifestations, neurological manifestations, hepatosplenic involvement and vertebral osteomyelitis. Among neurological complications, encephalopathy is by far the most common. Other neurological manifestations are very rare. We report a case of an 11-year-old boy, with a posterior cervical lymphadenopathy and fever. Cat scratch disease was diagnosed and treated after a positive "Whartin-Starry" stain on lymph node biopsy. Two weeks after treatment, the patient was readmitted presenting an acute episode of left hemiplegia. A brain MRI demonstrated a right subcortical fronto-parietal lesion with no contrast enhancement. Complete recovery was observed after corticosteroid treatment.

PMID: 15476060 [PubMed - indexed for MEDLINE]

417. Arch Pediatr. 2004 Oct;11(10):1209-11.

[Sudden sight impairment revealing a cat-scratch disease: report of three cases].

[Article in French]

Besson-Leaud L, Mancel E, Missotte I, Morlat C, Menager C.

Service de pédiatrie, CHT de Magenta, BP J5, 98849 Nouméa, Nouvelle-Calédonie. laurentbessonleaud@hotmail.com

Cat-scratch disease is a frequent but innocuous cause of chronic lymphadenopathy in children. Numerous atypical forms have been described. We report three cases of acute sight impairment revealing a cat-scratch disease. BACKGROUND: A 13 year-old boy and two girls aged 10 and 13 suffered from a sudden bilateral sight impairment with papillary edema, with fever in two cases. Neurological examinations, X-rays and lumbar puncture results were found normal. However, all patients were tested positive to Bartonella Henselae. Antibiotic and anti-inflammatory treatments were efficient in two cases. CONCLUSION: Cat-scratch disease can be characterized by an isolated and acute sight impairment with a stellate neuroretinitis. The potency of antibiotic treatments is debatable.

PMID: 15475278 [PubMed - indexed for MEDLINE]

418. Ned Tijdschr Geneeskd. 2004 Aug 14;148(33):1636-41.

[Subcutaneous nodules with malignant presentation, but caused by infection].

[Article in Dutch]

Hermans SM, Schouten WE, Faber TE, Hoepelman IM, Andriesse GI.

Universitair Medisch Centrum, Afd. Interne Geneeskunde en Infectieziekten, Postbus 85.500, 350o8 GA Utrecht.

Three patients, a woman aged 32, a boy aged 6.5 and a man aged 56 years, presented with a subcutaneous mass suggesting a malignancy: respectively a rubbery swelling, painful to the touch below the left scapula, a partly massive, partly soft swelling on the inside of the left upper leg, and a non-fluctuating mass near the right eighth rib, parasternally. Additional diagnostic investigation revealed an infectious cause: respectively Mycobacterium tuberculosis, Bartonella henselae and Salmonella typhi. Antimicrobial therapy was successful. Subcutaneous masses suspected of being a benign or malignant tumour are sometimes caused by an infection. The differential diagnosis is extensive. Sometimes the travel anamnesis yields helpful information. It is concluded that besides histopathological examination, microbiological investigation can play a major role in the evaluation of subcutaneous masses.

PMID: 15455512 [PubMed - indexed for MEDLINE]

419. Mund Kiefer Gesichtschir. 2004 Nov;8(6):381-6. Epub 2004 Sep 9.

[Solitary nontuberculous mycobacterial infection of a cervical lymph node caused by Bartonella henselae (cat scratch disease)].

[Article in German]

Erbe M, Lindenfelser R.

Gemeinschaftspraxis für Mund-, Kiefer-, Gesichtschirurgie, Plastische Operationen, Aachen. M.Erbe@t-online.de

Cat scratch disease (CSD) is a common cause of subacute regional lymphadenopathy. Cats are the principal reservoir of Bartonella henselae, the etiologic agent in most cases of CSD. Because the histopathological findings are typical but not specific, a wide range of other agents must be considered in differential diagnosis. We report on a patient with a solitary swelling of the neck which remained over months with initial features suggestive of unspecific lymphadenitis, but who, after careful history taking and further serological testing, had cat scratch disease.

PMID: 15365888 [PubMed - indexed for MEDLINE]

420. J Infect Chemother. 2004 Aug;10(4):227-33.

Clinical implication of prolonged fever in children with cat scratch disease.

Tsujino K, Tsukahara M, Tsuneoka H, Ichihara K, Furuya T, Kawauchi S, Oga A, Sasaki K.

Department of Pathology, Yamaguchi University School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan. tsujino@yamaguchi-u.ac.jp

Cat scratch disease, caused by Bartonella henselae, typically presents with a localized lymphadenopathy with a brief period of fever and general symptoms. However, there are atypical cases with a wide spectrum of clinical manifestations including prolonged fever (> or =37.5 degrees C, for more than 7 days), or with systemic complication, or without lymphadenopathy. We analyzed relationships among those manifestations in children with cat scratch disease. A total of 127 patients were serologically diagnosed as having Bartonella infection between 1997 and 2003. Relationships among clinical manifestations were analyzed by use of multiple regression and multiple logistic regression analyses. Of the 127 seropositive cases, 75 (59.1%) had typical cat scratch disease and 52 (40.9%) had an atypical one. As atypical manifestations, 46 (36.2%) had prolonged fever, 23 (18.1%) had no lymphadenopathy, and 21 (16.5%) had complications: hepatic/splenic abscesses or low-echoic lesions, hepatic granuloma, and central nervous system involvements. Prolonged fever was observed in 20 (87%) of the 23 cases without lymphadenopathy and 16 (76.2%) of the 21 cases with complications. By multiple regression analysis, the duration of fever was significantly associated with both the absence of lymphadenopathy and the presence of complications. The child suffering from cat scratch disease without lymphadenopathy or with complication tends to have prolonged fever. Conversely, when a child has a prolonged fever of unknown origin, possibility of cat scratch disease should be considered, and a search for underlying systemic complications is recommended for prompt diagnosis and appropriate treatment.

PMID: 15365864 [PubMed - indexed for MEDLINE]

421. J Feline Med Surg. 2004 Oct;6(5):287-96.

Prevalence of infectious diseases in feral cats in Northern Florida.

Luria BJ, Levy JK, Lappin MR, Breitschwerdt EB, Legendre AM, Hernandez JA, Gorman SP, Lee IT.

Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 S.W. 16th Avenue, Box 100126, Gainesville, FL 32610, USA.

Objectives of this study were to determine prevalence of infection in feral cats in Northern Florida with a select group of infectious organisms and to determine risk factors for infection. Blood samples or sera from 553 cats were tested with a panel of antibody, antigen or PCR assays. Male cats were at higher risk for FIV, Mycoplasma haemofelis, and M. haemominutum. Infection with either FeLV or FIV was associated with increased risk for coinfection with the other retrovirus, M. haemofelis, or M. haemominutum. Bartonella henselae had the highest prevalence and was the only organism that did not have any associated risk for coinfection with other organisms. Feral cats in this study had similar or lower prevalence rates of infections than those published for pet cats in the United States. Thus, feral cats assessed in this study appear to be of no greater risk to human beings or other cats than pet cats.

PMID: 15363760 [PubMed - indexed for MEDLINE]

422. Kansenshogaku Zasshi. 2004 Jul;78(7):574-9.

[Evaluation of isolation media for the detection of Bartonella henselae--isolation of Bartonella henselae from domestic cats].

[Article in Japanese]

Tsuneoka H, Ishida C, Umeda A, Inokuma H, Tsukahara M.

Department of Clinical Laboratory, Yamaguchi-Kouseiren Nagato General Hospital.

Bartonella henselae is a causative agent of cat scratch disease. We preliminarily tested four media for the bacterial growth, including agar plates with sheep, horse or rabbit blood, and chocolate agar. Of these media, rabbit blood and chocolate agar plate were found to be more excellent for the growth than the medium with sheep or horse blood. Blood samples from 60 domestic cats in Yamaguchi Prefecture were then cultured using 7% rabbit blood agar plates and BACTEC9050 (BD), automated blood culture microbial detection system. B. henselae was isolated from six of the 60 (10%) blood samples. Tiny colonies of B. henselae were visible on the agar medium after one week of culture at 35 degrees C in the 5% CO2 atmosphere. BACTEC 9050 detected B. henselae in one of the 10 blood samples and it took two weeks to detect the bacteria automatically, though gram stain failed to show organisms in the blood culture bottle. In conclusion, rabbit blood or chocolate agar and incubation of agar media more than one week and of BACTEC more than two weeks are recommended for the detection of B. henselae.

PMID: 15359889 [PubMed - indexed for MEDLINE]

423. Arch Pediatr. 2004 Sep;11(9):1046-53.

[Hepatic abscesses in childhood: retrospective study about 33 cases observed in New-Caledonia between 1985 and 2003].

[Article in French]

Guittet V, Ménager C, Missotte I, Duparc B, Verhaegen F, Duhamel JF.

Service de pédiatrie, CHT Gaston-Bourret, 98800 Nouméa, Nouvelle-Calédonie. vguittet@caramail.com

Hepatic abscesses in childhood are rarely observed in Europe. The aim of this word was to study how to diagnose and how to treat an hepatic abscess.METHODS: Between 1985 and 2003, we recensed retrospectively 33 cases of hepatic abscesses hospitalised in the paediatric unit of Noumea. RESULTS: Children were mainly melanesians (79%), 7 years old on average, having abdominal pains, a clinical and biological infectious syndrome, and abscesses images on ultrasonography or computed tomography. The identified micro-organisms included Entamoeba histolytica in 30% (10 cases); Staphylococcus aureus in 15% (five cases), Staphylococcus coagulase negative in 6% (two cases), Streptococcus D in 3% (one case); Bartonella henselae in 9% (three cases); ascaris in 6% (two cases); Mycobacterium tuberculosis in 6% (two cases). In eight cases no bacteria was identified (24%) but the good evolution after antibiotics and the negative amoebic serology looked like pyogenic abscesses. Two abscesses were aspirated, two were drained, one child had a surgical intervention. There was no death. Following a mean duration of 1 month for antibiotics treatment, outcome was always favourable. CONCLUSION: Diagnosis of hepatic abscess can be difficult. Ultrasonography shows the abscess but not the causal agent. The amoebic serology is sensible, consequently, its negativity leads to evoke a pyogenic agent. Early antibiotic treatment against pyogenic, anaerobic bacteria, and Entamoeba histolytica is required. Hepatic abscesses in ascaridiosis, tuberculosis and cat-scratch disease are less frequently encountered. If diagnosis remains doubtful or clinical evolution worsens, or if abscess volume increases, a percutaneous aspiration or drainage is needed.

PMID: 15350993 [PubMed - indexed for MEDLINE]

424. Lancet. 2004 Aug 28-Sep 3;364(9436):758.

The right answer.

Avidor B, Giladi M.

Comment on Lancet. 2003 May 24;361(9371):1786.

PMID: 15337400 [PubMed - indexed for MEDLINE]

425. Vet Microbiol. 2004 Sep 8;102(3-4):183-8.

Pathogen carriage by the cat flea Ctenocephalides felis (Bouché) in the United Kingdom.

Shaw SE, Kenny MJ, Tasker S, Birtles RJ.

Department of Clinical Veterinary Science, University of Bristol, Langford House, Langford, North Somerset BS40 5DU, UK. susan.e.shaw@bristol.ac.uk

The carriage of Bartonella, Rickettsia felis and haemoplasma species was investigated in cat fleas (Ctenocephalides felis) collected from 121 cats and dogs in the United Kingdom. DNA extracted from fleas was analysed using genus and species-specific PCR and amplicons were characterised using DNA sequencing. Fifty percent of flea samples were PCR positive for at least one pathogen. Twenty one percent were positive for R. felis, 17% for Bartonella henselae, 40% for haemoplasma species and 20% were infected with more than one of the pathogen species studied. It is clear from the results in this study that companion cats and dogs are commonly infested with Ct. felis carrying bacterial pathogens of significance to human and animal health. These findings raise the possibility that Ct. felis found on dogs and cats are a potential source of infection with such pathogens for humans.

PMID: 15327793 [PubMed - indexed for MEDLINE]

426. Zhonghua Liu Xing Bing Xue Za Zhi. 2004 Jul;25(7):602-6.

[Study on Bartonella infection using molecular biological diagnostic techniques from China].

[Article in Chinese]

Li DM, Yu DZ, Liu QY, Hai R, Guo BH.

Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.

OBJECTIVE: To establish polymerase chain reaction (PCR) technique for the detection of specific genes related to species of genus Bartonella, and for diagnosing clinically suspected cat-scratch disease (CSD) case complicated with pneumonia on both lungs. The appearance of Bartonella infectious diseases calls for genus and species detection and tools for identification in order to make clinical diagnosis and carry on epidemiological studies. METHODS: One pair of primer TIle.455p-TAla.885n was designed based on the fact that tRNA(Ile)-tRNA(Ala) intergenic spacer region in 16S-23S rRNA intergenic spacer (ITS) of genus Bartonella were high variable sequences flanked by completely conserved tRNA-encoding genes. 16S-23S rRNA was longer than that which had been described in other bacteria. Two published pairs of primers were used to directly detect the specific gene fragments of Bartonella species DNA extracts from human blood, followed by PCR product Sequencing and nucleotide base sequence analysis. RESULTS: Amplification products of the three pairs of primers had the same predicted size of those in Bartonella spp. According to the different length of electrophoresis bank, the sample was identified as a species of genus Bartonella other than the positive control. Sequence analysis showed that the nuleotide sequence from the PCR product of primer TIle.455p-TAla.885n was identical to the Bartonella isolated from Yunnan in China. CONCLUSIONS: PCR-based assay provided a simple and rapid means to detect pathogenic Bartonella species in humans and mammalian hosts as well as in arthropod vecters. This study suggested that this pathogenic Bartonella species existed in patients in northern and southern parts of China.

PMID: 15308042 [PubMed - indexed for MEDLINE]

427. Scand J Infect Dis. 2004;36(6-7):494-5.

Cat-scratch disease presenting as a breast mass.

Godet C, Roblot F, Le Moal G, Roblot P, Frat JP, Becq-Giraudon B.

Departments of Infectious Diseases, University Hospital, Poitiers, France. c.godet@chu-poitiers.fr

The case of a 14-y-old girl who presented with a mass in her left breast after having contact with a guinea pig is presented. The diagnosis of cat-scratch disease was made by detection of Bartonella henselae DNA by PCR analysis of abscess aspirate.

PMID: 15307578 [PubMed - indexed for MEDLINE]

428. Parassitologia. 2004 Jun;46(1-2):127-9.

[Prevalence of Bartonella henselae in stray and domestic cats in different Italian areas: evaluation of the potential risk of transmission of Bartonella to humans].

[Article in Italian]

Fabbi M, Vicari N, Tranquillo M, Pozzi C, Prati P, De Meneghi D, Bertoletti I, Lauzi S, Guiso P, Genchi C.

Sezione diagnostica di Pavia, Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna via Taramelli, 7 27100 Pavia. mfabbi@bs.izs.it

Bartonella henselae is the major etiological agent of Cat Scratch Disease in humans. Cats act as the natural reservoir of B. henselae and can transmit the infection to humans by bite or scratch. The diffusion of B. henselae was evaluated by seroprevalence and bacteremic status in different stray cat populations located in nine areas of Northern Italy. A total of 1585 cats were tested by blood culture and 361 (23%) resulted bacteremic; 1416 out off 1585 cats were also tested for Bartonella henselae antibodies and 553 (39%) resulted seropositive. The molecular typing of the isolates showed that 26% of bacteremic cats were infected with B. henselae type I, 52% with B. henselae type II, 16% were co-infected with both and 5% infected with B. Clarridgeiae. Moreover 165 domestic cats were tested by blood culture and serological test (IFA test cut-off: 1:64). 35 cats (21%) resulted bacteremic and 49 (43.5%) were seropositive. The molecular typing of the Bartonella isolates of the domestic cats showed that 45% of bacteremic cats were infected with B. henselae type I, 36.5% with B. henselae type II, 12% were coinfected with both and 6% infected with B. Clarridgeiae. For a completely evaluation of health status of the cat for B. henselae infection, the authors suggest both blood culture and serological tests. Nevertheless a nonbacteremic cat with positive serology result should be reevaluated for possible recurrent bacteremia.

PMID: 15305701 [PubMed - indexed for MEDLINE]

429. Am J Clin Pathol. 2004 Jun;121 Suppl:S71-80.

Cat-scratch disease: historic, clinical, and pathologic perspectives.

Lamps LW, Scott MA.

Department of Pathology, University of Arkansas for Medical Sciences, Little Rock 72205, USA.

Cat-scratch disease (CSD) initially was described in 1931, but the etiologic agent (Bartonella henselae) was not elucidated until decades later. This disease is the most common cause of chronic lymphadenopathy among children and adolescents, characteristically manifesting as subacute regional lymphadenitis with an associated inoculation site due to a cat scratch or bite, often accompanied by fever. The hallmark histologic lesion is granulomatous inflammation with a central stellate microabscess. Numerous atypical manifestations of CSD have been described, and these often lack the characteristic superficial lymphadenopathy and inoculation site papule. These atypical forms may be misdiagnosed initially as other infectious processes or neoplasms. We present a review of the history and epidemiologic features of CSD, describe common and unusual clinicopathologic manifestations, and discuss current diagnostic modalities.

PMID: 15298152 [PubMed - indexed for MEDLINE]

430. J Clin Microbiol. 2004 Aug;42(8):3462-8.

Bartonella koehlerae, a new cat-associated agent of culture-negative human endocarditis.

Avidor B, Graidy M, Efrat G, Leibowitz C, Shapira G, Schattner A, Zimhony O, Giladi M.

The Bernard Pridan Laboratory for Molecular Biology of Infectious Diseases. Tel-Aviv Sourasky Medical Center, 6 Weizmann St., Tel-Aviv 64239, Israel. bavidor@tasmc.health.gov.il

Bartonella koehlerae is reported for the first time to be a human pathogen that causes culture-negative endocarditis. It is also shown that this species, isolated twice before from domestic cats, can be recovered as well from a stray cat population in Israel. This work follows a recent report of the same case in which the causative agent was misidentified as B. henselae, based on serology and PCR-restriction fragment length polymorphism (RFLP) analysis (A. Schattner, O. Zimhony, B. Avidor, and M. Gilad, Lancet 361:1786, 2003). B. koehlerae was identified in the valvular tissue of an endocarditis patient by DNA sequencing of the PCR products of two Bartonella genes: the genes for citrate synthase (gltA) and riboflavin synthase (ribC). The commonly used PCR-RFLP analysis of the TaqI-digested gltA PCR product did not distinguish between B. koehlerae and B. quintana or between B. elizabethae and B. clarridgeiae. PmlI digestion of the gltA amplification product failed to differentiate between B. quintana, B. clarridgeiae, and B. elizabethae. RFLP analysis of the heat shock protein (htrA) gene by TaqI digestion misidentified B. koehlerae as B. henselae. However, RFLP analysis of the ribC PCR product, digested with TaqI, was able to distinguish between the human endocarditis-associated Bartonella species tested, B. henselae, B. quintana, B. elizabethae, and B. koehlerae, as well as between the cat-associated Bartonella species, B. henselae and B. clarridgeiae. Given the expanding number of Bartonella species emerging as human pathogens, it is suggested that PCR-RFLP analysis for the diagnosis of Bartonella infections target several genes and be coupled with DNA sequencing to avoid species identification.

PMCID: PMC497599 PMID: 15297484 [PubMed - indexed for MEDLINE]

431. J Clin Microbiol. 2004 Jul;42(7):3346-9.

Evaluation of indirect fluorescence antibody assay for detection of Bartonella clarridgeiae and Seroprevalence of B. clarridgeiae among patients with suspected cat scratch disease.

Tsuneoka H, Umeda A, Tsukahara M, Sasaki K.

Department of Pathology, Yamaguchi University School of Medicine, Ube, Japan. htsuneoka@mx52.tiki.ne.jp

The possibility of Bartonella clarridgeiae being a causative agent of cat scratch disease (CSD) was investigated by using indirect fluorescence antibody assays with 288 suspected CSD patients. Immunoglobulin G antibody to noncocultivated B. clarridgeiae was suitable only for detection of B. clarridgeiae antibody. Significant cross-reactivity between Bartonella henselae and B. clarridgeiae was noted, and no CSD case caused by B. clarridgeiae was detected.

PMCID: PMC446241 PMID: 15243113 [PubMed - indexed for MEDLINE]

432. Prev Vet Med. 2004 Jun 10;64(1):63-71.

Seroprevalence of and risk factors for Bartonella henselae and Bartonella quintana infections among pet cats in Jordan.

Al-Majali AM.

Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan. almajali@just.edu.jo

To determine the seroprevalences of Bartonella henselae and Bartonella quintana antibodies in Jordanian pet cats, serum samples from 153 cats from three geographical regions were analyzed. Seroprevalences were determined by indirect immunofluorescence. The true seroprevalences to B. henselae and B. quintana were 32 and 1.5%, respectively. The seroprevalence of B. henselae-specific antibodies in cats from northern Jordan was significantly higher than in cats from the central or southern parts of Jordan. The seroprevalence to B. henselae increased to age 2 years. Odds of seropositivity were higher in cats living outdoors, showing hunting behavior, having a flea infestation and of a mixed breed. No association was detected with sex.

PMID: 15219970 [PubMed - indexed for MEDLINE]

433. Emerg Infect Dis. 2004 May;10(5):967-8.

Rickettsia felis, Bartonella henselae, and B. clarridgeiae, New Zealand.

Kelly PJ, Meads N, Theobald A, Fournier PE, Raoult D.

PMID: 15216855 [PubMed - indexed for MEDLINE]

434. Clin Tech Small Anim Pract. 2004 May;19(2):68-74.

Infection and blood transfusion: a guide to donor screening.

Reine NJ.

Bobst Hospital, Jaqua Transfusion Medicine Service, Animal Medical Center, 510 East 62nd Street, New York, NY 10021, USA. nyssa.reine@amcny.org

In recent years, blood-component therapy has become more accessible in veterinary practice. As with human medicine, care must be taken to minimize the risk of disease transmission from donor to recipient. Determining the appropriate diseases to screen for is complicated by regional variations in disease incidence, the existence of chronic carrier states for some diseases, the difficulty in screening-test selection, and testing cost. The feline diseases considered include retroviral infections, feline coronaviruses, ehrlichiosis (Ehrlichia canis-like), anaplasmosis (Anaplasma phagocytophilum), neorickettsiosis (Neorickettsia risticii), hemoplasmosis (Mycoplasma hemofelis and M. hemominutum, previously feline hemobartonellosis), and cytauxzoonosis (Cytauxzoon felis). The canine diseases considered in this paper include babesiosis (Babesia canis and B. gibsonii,) ehrlichiosis (E. canis and E. ewingii), anaplasmosis (A. phagocytophilum), neorickettsiosis (N. risticii var. atypicalis), leishmaniasis (Leishmania donovani complex), brucellosis (Brucella canis), hemoplasmosis (M. hemocanis, previously canine hemobartonellosis), and bartonellosis (Bartonella vinsonii).

PMID: 15179926 [PubMed - indexed for MEDLINE]

435. J Neuroophthalmol. 2004 Jun;24(2):186-7.

Cat scratch disease in two brothers.

Foroozan R.

PMID: 15179075 [PubMed - indexed for MEDLINE]

436. Infect Immun. 2004 Jun;72(6):3097-105.

Predominant outer membrane antigens of Bartonella henselae.

Chenoweth MR, Greene CE, Krause DC, Gherardini FC.

Department of Microbiology, University of Georgia, Athens 30602, USA.

A hallmark of Bartonella henselae is persistent bacteremia in cats despite the presence of a vigorous host immune response. To understand better the long-term survival of B. henselae in cats, we examined the feline humoral immune response to B. henselae outer membrane (OM) proteins in naturally and experimentally infected cats. Initially, a panel of sera (n = 42) collected throughout North America from naturally infected cats was used to probe B. henselae total membranes to detect commonly recognized antigens. Twelve antigens reacted with sera from at least 85% of cats, and five were recognized by sera from all cats. To localize these antigens further, OMs were purified on discontinuous sucrose density step gradients. Each membrane fraction (OM, hybrid or inner membrane [IM]) contained less than 1% of the total malate dehydrogenase activity (soluble marker), indicating very little contamination by cytoplasmic proteins. FtsI, an integral IM cell division protein, was used to identify the low-density fraction (rho = 1.13 g/cm3) as putative IM (<5% of the total FtsI localized to the high-density fraction) while lipopolysaccharide (LPS) and Pap31, a homolog of the Bartonella quintana heme-binding protein A (HbpA), defined the high-density fraction (rho = 1.20 g/cm3) as putative OM. Additionally, little evidence of cross-contamination between the IM and OM was evident by two-dimensional gel electrophoresis. When purified OMs were probed with feline sera, antigenic proteins profiles were very similar to those observed with total membranes, indicating that many, but not all, of the immunoreactive proteins detected in the initial immunoblots were OM components. Interestingly, two-dimensional immunoblots indicated that B. henselae LPS and members of the Hbp family of proteins did not appear to stimulate an humoral response in any infected cats. Seven proteins were recognized by at least 70% of sera tested, but only three were recognized by all sera. Nanospray-tandem mass spectrometry was used to identify OM components, including the immunodominant OM proteins. Recognition of the nonimmunogenic nature of the major OM components, such as LPS, and identification of the predominant immunogens should elucidate the mechanisms by which B. henselae establishes persistent bacteremic infections within cats. Additionally, the common antigens may serve as potential feline vaccine candidates to eliminate the pathogen from its animal reservoir.

PMCID: PMC415646 PMID: 15155610 [PubMed - indexed for MEDLINE]

437. Int J Med Microbiol. 2004 Apr;293(7-8):463-70.

Host cell modulation by human, animal and plant pathogens.

Andersson SG, Kempf VA.

Department of Molecular Evolution, Evolutionary Biology Center, Uppsala University, Uppsala, Sweden. Siv.Andersson@ebc.uu.se

Members of the alpha-proteobacteria display a broad range of interactions with higher eukaryotes. Some are pathogens of humans, such as Rickettsia and Bartonella that are associated with diseases like epidemic typhus, trench fever, cat scratch disease and bacillary angiomatosis. Others like the Brucella cause abortions in pregnant animals. Yet other species have evolved elaborate interactions with plants; in this group we find both plant symbionts and parasites. Despite radically different host preferences, extreme genome size variations and the absence of toxin genes, similarities in survival strategies and host cell interactions can be recognized among members of the alpha-proteobacteria. Here, we review some of these similarities, with a focus on strategies for modulation of the host target cell.

PMID: 15149019 [PubMed - indexed for MEDLINE]

438. J Am Vet Med Assoc. 2004 Apr 15;224(8):1270-9.

Cat scratch disease and other zoonotic Bartonella infections.

Chomel BB, Boulouis HJ, Breitschwerdt EB.

Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.

PMID: 15112775 [PubMed - indexed for MEDLINE]

439. Kansenshogaku Zasshi. 2004 Mar;78(3):270-3.

[A case of Bartonella henselae infection from a dog].

[Article in Japanese]

Yamanouchi H, Izumikawa K, Hisamatsu T, Yoshinaga M, Sasaki E, Izumikawa K, Hayakawa T, Hara K, Maruyama S, Ohtani H, Shimokawa I.

Izumikawa Hospital.

A 50-year-old male with left cervical lymphadenopathy visited our hospital. Infectious and lymphomatous diseases were suspected in the patient. Since the patient owned a dog, which often licked the patient's face, Bartonella infection was also suspected. Histopathological examination in the lymph node biopsy revealed the epithelioid granuloma, but B. henselae was not detected from the culture of the lymphnode. B. henselae DNA also was not detected from the lymph node. Since the antibody titer (lgG) to B. henselae showed 1:128 by immunofluorescent antibody technique (IFA), he was serdogicalg diagnosed as cat-scratch disease. 'Cat-scratch disease' is named after cat scratch, however we propose 'B. henselae infection' which is more appropriate since other animals could serve as a cause of infection.

PMID: 15103910 [PubMed - indexed for MEDLINE]

440. Vet Res. 2004 Mar-Apr;35(2):233-41.

Seroprevalence of Bartonella infection in American free-ranging and captive pumas (Felis concolor) and bobcats (Lynx rufus).

Chomel BB, Kikuchi Y, Martenson JS, Roelke-Parker ME, Chang CC, Kasten RW, Foley JE, Laudre J, Murphy K, Swift PK, Kramer VL, O'brien SJ.

Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA 95616, USA. bbchomel@ucdavis.edu

Bartonella henselae is the main agent of cat scratch disease in humans and domestic cats are the main reservoir of this bacterium. We conducted a serosurvey to investigate the role of American wild felids as a potential reservoir of Bartonella species. A total of 479 samples (439 serum samples and 40 Nobuto strips) collected between 1984 and 1999 from pumas (Felis concolor) and 91 samples (58 serum samples and 33 Nobuto strips) collected from bobcats (Lynx rufus) in North America, Central America and South America were screened for B. henselae antibodies. The overall prevalence of B. henselae antibodies was respectively 19.4% in pumas and 23.1% in bobcats, with regional variations. In the USA, pumas from the southwestern states were more likely to be seropositive for B. henselae (prevalence ratio (PR) = 2.82, 95% confidence interval (CI) = 1.55, 5.11) than pumas from the Northwest and Mountain states. Similarly, adults were more likely to be B. henselae seropositive than juveniles and kittens (PR = 1.77, 95% CI = 1.07, 2.93). Adult pumas were more likely to have higher B. henselae antibody titers than juveniles and kittens (p = 0.026). B. henselae antibody prevalence was 22.4% (19/85) in bobcats from the USA and 33.3% (2/6) in the Mexican bobcats. In the USA, antibody prevalence varied depending on the geographical origin of the bobcats. In California, the highest prevalence was in bobcats from the coastal range (37.5%). These results suggest a potential role of wild felids in the epidemiological cycle of Bartonella henselae or closely related Bartonella species.

PMID: 15099499 [PubMed - indexed for MEDLINE]

441. Ophthalmologe. 2005 May;102(5):524-6.

[Cotton wool spots in a 16-year-old girl].

[Article in German]

Pieh C, Ness T, Lagrèze WA.

Universitäts-Augenklinik Freiburg, Freiburg. pieh@aug.ukl.uni-freiburg.de

PMID: 15095109 [PubMed - indexed for MEDLINE]

442. Retina. 2004 Feb;24(1):176-8.

Retinal and optic nerve neovascularization associated with cat scratch neuroretinitis.

Mason JO 3rd.

Department of Ophthalmology, University of Alabama at Birmingham, 700 South 18th Street, Suite 505, Birmingham, AL 35233, USA. retinaconsultant@mindspring.com

PMID: 15076968 [PubMed - indexed for MEDLINE]

443. Acta Dermatovenerol Croat. 2004;12(2):92-5.

A child with Bartonella henselae osteomyelitis of the right humerus.

Ledina D, Rincić J, Ivić I, Marasović D, Ledina D.

Department of Infectious Diseases Split University Hospital Center, Soltanska 1, 21000 Split, Croatia. dragan.ledina@krizine.kbsplit.hr

We present a case of a 22-month-old child with swollen upper part of the right arm and osteolytic lesion of the right humerus, which resembled a neoplastic process. Epidemiological history revealed no scratch marks on the skin or cutaneous papule or pustule. Presumptive diagnosis of hematogenous osteomyelitis was established, but treatment with fusidic acid was unsuccessful. Histological examination of the bioptic specimen of the soft tissue swelling showed a lymph node morphology, with numerous granulomas with central stellate necrosis. Indirect immunofluorescence assay for Bartonella henselae yielded positive results. New treatment included 15 days of trimetoprime and sulfamethoxazole, followed by azithromycin for 5 days. Four months later, swelling resolved and osteolytic lesion almost completely healed with formation of surrounding sclerosis. In conclusion, cat-scratch disease without positive epidemiological history and primary cutaneous papule or pustule may be a serious diagnostic problem, but can be solved by serological and histological examination.

PMID: 15075043 [PubMed - indexed for MEDLINE]

444. J Clin Microbiol. 2004 Apr;42(4):1420-7.

Study of genotypes and virB4 secretion gene of Bartonella henselae strains from patients with clinically defined cat scratch disease.

Woestyn S, Olivé N, Bigaignon G, Avesani V, Delmée M.

Microbiology Unit, Faculty of Medicine, University of Louvain, B-1200 Brussels, Belgium. sophie.woestym@pi.be

Bartonella henselae is the causative agent of cat scratch disease (CSD), which usually presents as a self-limiting lymphadenopathy. Occasionally, the bacteria will spread and be responsible for tissue and visceral involvement. Two B. henselae genotypes (genotypes I and II) have been described to be responsible for uncomplicated CSD on the basis of 16S rRNA sequence analysis. A type IV secretion system (T4SS) similar to the virulence-associated VirB system of Agrobacterium tumefaciens was recently identified in the B. henselae Houston-1 genotype I strain. We studied the correlations of the B. henselae genotypes with the clinical presentations and with the presence of T4SS. Isolates originated from CSD patients whose lymph nodes were prospectively analyzed. B. henselae genotype I was identified in 13 of 42 patients (30%). Among these, two teenage twins presented with hepatosplenic CSD and one immunocompetent adult presented with osteomyelitis. Genotype II was detected in 28 of 42 patients (67%), all of whom presented with uncomplicated CSD. The last patient was infected with both genotypes. T4SS was studied by PCR amplification of the virB4 gene. Amplification of virB4 codons 146 to 256, 273 to 357, and 480 to 537 enabled us to detect 66, 90, and 100% of the B. henselae isolates, respectively. Sequence analysis revealed sequence variations that correlated with genotype distribution. Our studies suggest that B. henselae genotype I strains harbor virB4 genes that are different from those harbored by genotype II strains and that genotype I strains might be more pathogenic.

PMCID: PMC387542 PMID: 15070983 [PubMed - indexed for MEDLINE]

445. J Fr Ophtalmol. 2004 Mar;27(3):285-90.

[Cat-scratch disease neuroretinitis].

[Article in French]

Donnio A, Buestel C, Ventura E, Merle H.

Service d'Ophtalmologie, CHU, Hôpital Pierre Zobda-Quitman, BP 632, 97261 Fort de France. angelique.donnio-cordoba@wanadoo.fr

We report a case of cat-scratch disease neuroretinitis for which systemic and ocular investigations proved the responsibility of Bartonella henselae. An 11-year-old boy was referred to the hospital in November 2002 for severe visual loss in the left eye over the preceding 2 weeks. At the same time, he also developed a flu-like illness. The best corrected acuity in the left eye was counting fingers at 30 cm. Posterior segment examination on the left eye showed an optic disk edema with papillary and peripapillary hemorrhages and serous retinal detachment, mild vitreous inflammation, and two little perivascular white spots. The medical history was unremarkable except for a cat scratch on his left forearm 2 months before. Four weeks of antibiotic therapy including oral rifampin and doxycycline was used. Bartonella henselae immunoglobulin M were first detected with Bartonella henselae immunoglobulin G testing negative at this time. A 3-week serum showed immunoglobulin M seroreversion, while Bartonella henselae immunoglobulin G appeared. Other causes of optic disk edema with macular star were excluded by biological data. Bartonella antibodies to both Bartonella henselae and Bartonella clarridgeiae were detected in the cat. Ophthalmic follow-up showed progressive resorption of the neuroretinitis and the visual acuity increased to 5/10. The significance of this case report lies in the reminder that this pathology can be the cause of neuroretinitis; the prognosis can be improved by earlier treatment.

PMID: 15039632 [PubMed - indexed for MEDLINE]

446. J Fr Ophtalmol. 2004 Feb;27(2):179-83.

[Cat's cratch disease and Parinaud's oculoglandular syndrome].

[Article in French]

Escarmelle A, Delbrassine N, De Potter P.

Service d'Ophtalmologie, Cliniques Universitaires St Luc, UCL, 10, avenue Hippocrate, 1200 Bruxelles, Belgique.

By presenting this case report describing Parinaud's oculoglandular syndrome, we review the medical literature on its most frequent etiology: catscratch disease, a self-limited, systemic illness caused by a Gram-negative bacillus, Bartonella henselae, principally affecting children under 15 years of age. Typical symptoms include regional lymphadenopathy, fever, malaise, and fatigue, possibly with more severe complications such as splenomegaly, granulomatous hepatitis, and encephalopathy. Ocular manifestations may include follicular conjunctivitis, Parinaud's oculoglandular syndrome, neuroretinitis, optic neuritis, and chorioretinitis. Diagnosis is based on serologic tests, and when necessary, antimicrobial treatment can be considered.

PMID: 15029049 [PubMed - indexed for MEDLINE]

447. Pediatr Nephrol. 2004 Jun;19(6):682-4. Epub 2004 Mar 11.

Development of IgA nephritis following cat scratch disease in a 13-year-old boy.

Hopp L, Eppes SC.

Department of Pediatrics, Division of Nephrology, A.I. duPont Hospital for Children, 1600 Rockland Road, P.O. Box 269, Wilmington, DE 19899, USA. Lhopp@nemours.org

We describe a 13-year-old boy who presented with hematuria and intermittent low-grade proteinuria at the time when he was diagnosed with cat scratch disease. Two months before presentation, he had a negative urinalysis during a routine physical evaluation. He continued to have microscopic hematuria for the next 6 months, when he developed gross hematuria and recurrence of low-grade proteinuria. The renal biopsy showed evidence of mild/moderate IgA nephropathy. We speculate that the immunological changes associated with cat scratch disease in this patient may have triggered the development of IgA nephropathy. A history or serological evidence of infection with Bartonella henselae may need to be sought in patients presenting with IgA nephritis.

PMID: 15015065 [PubMed - indexed for MEDLINE]

448. Clin Diagn Lab Immunol. 2004 Mar;11(2):423-5.

Prevalence of Bartonella clarridgeiae and Bartonella henselae in domestic cats from France and detection of the organisms in erythrocytes by immunofluorescence.

Rolain JM, Locatelli C, Chabanne L, Davoust B, Raoult D.

Unité des Rickettsies CNRS UMR-A 6020, IFR 48, Faculté de Médecine, Université de la Méditerranée, 13385 Marseille Cedex 05, France.

The prevalence of Bartonella infection in a pet cat population from France was found to be 8.1% (8 of 99 cats). The intraerythrocytic location of Bartonella clarridgeiae is shown for the first time, and we show that immunofluorescence detection of the organism in erythrocytes correlates with the number of bacteria in blood.

PMCID: PMC371207 PMID: 15013998 [PubMed - indexed for MEDLINE]

449. Seizure. 2004 Apr;13(3):191-5.

Epilepsia partialis continua in cat scratch disease.

Puligheddu M, Giagheddu A, Genugu F, Giagheddu M, Marrosu F.

Department of Cardiovascular and Neurological Sciences, University of Cagliari, SS 554, Bivio Sestu, 09042 Monserrato, Cagliari, Italy.

Erratum in Seizure. 2006 Jul;15(5):357. Dosage error in article text.

Cat scratch disease (CSD) is a world-wide, diffuse, non-epidemic infection caused by the Gram-negative bacillus Bartonella henselae. The occurrence of encephalopathy represents an infrequent and atypical complication, whose manifestations include ischemic strokes, transverse myelitis and epileptic seizures. Status epilepticus has been described as the most frequent emergency in CSD encephalopathy. In this report, we describe a case of CSD complicated by an epilepsia partialis continua (EPC) manifested as rhythmic movements of the flexor muscles of the left hand. Although CSD is a benign, self-limited disease and a complete neurological recovery usually occurs, in the present case the EPC resulted in a partial epilepsy. Magnetic resonance imaging (MRI), single photon emission computed tomography (SPECT) and back-averaged EEG data recorded during myoclonic activity document this CSD complication.

PMID: 15010059 [PubMed - indexed for MEDLINE]

450. Microbiol Immunol. 2004;48(2):103-9.

First isolation of Bartonella henselae type I from a cat-scratch disease patient in Japan and its molecular analysis.

Maruyama S, Izumikawa K, Miyashita M, Kabeya H, Mikami T, Yamanouchi H, Sasaki E, Yoshida H, Izumikawa K.

Laboratory of Veterinary Public Health, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Kanagawa, Japan. maruyama@brs.nihon-u.ac.jp

We isolated Bartonella henselae from an inguinal lymph node of a 36-year-old male patient with cat-scratch disease. The patient had many areas of erythema on his body, swelling of the left inguinal lymph nodes with pain and slight fever. The diagnosis was made on the basis of polymerase chain reaction for B. henselae DNA from the lymph node biopsies and blood sample, and isolation of the organism, histology of the lymph node and serology with an indirect immunofluorescent antibody test. We also analyzed the genome profiles for five strains of 90 isolates from the lymph node by pulsed-field gel electrophoresis after Not I endonuclease digestion. We found two different genomic profiles. These results suggest that the patient had been either co-infected or re-infected with two genetically different strains of B. henselae.

PMID: 14978335 [PubMed - indexed for MEDLINE]

451. Eur Neurol. 2004;51(2):109-10. Epub 2004 Feb 11.

MR signal changes in a child with cat scratch disease encephalopathy and status epilepticus.

Ogura K, Hara Y, Tsukahara H, Maeda M, Tsukahara M, Mayumi M.

Department of Pediatrics, Faculty of Medicine, Obama Hospital, Fukui Medical University, Fukui 910-1193, Japan.

PMID: 14963382 [PubMed - indexed for MEDLINE]

452. J Clin Microbiol. 2004 Feb;42(2):652-9.

Prevalence, risk factors, and genetic diversity of Bartonella henselae infections in pet cats in four regions of the United States.

Guptill L, Wu CC, HogenEsch H, Slater LN, Glickman N, Dunham A, Syme H, Glickman L.

Department of Veterinary Clinical Sciences, Pathobiology Center for Applied Ethology and Human-Animal Interaction, Purdue University, West Lafayette, Indiana 47907, USA. guptillc@purdue.edu

Blood was collected from a convenience sample of 271 pet cats aged 3 months to 2 years (mean age, 8 months, median and mode, 6 months) between May 1997 and September 1998 in four areas of the United States (southern California, Florida, metropolitan Chicago, and metropolitan Washington, D.C.). Sixty-five (24%) cats had Bartonella henselae bacteremia, and 138 (51%) cats were seropositive for B. henselae. Regional prevalences for bacteremia and seropositivity were highest in Florida (33% and 67%, respectively) and California (28% and 62%, respectively) and lowest in the Washington, D.C. (12% and 28%, respectively) and Chicago (6% and 12%, respectively) areas. No cats bacteremic with B. clarridgeiae were found. The 16S rRNA type was determined for 49 B. henselae isolates. Fourteen of 49 cats (28.6%) were infected with 16S rRNA type I, 32 (65.3%) with 16S rRNA type II, and three (6.1%) were coinfected with 16S rRNA types I and II. Flea infestation was a significant risk factor for B. henselae bacteremia (odds ratio = 2.82, 95% confidence interval, 1.1 to 7.3). Cats >or=13 months old were significantly less likely to be bacteremic than cats

PMCID: PMC344466 PMID: 14766832 [PubMed - indexed for MEDLINE]

453. Appl Environ Microbiol. 2004 Feb;70(2):656-63.

Growth characteristics of Bartonella henselae in a novel liquid medium: primary isolation, growth-phase-dependent phage induction, and metabolic studies.

Chenoweth MR, Somerville GA, Krause DC, O'Reilly KL, Gherardini FC.

Laboratory of Human Bacterial Pathogenesis, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana 59840, USA.

Bartonella henselae is a zoonotic pathogen that usually causes a self-limiting infection in immunocompetent individuals but often causes potentially life-threatening infections, such as bacillary angiomatosis, in immunocompromised patients. Both diagnosis of infection and research into the molecular mechanisms of pathogenesis have been hindered by the absence of a suitable liquid growth medium. It has been difficult to isolate B. henselae directly from the blood of infected humans or animals or to grow the bacteria in liquid culture media under laboratory conditions. Therefore, we have developed a liquid growth medium that supports reproducible in vitro growth (3-h doubling time and a growth yield of approximately 5 x 10(8) CFU/ml) and permits the isolation of B. henselae from the blood of infected cats. During the development of this medium, we observed that B. henselae did not derive carbon and energy from the catabolism of glucose, which is consistent with genome nucleotide sequence data suggesting an incomplete glycolytic pathway. Of interest, B. henselae depleted amino acids from the culture medium and accumulated ammonia in the medium, an indicator of amino acid catabolism. Analysis of the culture medium throughout the growth cycle revealed that oxygen was consumed and carbon dioxide was generated, suggesting that amino acids were catabolized in a tricarboxylic acid (TCA) cycle-dependent mechanism. Additionally, phage particles were detected in the culture supernatants of stationary-phase B. henselae, but not in mid-logarithmic-phase culture supernatants. Enzymatic assays of whole-cell lysates revealed that B. henselae has a complete TCA cycle. Taken together, these data suggest B. henselae may catabolize amino acids but not glucose to derive carbon and energy from its host. Furthermore, the newly developed culture medium should improve isolation of B. henselae and basic research into the pathogenesis of the bacterium.

PMCID: PMC348914 PMID: 14766538 [PubMed - indexed for MEDLINE]

454. J Am Anim Hosp Assoc. 2004 Jan-Feb;40(1):6-12.

Bartonella: a new etiological agent of feline ocular disease.

Ketring KL, Zuckerman EE, Hardy WD Jr.

All Animal Eye Clinic, Cincinnati, Ohio 45249, USA.

PMID: 14736899 [PubMed - indexed for MEDLINE]

455. J Clin Microbiol. 2004 Jan;42(1):264-8.

Prevalence of Bartonella henselae in Italian stray cats: evaluation of serology to assess the risk of transmission of Bartonella to humans.

Fabbi M, De Giuli L, Tranquillo M, Bragoni R, Casiraghi M, Genchi C.

Sezione Diagnostica di Pavia, Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna "Bruno Ubertini," 27100 Pavia, Italy. mfabbi@bs.izs.it

Bartonella henselae is the major etiological agent of cat scratch disease in humans. Cats act as the natural reservoir of B. henselae and can transmit the infection to humans by a bite or scratch. The prevalence of B. henselae in cat populations was evaluated by serological and bacteriological tests. A total of 769 stray cats from three urban and three rural areas in northern Italy were sampled between January 1999 and December 2000. The positive and the negative predictive values of serological tests with respect to bacteremic status were evaluated. Tests of a total of 140 cats (18%) resulted in detection of bacteremia. A total of 540 cats were tested by serology; 207 (38%) were seropositive. Of the 531 cats tested by both methods, the results for 65 (12.2%) showed both bacteremia detection and seropositivity. The molecular typing of the isolates showed that 20.6% of bacteremic cats were infected with B. henselae type I strain, 61.1% were infected with B. henselae type II, and 18.3% were coinfected with both. A statistically significant difference in antibody and bacteremia prevalences among geographical areas was detected. Statistical analysis showed no association between characteristics such as seroprevalence-bacteremic status, sex, general health status, and the presence of ectoparasites. The negative predictive value of serological test was 84.7%, and the positive predictive value was 31.8%. Receiving operator characteristic analysis of the data showed that serological tests had a low predictive value in relation to the bacteremic status of a cat; in surveys aimed at assessing the real risk of B. henselae infection in a human population, therefore, we suggest the use of blood culture as the reference test. Nevertheless, both blood culture assays and serological tests for Bartonella infection should be performed for a complete evaluation of the health status of cats.

PMCID: PMC321649 PMID: 14715763 [PubMed - indexed for MEDLINE]

456. 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]

457. Clin Infect Dis. 2004 Jan 1;38(1):145-8. Epub 2003 Dec 5.

High prevalence of antibodies to Bartonella henselae among Italian children without evidence of cat scratch disease.

Massei F, Messina F, Gori L, Macchia P, Maggiore G.

Dipartimento di Medicina della Procreazione e dell'Età Evolutiva, Università di Pisa, Pisa, Italy.

Few data are available on the seroprevalence of antibodies to Bartonella henselae among children. We retrospectively evaluated the presence of immunoglobulin G and M class antibodies to B. henselae in 508 children living in central Italy who were apparently free of any features suggesting B. henselae infection. We found that B. henselae infection is common among children in central Italy, occurs early in life, is in most cases asymptomatic, and resolves spontaneously.

PMID: 14679462 [PubMed - indexed for MEDLINE]

458. Acta Ophthalmol Scand. 2003 Dec;81(6):653-7.

Neuroretinitis associated with cat-scratch disease in Japanese patients.

Kodama T, Masuda H, Ohira A.

Department of Ophthalmology, Shimane Medical University, Izumo, Shimane, Japan. fifa2002@shimane-med.ac.jp

PURPOSE: To clarify the prevalence and clinical profile of neuroretinitis associated with cat-scratch disease (CSD) in Japan. METHODS: Japanese patients were searched using a computer web site, Japana Centra Revuo Medicina. Location of patients, medical history, systemic and intraocular findings, treatments and visual outcome were examined. RESULTS: We reviewed 15 eyes of 14 patients, including our own case. Incidences of the disease were more common in summer than in winter and presented in the warmer parts of Japan. All patients had been previously healthy and had been exposed to cats or flea bites. Of the 14 patients, 13 (93%) had febrile illness and seven of these (54%) had lymphadenopathy. Uveitis and macular stars were observed in 11 of 15 eyes (73%). Most patients were treated with antibiotics and systemic steroids and visual prognoses were good. CONCLUSIONS: The clinical features of CSD-associated neuroretinitis in Japan are similar to those in other countries. Its distribution may correlate with the prevalence of Bartonella henselae-seropositive cats in Japan.

PMID: 14641271 [PubMed - indexed for MEDLINE]

459. Breast J. 2003 Nov-Dec;9(6):497-500.

An unusual case of cat-scratch disease from Bartonella quintana mimicking inflammatory breast cancer in a 50-year-old woman.

Povoski SP, Spigos DG, Marsh WL.

Division of Surgical Oncology, Department of Surgery, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Ohio State University, Columbus, Ohio 43210-1228, USA. povoski-1@medctr.osu.edu

Cat-scratch disease of the breast has been previously reported. This report describes a very unusual case of cat-scratch disease of the breast caused by Bartonella quintana in which the clinical and radiographic presentation mimicked that of inflammatory breast cancer.

PMID: 14616946 [PubMed - indexed for MEDLINE]

460. Emerg Infect Dis. 2003 Oct;9(10):1337-40.

Cat or dog ownership and seroprevalence of ehrlichiosis, Q fever, and cat-scratch disease.

Skerget M, Wenisch C, Daxboeck F, Krause R, Haberl R, Stuenzner D.

Division of Infectious Diseases, Department of Medicine, University Hospital Graz, Auenbruggerplatz 15, A-8036 Graz, Austria.

PMCID: PMC3033070 PMID: 14609477 [PubMed - indexed for MEDLINE]

461. J Clin Microbiol. 2003 Nov;41(11):5337-9.

Fatal case of endocarditis associated with Bartonella henselae type I infection in a domestic cat.

Chomel BB, Wey AC, Kasten RW, Stacy BA, Labelle P.

Department of Population Health and Reproduction, Veterinary Medicine Teaching Hospital, School of Veterinary Medicine, University of California, Davis, California 95616, USA. bbchomel@ucdavis.edu

We report the first feline case of Bartonella henselae endocarditis. Despite negative blood cultures, the cat had high Bartonella antibody titers and B. henselae type I DNA was detected in the damaged aortic valve. Microscopic examination of the valve revealed endocarditis with small silver positive coccoid structures in endothelial cells.

PMCID: PMC262472 PMID: 14605199 [PubMed - indexed for MEDLINE]

462. J Clin Microbiol. 2003 Nov;41(11):5071-9.

Characterization of the natural population of Bartonella henselae by multilocus sequence typing.

Iredell J, Blanckenberg D, Arvand M, Grauling S, Feil EJ, Birtles RJ.

Centre for Infectious Diseases and Microbiology, Westmead Hospital, University of Sydney, Sydney, New South Wales, Australia. joni@icpmr.wsahs.nsw.gov.au

Investigations of the population genetics of Bartonella henselae have demonstrated a high level of diversity among strains, and the delineation of isolates into one of two subtypes, type I (Houston) and type II (Marseille), represented by specific 16S ribosomal DNA (rDNA) sequences, has long been considered the most significant genotypic division within the species. This belief is challenged by recent work suggesting a role for horizontal gene exchange in generating intraspecies diversity. We attempted to resolve this issue and extend exploration of the population structure of B. henselae by using multilocus sequence typing (MLST) to examine the distribution of polymorphisms within nine different genes in a sample of 37 human and feline isolates. MLST distinguished seven sequence types (STs) that resolved into three distinct lineages, suggesting a clonal population structure for the species, and support for these divisions was obtained by macrorestriction analysis using pulsed-field gel electrophoresis. The distribution of STs among isolates recovered from human infections was not random, and such isolates were significantly more often associated with one particular ST, lending further support to the suggestion that specific genotypes contribute disproportionately to the disease burden in humans. All but one isolate lay on lineages that bore the representative strain of either the Houston or Marseille subtype. However, the distribution of the two 16S rDNA alleles among the isolates was not entirely congruent with their lineage allocations, indicating that this is not a sensitive marker of the clonal divisions within the species. The inheritances of several of the genes studied could not be reconciled with one another, providing further evidence of horizontal gene transfer among B. henselae strains and suggesting that recombination has a role in shaping the genetic character of bartonellae.

PMCID: PMC262510 PMID: 14605141 [PubMed - indexed for MEDLINE]

463. J Pediatr Ophthalmol Strabismus. 2003 Sep-Oct;40(5):302-3.

Conjunctival cat-scratch disease simulating rhabdomyosarcoma.

Marr BP, Shields CL, Shields JA, Eagle RC Jr.

Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.

PMID: 14560840 [PubMed - indexed for MEDLINE]

464. Clin Infect Dis. 2003 Nov 1;37(9):1149-54. Epub 2003 Oct 7.

Long-term serological analysis and clinical follow-up of patients with cat scratch disease.

Metzkor-Cotter E, Kletter Y, Avidor B, Varon M, Golan Y, Ephros M, Giladi M.

Bernard Pridan Laboratory for Molecular Biology of Infectious Diseases, Aviv Sourasky Medical Center, Tel Aviv, Israel.

A highly specific enzyme immunoassay (EIA) was recently described for use in the diagnosis of cat scratch disease (CSD). However, data regarding EIA antibody kinetics or its correlation with long-term clinical follow-up data are lacking. The association between antibody kinetics, clinical spectrum, and disease duration were studied in 98 patients with CSD. The median duration of follow-up was 35.3 weeks (range, 2-211.3 weeks). Results of EIA testing for detection of anti-Bartonella henselae immunoglobulin M (IgM) antibodies (detected in 53% of the patients) remained positive for < or =3 months. Therefore, the presence of IgM indicated acute infection. Titers of immunoglobulin G (IgG) also decreased over time; 25% of the patients remained seropositive for >1 year after the onset of CSD. Onset of CSD in patients with an IgG titer with an optical density of > or =1.0 occurred within the prior 12 months. No association was found between antibody titers or their kinetics and the clinical manifestations or duration of disease. EIA allows for the identification of atypical manifestations of CSD that were unrecognized before the use of serological assays. Complete recovery from these manifestations may take months. Results of this study provide additional data supporting the utility of EIA in the serodiagnosis of CSD.

PMID: 14557957 [PubMed - indexed for MEDLINE]

465. Gene. 2003 Aug 14;313:103-9.

Rapid and efficient transposon mutagenesis of Bartonella henselae by transposome technology.

Riess T, Anderson B, Fackelmayer A, Autenrieth IB, Kempf VA.

Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Eberhard Karls Universität, D-72076 Tübingen, Germany.

Molecular genetics are difficult to perform in Bartonella henselae, the causative agent of cat scratch disease and the vasculoproliferative disorders bacillary angiomatosis and bacillary peliosis. To elucidate the underlying bacterial pathogenic mechanisms, genetic manipulation of B. henselae is the method of choice. We describe how to perform transposon mutagenesis in B. henselae using transposome technology. B. henselae mutants revealed by this technique showed random transpositional insertion into the chromosome. In contrast to transposon mutagenesis by conjugational transfer, transposome technology allows transposon mutagenesis of early passaged Bartonella spp. with approximately 100-fold higher efficiency. The results show that transposome technique is a rapid, efficient and simple method to generate transposon mutants of B. henselae.

PMID: 12957381 [PubMed - indexed for MEDLINE]

466. Clin Infect Dis. 2003 Sep 15;37(6):860; author reply 860-1.

Isolated splenic cat scratch disease.

Bernard L, Ghez D, Perronne C.

Comment on Clin Infect Dis. 2003 Jan 1;36(1):e10-3.

PMID: 12955654 [PubMed - indexed for MEDLINE]

467. Vet Clin North Am Small Anim Pract. 2003 Jul;33(4):809-25.

Bartonellosis.

Guptill L.

Department of Veterinary Clinical Sciences, Purdue University, 625 Harrison Street, West Lafayette, IN 47907, USA. guptillc@purdue.edu

The role of Bartonella species as pathogens in dogs and cats is being defined. Diagnosis and treatment of Bartonella infections of dogs and cats remain challenging. As new information regarding Bartonella infections of companion animals becomes available, the understanding of the pathogenesis of these infections will improve. Most Bartonella species infecting dogs and cats are zoonotic, with B henselae the most important zoonotic species. B henselae bacteremia is common in domestic cats, and cats transmit B henselae to people. Transmission of Bartonella infections among cats and dogs is believed to occur primarily by way of arthropod vectors. Control of arthropod vectors and avoiding interactions with pets that result in scratches or bites are the most effective means to prevent transmission between animals and people.

PMID: 12910745 [PubMed - indexed for MEDLINE]

468. DNA Cell Biol. 2003 Jun;22(6):431-40.

The role of the host immune response in pathogenesis of Bartonella henselae.

Resto-Ruiz S, Burgess A, Anderson BE.

Department of Medical Microbiology and Immunology, College of Medicine, University of South Florida, Tampa 33612, USA.

Bartonella henselae can infect humans resulting in a wide range of disease syndromes including cat-scratch disease, fever with bacteremia, endocarditis, bacillary angiomatosis, and bacillary peliosis hepatis, among others. The nature and severity of the clinical presentation correlates well with the status of the hosts' immune system. Individuals with impaired immune function, including HIV infection, progress to systemic infections more often. Patients with intact immune function who become infected with B. henselae usually get cat-scratch disease, a disease that usually involves lymphadenopathy resulting from a strong cellular immune response to the bacterium. However, immunocompromised patients often progress to bacillary angiomatosis or bacillary peliosis hepatis. The reduced ability of the hosts immune response to control bacterial infection apparently results in a bacteremia of longer duration, and in some patients the presence of angiogenic lesions that are unique among bacterial infections to Bartonella. Recently, the role of immune effector cells that produce angiogenic cytokines upon stimulation with B. henselae has been proposed. Here, the current status of the role of the immune response in both controlling infection and in B. henselae-triggered immunopathogenesis is presented.

PMID: 12906736 [PubMed - indexed for MEDLINE]

469. J Clin Microbiol. 2003 Aug;41(8):4001-2.

First isolation and detection by immunofluorescence assay of Bartonella koehlerae in erythrocytes from a French cat.

Rolain JM, Fournier PE, Raoult D, Bonerandi JJ.

PMCID: PMC179770 PMID: 12904442 [PubMed - indexed for MEDLINE]

470. J Clin Microbiol. 2003 Aug;41(8):3991-3.

Cat scratch disease presenting as orbital abscess and osteomyelitis.

Mirakhur B, Shah SS, Ratner AJ, Goldstein SM, Bell LM, Kim JO.

Divisions of General Pediatrics, The Children's Hospital of Philadelphia. Scheie Eye Institute, Philadelphia, Pennsylvania 19104, USA.

Ocular manifestations of cat scratch disease are uncommon. The diagnosis is usually made on the basis of increasing Bartonella henselae serum antibody titers. We report a child presenting with orbital abscess and osteomyelitis who was diagnosed with hepatosplenic cat scratch disease by detection of B. henselae DNA in the orbital abscess fluid.

PMCID: PMC179855 PMID: 12904438 [PubMed - indexed for MEDLINE]

471. Scand J Infect Dis. 2003;35(5):358-9.

First case in Bulgaria of Parinaud's oculoglandular syndrome associated with Bartonella henselae.

Komitova R, Bosheva M, Sander A, Spasova M, Atanasova M.

PMID: 12875532 [PubMed - indexed for MEDLINE]

472. Infect Immun. 2003 Aug;71(8):4818-22.

Molecular characterization of the sucB gene encoding the immunogenic dihydrolipoamide succinyltransferase protein of Bartonella vinsonii subsp. berkhoffii and Bartonella quintana.

Gilmore RD Jr, Carpio AM, Kosoy MY, Gage KL.

Molecular Bacteriology Section, Bacterial Zoonoses Branch, Division of Vector-Borne Infectious Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado 80522, USA. rbg9@cdc.gov

Members of the genus Bartonella have historically been connected with human disease, such as cat scratch disease, trench fever, and Carrion's disease, and recently have been recognized as emerging pathogens causing other clinical manifestations in humans. However, because little is known about the antigens that elicit antibody production in response to Bartonella infections, this project was undertaken to identify and molecularly characterize these immunogens. Immunologic screening of a Bartonella vinsonii subsp. berkhoffii genomic expression library with anti-Bartonella antibodies led to the identification of the sucB gene, which encodes the enzyme dihydrolipoamide succinyltransferase. Antiserum from a mouse experimentally infected with live Bartonella was reactive against recombinant SucB, indicating the mounting of an anti-SucB response following infection. Antigenic cross-reactivity was observed with antiserum against other Bartonella spp. Antibodies against Coxiella burnetti, Francisella tularensis, and Rickettsia typhi also reacted with our recombinant Bartonella SucB. Potential SucB antigenic cross-reactivity presents a challenge to the development of serodiagnostic tests for other intracellular pathogens that cause diseases such as Q fever, rickettsioses, brucelloses, tularemia, and other bartonelloses.

PMCID: PMC166034 PMID: 12874367 [PubMed - indexed for MEDLINE]

473. Ann N Y Acad Sci. 2003 Jun;990:407-8.

Seroprevalence of Bartonella henselae and Bartonella quintana infections in Poland in 1998-2001.

Podsiadły E, Sokolowska E, Tylewska-Wierzbanowska S.

National Institute of Hygiene, 24 Chocimska Street, 00-791 Warsaw, Poland. epodsiadly@pzh.gov.pl

PMID: 12860664 [PubMed - indexed for MEDLINE]

474. Ann N Y Acad Sci. 2003 Jun;990:404-6.

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

Podsiadły E, Chmielewski T, Tylewska-Wierzbanowska S.

National Institute of Hygiene, 00-791 Warsaw, Poland. epodsiadly@pzh.gov.pl

To investigate the role of B. henselae in patients with symptoms suggesting neuroborreliosis, serum and cerebrospinal fluid samples were tested with serological and PCR methods. Among 17 examined patients, in 12 cases Borrelia burgdorferi infections were detected, in 1 case Bartonella henselae infection was ascertained, and in two patients mixed B. burgdorferi and B. henselae infections were found. These results indicate that mixed infections should be taken into consideration in establishing diagnosis of neurological disorders. Further study of this conclusion is needed.

PMID: 12860663 [PubMed - indexed for MEDLINE]

475. Ann N Y Acad Sci. 2003 Jun;990:397-403.

Cat scratch disease with lymphadenitis, vertebral osteomyelitis, and spleen abscesses.

Rolain JM, Chanet V, Laurichesse H, Lepidi H, Beytout J, Raoult D.

Unité des Rickettsies CNRS UMR-A 6020, IFR 48, Faculté de Médecine, Université de la Méditerranée, 13385 Marseille Cedex 05, France.

In this report we describe a 30-year old male patient with vertebral osteomyelitis and spleen abscesses with cat scratch disease. The diagnosis was made on the basis of molecular detection of Bartonella henselae either on lymph node biopsies or on bone biopsy, histology of the lymph node, serology using either our in-house microimmunofluorescence assay or a commercial kit (Focus Technologies). Immunofluorescent detection was also performed directly on slide appositions using a monoclonal antibody. Treatment consisted of administration of antibiotics with rapid clinical improvement and a stabilization of skeletal lesions on the magnetic resonance imaging performed three months later. Twenty two other cases of this unusual manifestation associated with cat scratch disease have been reported in the literature and are reviewed here. Our case represents the second case of osteomyelitis associated with cat scratch disease in which B. henselae has been specifically identified as the etiological agent using several direct and indirect methods.

PMID: 12860662 [PubMed - indexed for MEDLINE]

476. Ann N Y Acad Sci. 2003 Jun;990:393-6.

Genetic variation of Bartonella henselae detected in lymph nodes from patients with cat scratch disease in Slovenia.

Triller K, Strus P, Petrovec M, Duh D, Avsic-Zupanc T.

Institute of Microbiology and Immunology, Medical Faculty of Ljubljana, 1000 Ljubljana, Slovenia.

PMID: 12860661 [PubMed - indexed for MEDLINE]

477. Ann N Y Acad Sci. 2003 Jun;990:267-78.

Clinical impact of persistent Bartonella bacteremia in humans and animals.

Chomel BB, Kasten RW, Sykes JE, Boulouis HJ, Breitschwerdt EB.

Department of Population Health and Reproduction, University of California, Davis 95616, USA. bbchomel@ucdavis.edu

Bartonella spp. are emerging vector-borne pathogens that cause persistent, often asymptomatic bacteremia in their natural hosts. As our knowledge progresses, it appears that chronic infection may actually predispose the host to mild, insidious nonspecific manifestations or induce, in selected instances, severe diseases. Persistent asymptomatic bacteremia is most common in animals that serve as the main reservoir for the specific Bartonella. In humans, these organisms are B. bacilliformis and B. quintana. Other Bartonella species, for which humans are not the natural reservoir, tend to cause persistent bacteremia only in immunodeficient individuals. In some of these individuals, endothelial cell proliferation may create lesions such as bacillary angiomatosis or bacillary peliosis. In cats, bacteremia of variable level and continuity may last for years. Some strains of B. henselae may induce clinical manifestations, including fever, mild neurological signs, reproductive disorders, whereas others do not induce clinically obvious disease. Reproductive disorders have also been reported in mice experimentally infected with B. birtlesii. Finally, canids constitute the most interesting naturally occurring animal model for the human disease. Like immunocompetent people, healthy dogs only occasionally demonstrate long-term bacteremia when infected with Bartonella spp. However, some dogs develop severe clinical manifestations, such as endocarditis, and the pathologic spectrum associated with Bartonella spp. infection in domestic dogs is rapidly expanding and resembles the infrequently reported clinical entities observed in humans. In coyotes, persistent bacteremia is more common than in domestic dogs. It will be of interest to determine if coyotes develop clinical or pathological indications of infection.

PMID: 12860639 [PubMed - indexed for MEDLINE]

478. Clin Diagn Lab Immunol. 2003 Jul;10(4):686-91.

Detection by immunofluorescence assay of Bartonella henselae in lymph nodes from patients with cat scratch disease.

Rolain JM, Gouriet F, Enea M, Aboud M, Raoult D.

Unité des Rickettsies, CNRS UMR 6020A, Faculté de Médecine, Université de la Méditerranée, 13385 Marseille Cedex 05, France.

Laboratory diagnosis of Bartonella henselae infections can be accomplished by serology or PCR assay on biopsy samples. The purpose of our work was to assess immunofluorescence detection (IFD) in lymph node smears using a specific monoclonal antibody directed against B. henselae and a commercial serology assay (IFA) compared with PCR detection. Among 200 lymph nodes examined from immunocompetent patients, 54 were positive for B. henselae by PCR, of which 43 were also positive by IFD. Among the 146 PCR-negative lymph nodes, 11 were positive by IFD. Based on PCR results, the specificity of this new technique was 92.5%, the sensitivity was 79.6%, and the positive predictive value was 79.6%. At a cutoff titer of 64, the sensitivity of the IFA was 86.8% and the specificity was 74.1%. Diagnosis of cat scratch disease (CSD) may be improved, with a specificity of 100%, when the two tests (IFD and IFA) were negative; the sensitivity was 97.4% if one of the two tests was positive. Since PCR-based detection with biopsy samples is available only in reference laboratories, we suggest using IFD coupled with the commercial serology test for the diagnosis of CSD.

PMCID: PMC164252 PMID: 12853405 [PubMed - indexed for MEDLINE]

479. J Clin Microbiol. 2003 Jul;41(7):3430-2.

Osteomyelitis caused by Bartonella henselae genotype I in an immunocompetent adult woman.

Woestyn S, Moreau M, Munting E, Bigaignon G, Delmée M.

Microbiology Unit, Faculty of Medicine, University of Louvain, Belgium. sophie.woestyn@pi.be

We report the first description of osteomyelitis due to Bartonella henselae genotype I in an immunocompetent middle-aged woman. The diagnosis was established by serology, histopathology, and PCR analysis of osseous and lymph node tissues. The mycobacteria growth indicator tube inoculated with the lymph node aspirate was used for PCR analysis.

PMCID: PMC165354 PMID: 12843112 [PubMed - indexed for MEDLINE]

480. Jpn J Ophthalmol. 2003 Jul-Aug;47(4):405-8.

A case of cat scratch disease neuroretinitis confirmed by polymerase chain reaction.

Fukushima A, Yasuoka M, Tsukahara M, Ueno H.

Department of Ophthalmology, Kochi Medical School, Kochi, Japan. fukusima@kochi-ms.ac.jp

BACKGROUND: Cat scratch disease neuroretinitis is caused by infection by Bartonella henselae. To demonstrate B. henselae infection, serologic examination is commonly used, but sometimes serologic examination is not adequate for correct diagnosis. Here we present a case of cat scratch disease neuroretinitis confirmed by polymerase chain reaction in addition to serologic examination. CASE: A 55-year-old woman, presenting with headache and high fever, had noticed visual disturbance. The best-corrected visual acuity in her right eye was 0.01. Meningitis, optic neuritis and retinitis were observed and she was treated with oral prednisolone. After repeated questioning, the patient remembered being scratched by a cat. Systemic examination focusing on B. henselae infection was conducted and B. henselae-specific immunoglobulin (Ig) G, but not IgM, was detected in both serum and cerebrospinal fluid. To confirm B. henselae infection, polymerase chain reaction (PCR) analysis using cerebrospinal fluid was performed and the presence of B. henselae-specific DNA was demonstrated. From these results, we diagnosed cat scratch disease neuroretinitis and treated the patient with minocycline hydrochloride together with prednisolone. Following this treatment regimen, the patient's condition improved, and the best-corrected visual acuity in her right eye increased to 0.6 five months after the onset. CONCLUSION: The PCR technique is useful to correctly diagnose cat scratch disease neuroretinitis, if patients exhibit marginal data on B. henselae-specific antibody titer.

PMID: 12842212 [PubMed - indexed for MEDLINE]

481. DNA Seq. 2003 Apr;14(2):87-94.

Cloning and characterization of an outer membrane protein (Lip18) from Helicobacter bizzozeronii.

Zhu J, Hsu YM, Chang CF, Chang CD, Simpson KW, Tu H, Chang YF.

College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA.

A recombinant lambda-Zap II phage was selected by screening a genomic library of Helicobacter bizzozeronii (Hb) using antibodies from a naturally infected cat. DNA sequencing resulted an open reading frame containing 172 codons with a predicted molecular mass of 18 kDa (Lip18). The amino acid sequence showed 22.1, 55.2, 56.7 and 57.1% identity to peptidoglycan-associated lipoprotein of Helicobacter pylori, Agrobacterium tumefaciens, Bartonella bacilliformis, respectively. A peptidoglycan associating alpha-helical motif (LALGQRRSVAVRDYLVS) was located in the C-terminal region. H. bizzozeronii contains a potential lipoprotein signal peptide cleavage site (Val-Val-Gly-Cys), and yields a predicted mature protein with 148 amino acids. The Lip18 was localized into the outer membrane of the bacteria. Immunoblot analysis of serum samples from a dog and cat naturally infected with Helicobacter spp was able to recognize the purified recombinant Lip18.

PMID: 12825349 [PubMed - indexed for MEDLINE]

482. Am J Trop Med Hyg. 2003 May;68(5):554-6.

Occurrence of Bartonella henselae and Bartonella quintana in a healthy Greek population.

Tea A, Alexiou-Daniel S, Arvanitidou M, Diza E, Antoniadis A.

A' Department of Microbiology, Laboratory of Hygiene, School of Medicine, Aristotelian University of Thessaloniki, Thessaloniki, Greece.

The purpose of this study was to determine the prevalence of IgM and IgG antibodies against Bartonella henselae and B. quintana in a healthy Greek population using a commercially available immunofluorescent test (Focus test). Five hundred healthy individuals were divided by sex into four age groups and three groups according to contact with cats. IgM antibodies were not detected in any of the subjects examined, while 99 (19.8%) and 75 (15%) were IgG seropositive to B. henselae and to B. quintana, respectively. No statistical difference in the seropositivity was observed among these groups. The IgG antibody titers ranged from 1/64 to 1/256 for B. henselae and from 1/64 to 1/512 for B. quintana. A high percentage (12.4%) of cross-reactivity between the two species was observed. Our data show that the prevalence of both Bartonella species in Greece is high. However, low IgG antibody levels are not sufficient evidence of active infection.

PMID: 12812344 [PubMed - indexed for MEDLINE]

483. Braz J Infect Dis. 2003 Feb;7(1):1-6.

What do we (not) know about the human bartonelloses?

Velho PE, Cintra ML, Uthida-Tanaka AM, de Moraes AM, Mariotto A.

Department of Internal Medicine, Medical School Sciences, State University of Campinas-FCM/Unicamp, São Paulo, Brazil. pvelho@obelix.unicamp.br

The human bartonelloses are a group of diseases with a rapidly increasing clinical spectrum. Well known manifestations such as Carrion's disease, trench fever, cat-scratch disease, and bacillary angiomatosis are examples of Bartonella sp. infection. Along with these diseases, recurrent bacteremia, endocarditis, septicemia, erythema nodosum, erythema multiforme, trombocytopenic purpura and other syndromes have been reported having been caused by bacteria of this genus. The infectious process and the pathogenesis of these microorganisms are poorly understood. The bartonelloses may have a benign and self-limited evolution in a host, or a potentially fatal one. These bacteria can provoke a granulomatous or an angioproliferative histopathologic response. As these diseases are not yet well defined, we have reviewed the four main human bartonelloses and have examined unclear points about these emergent diseases.

PMID: 12807686 [PubMed - indexed for MEDLINE]

484. J Infect. 2003 May;46(4):244-6.

Bartonella quintana and Mycobacterium tuberculosis coinfection in an HIV-infected patient with lymphadenitis.

Bernit E, Veit V, La Scola B, Tissot-Dupont H, Gachon J, Raoult D, Harlé JR.

Service de Médecine interne, Hôpital de la Conception, 13005 Marseille, France.

Cat scratch disease (CSD) is usually associated with Bartonella henselae infection in patients with a history of cat exposure, but Bartonella quintana may also be a cause of chronic lympadenopathy in patients with cat or flea contact. The lymph node histopathology of CSD and tuberculosis may be indistinguishable. We report herein the first description of lymph node coinfection with B. quintana and M. tuberculosis in a 32-year HIV-infected woman. Culture of lymph node biopsy material on Columbia agar with sheep blood and on human endothelial cells in shell vial allowed us to isolate not only B. quintana, but also M. tuberculosis hominis.

PMID: 12799150 [PubMed - indexed for MEDLINE]

485. Pediatr Infect Dis J. 2003 May;22(5):467-8.

Cat-scratch disease occurring in three siblings simultaneously.

Gonzalez BE, Correa AG, Kaplan SL.

Department of Pediatrics, Division of Infectious Diseases, Baylor College of Medicine, Houston, TX, USA.

We report for the first time three siblings with cat-scratch disease occurring simultaneously. Case 1 was an 8-year-old boy with enlarged supraclavicular lymph nodes and fever. Case 2 was the 11-year-old sister whose presentation was a prolonged febrile illness. Case 3 was a 13-year-old male adolescent with adenitis of the neck and thigh. All three patients were treated with rifampin with improvement of their symptoms.

PMID: 12797315 [PubMed - indexed for MEDLINE]

486. Lancet. 2003 May 24;361(9371):1786.

Asking the right question.

Schattner A, Zimhony O, Avidor B, Giladi M.

Department of Medicine, Kaplan Medical Centre, 76100, Rehovot, Israel. amimd@clalit.org.il

Comment in Lancet. 2004 Aug 28-Sep 3;364(9436):758.

PMID: 12781538 [PubMed - indexed for MEDLINE]

487. Ocul Immunol Inflamm. 2002 Jun;10(2):147-50.

Submacular exudates with serous retinal detachment caused by cat scratch disease.

Matsuo T, Kato M.

Department of Ophthalmology, Okayama University Medical School, Okayama City, Japan. matsuot@cc.okayama-u.ac.jp

PURPOSE: To present submacular exudates as a manifestation of cat scratch disease. METHODS: Report of two cases. RESULTS: The first patient, a 34-year-old man, developed submacular exudates with serous retinal detachment ten days after having axillary lymphadenopathy and fever. The second patient, a 30-year-old woman, developed submacular exudates with serous retinal detachment mimicking central serous chorioretinopathy. Fluorescein angiography revealed late staining of the subretinal lesions in both cases. The lesion resolved spontaneously in the first patient, while sulfamethoxazole and trimethoprim was required for the second patient. Both patients had a positive IgG titer for Bartonella henselae. CONCLUSIONS: Submacular exudates with serous retinal detachment can occur in cat scratch disease. Cat scratch disease should be included in the differential diagnosis of submacular exudates with central serous chorioretinopathy.

PMID: 12778351 [PubMed - indexed for MEDLINE]

488. Eur Radiol. 2003 Jun;13(6):1363-9. Epub 2002 Oct 2.

Lymphadenopathy at the medial epitrochlear region in cat-scratch disease.

Gielen J, Wang XL, Vanhoenacker F, De Schepper H, De Beuckeleer L, Vandevenne J, De Schepper A.

Department of Radiology, University Hospital Antwerp, Wilrijkstraat 10, 2650 Edegem, Belgium.

Our objective was to describe the imaging features of lymphadenopathy at the medial epitrochlear region as frequently seen in cat-scratch disease (CSD) and to compare these features with those seen in non-CSD. Ten patients (four males and six females) presented with a subcutaneous soft tissue mass at the medial epitrochlear region. Three patients were younger than 15 years. Magnetic resonance imaging was performed in all patients. All lesions turned out to be regional lymphadenopathy instead of soft tissue neoplasm. They were caused by benign disorders in eight cases, including seven CSD and one other infection, and in two cases by metastatic disease. All lesions, except for three benign ones, were solitary. On MRI, high signal intensity (SI) strands in the surrounding soft tissue on T2-weighted images (WI) were present in all cases. Three cases of CSD showed homogeneous SI on both T1- and T2WI. After contrast administration, a moderate, homogeneous enhancement was seen. The other seven lesions, except for one metastasis, had both solid and liquid components. Liquid components showed high SI on T2WI without enhancement, whereas solid components had intermediate SI on T2WI and marked enhancement after contrast administration. Pathological findings in seven patients, including four with CSD, supported the tentative diagnosis made on MRI. One of two patients with CSD had positive serological test. Cat-scratch disease is a major cause of a soft tissue swelling at the medial epitrochlear region. Identification of lymphadenopathy and its presentation on MRI may be helpful in eliciting an animal-scratch history and achieving diagnostic and therapeutic aims in patients without primary cancer.

PMID: 12764654 [PubMed - indexed for MEDLINE]

489. Ann Hematol. 2003 Jul;82(7):455-7. Epub 2003 May 23.

Monoclonal and biclonal gammopathy in two patients infected with Bartonella henselae.

Krause R, Auner HW, Daxböck F, Mulabecirovic A, Krejs GJ, Wenisch C, Reisinger EC.

Division of Infectious Diseases, Department of Internal Medicine, Karl-Franzens University, Auenbruggerplatz 15, 8036 Graz, Austria. robert.krause@kfunigraz.ac.at

Two immunocompetent patients with cat-scratch disease due to infection with Bartonella henselae developed monoclonal and biclonal gammopathy. Neither patient had evidence of any other known cause of plasma cell dyscrasia, and antibiotic eradication of Bartonella henselae infection resulted in the prompt disappearance of the gammopathy. Hence, cat-scratch disease should be added to the list of possible underlying disorders in individuals presenting with monoclonal and biclonal gammopathy.

PMID: 12764550 [PubMed - indexed for MEDLINE]

490. Arch Soc Esp Oftalmol. 2003 Apr;78(4):223-6.

[Severe retinal phlebitis in ocular bartonellosis].

[Article in Spanish]

Díaz-Valle D, Toledano Fernández N, Arteaga Sánchez A, Miguélez Sánchez R, Pascual Allen D.

Hospital General de Móstoles, Madrid, España. ddiazval@nacom.es

PURPOSE/METHODS: To report the clinical case of a 34-year-old male with atypical ophthalmic manifestations of cat-scratch disease (ocular bartonellosis), including an extensive retinal phlebitis, as well as the evolution of the clinical picture with treatment. RESULTS/CONCLUSIONS: The clinical diagnosis of ocular bartonellosis was serologically confirmed. Oral treatment with ciprofloxacine healed the phlebitis and the neuroretinitis, with a residual optic disk pallor. This case exemplifies the diversitiy of ocular manifestations of this disease. The authors recommend considering this condition in the differential diagnosis of posterior uveitis in young patients.

PMID: 12743848 [PubMed - indexed for MEDLINE]

491. Arch Pathol Lab Med. 2003 Jun;127(6):706-10.

Rapid polymerase chain reaction-based confirmation of cat scratch disease and Bartonella henselae infection.

Margolis B, Kuzu I, Herrmann M, Raible MD, Hsi E, Alkan S.

Department of Pathology, Loyola University Medical Center, Maywood, Ill 60153, USA.

CONTEXT: Cat scratch disease (CSD) commonly occurs secondary to Bartonella henselae infection, and the diagnosis has traditionally been made by microscopic findings, the identification of organisms by cytochemistry, and clinical history. However, cytochemical analysis tends to be very difficult to interpret, and histology alone may be insufficient to establish a definitive diagnosis of CSD. OBJECTIVE: To demonstrate the presence of B henselae in tissue suspected of involvement by CSD, using a novel polymerase chain reaction (PCR) assay. DESIGN: Isolates of B henselae (American Tissue Culture Collection 49793) and Afipia felis (American Tissue Culture Collection 49714) were cultured on blood agar and buffered charcoal yeast extract agar, respectively. DNA was isolated from these organisms and from formalin-fixed, paraffin-embedded tissue sections with involvement by CSD (8 patients). Negative controls included water, human placental tissue, and lymph node specimens from 6 patients with reactive lymphoid hyperplasia and from 2 patients with granulomatous lymphadenitis. A primer complementary to B henselae citrate synthase gltA gene sequence was designed to perform a seminested PCR amplification. For restriction fragment length polymorphism analysis, PCR products were digested by TaqI restriction enzyme and analyzed by gel electrophoresis. RESULTS: Seminested PCR analysis of the cultured isolates of B henselae, but not of A felis, showed specific amplification. However, nonnested PCR did not provide consistently positive results in tissue sections with CSD. Therefore, we used a seminested PCR, which revealed positivity in all of the cases with clinicopathologic diagnoses of CSD. None of the negative controls showed positivity. Restriction enzyme provided confirmation of the specific PCR amplification of the B henselae sequence. CONCLUSIONS: Since the amplification product has a low molecular size (<200 base pairs), this assay is useful for detection of B henselae in formalin-fixed, paraffin-embedded tissues. The seminested PCR protocol described here can be used for rapid and reliable confirmation of B henselae in samples that are histologically suggestive of CSD.

PMID: 12741894 [PubMed - indexed for MEDLINE]

492. J South Orthop Assoc. 2002 Summer;11(2):119-23.

Chronic osteomyelitis associated with cat-scratch disease.

Prybis BG, Eady JL, Kotchmar GS Jr.

Department of Orthopmdic, University of South Carolina School of Medicine, Columbia, SC 29203, USA.

Cat-scratch disease (CSD) is usually a self-limited illness, though atypical presentations of infection with Bartonella henselae can occur, including osteomyelitis, oculoglandular syndrome, and granulomatous hepatitis. We describe a 6-year-old boy who had atypical CSD osteomyelitis of the left proximal femoral metaphysis due to a cat scratch. This is the second paper to report serial serology of B henselae, and the second paper to identify plasma cells on histologic examination, compatible with chronic osteomyelitis. The diagnosis was made by clinical, serologic, and histologic examination. Sixteen cases of atypical CSD osteomyelitis have been reported in the English literature and are reviewed in this paper.

PMID: 12741593 [PubMed - indexed for MEDLINE]

493. Nihon Rinsho. 2003 Feb;61 Suppl 2:464-8.

[Cat scratch disease].

[Article in Japanese]

Yoshida H, Kusaba N.

Yame General Hospital.

PMID: 12722263 [PubMed - indexed for MEDLINE]

494. Med Clin (Barc). 2003 Apr 12;120(13):494-5.

[Kinetics of Bartonella spp. IgG antibodies in cat-scratch disease and in asymptomatic HIV-infected patients].

[Article in Spanish]

García-García JA, Vargas J, Mira JA, Vergara-López S, Macías J, Pineda JA.

Servicio de Medicina Interna. Hospital Universitario de Valme. Sevilla. Spain.

BACKGROUND AND OBJECTIVE: Our goal was to investigate the kinetics of serum IgG antibodies against Bartonella spp. in patients with cat-scratch disease and in HIV-infected indiviuals. PATIENTS AND METHOD: Sequential determinations were made in seven patients with cat scratch disease and in seven HIV-infected individuals who were seropositive for this bacteria. RESULTS: In five patients from each group, serum antibodies fell under the positivity threshold within two years. Two HIV coinfected patients harbored Bartonella spp. DNA in bone marrow. CONCLUSIONS: These results suggest that the finding of a positive titer of serum IgG against Bartonella spp. is a marker of acute or recent infection.

PMID: 12716542 [PubMed - indexed for MEDLINE]

495. Vet Microbiol. 2003 May 29;93(3):261-73.

Detection and characterization of feline Bartonella henselae in the Czech Republic.

Melter O, Hercík K, Weyant RS, Janecek J, Nemec A, Mecera J, Gonzorová L, Branny P.

National Institute of Public Health, Srobárova 48, 10042 Prague, Czech Republic. melter@szu.cz

The aims of the study were to characterize isolates of Bartonella henselae and to determine the prevalence of bacteremic domestic cats in urban and suburban parts of Prague, Czech Republic. Five (18%) gram-negative fastidious bacterial single-cat isolates were recovered from 27 hemocultures incubated without previous freezing. Four of these isolates originated from flea infested stray cats (n=6) and one from a shelter cat without any ectoparasites (n=21). None of the 34 previously frozen specimens from flea free pet cats yielded any bacteria. All five isolates were catalase and oxidase negative. Their enzymatic activity, RFLP profile of citrate synthetase gene (gltA) and DNA-DNA hybridization results were typical of B. henselae. According to their PvuII and BglI ribotypes the isolates could be allocated to two homogeneous groups. Ribotype HindIII and RFLP of 16S-23S rRNA spacer region analysis gave unique profiles different from those of Bartonella quintana, Bartonella elizabethae and Bartonella clarridgeiae. The 16S rRNA type-specific amplification revealed an identical profile typical of B. henselae genotype II for all the cat isolates studied. Pulsed-field gel electrophoresis (PFGE) assigned a different profile to each of the isolates studied. Determination of the enzymatic activity, RFLP of gltA gene, RFLP of 16S-23S rRNA spacer region, and HindIII ribotype could be efficient tools for identification of B. henselae isolates. Ribotyping (PvuII, BglI), 16S rRNA typing and PFGE may be useful methods to prospect ecology and epidemiology of the agent.

PMID: 12695049 [PubMed - indexed for MEDLINE]

496. Scand J Infect Dis. 2003;35(2):149.

Bartonella henselae: association with the development of transient lupus anticoagulant and asymptomatic prolongation of activated partial thromboplastin time.

Economou M, Lithoxopoulou M, Aivazis V, Tsakalidis C, Athanassiou-Metaxa M.

Comment on Scand J Infect Dis. 2002;34(1):67-9.

PMID: 12693573 [PubMed - indexed for MEDLINE]

497. Med Clin (Barc). 2003 Mar 29;120(11):437.

[Transverse myelitis associated with cat-scratch disease].

[Article in Spanish]

Turon Estrada A, Osuna Pulido MT, Colomer Pairés J, Vilanova Busquets JC.

PMID: 12681227 [PubMed - indexed for MEDLINE]

498. Microbiol Immunol. 2003;47(2):147-53.

Seroprevalence of Bartonella henselae, Toxoplasma gondii, FIV and FeLV infections in domestic cats in Japan.

Maruyama S, Kabeya H, Nakao R, Tanaka S, Sakai T, Xuan X, Katsube Y, Mikami T.

Laboratory of Veterinary Public Health, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa 252-8510 Japan. maruyama@brs.nihon-u.ac.jp

Seroprevalence of Bartonella henselae, Toxoplasma gondii, feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV) infections was investigated in 1,447 domestic cats derived from the north (Hokkaido) to the south (Okinawa) prefectures in Japan. Of the cats investigated, 8.8% (128/1,447) were seropositive to B. henselae, 5.4% (78/1,447) to T. gondii, 9.8% (107/1,088) to FIV, and 2.9% (32/1,088) to FeLV, respectively. For B. henselae infection, the positive rate varied from 11.5% in cats of 1 to <2 years old to 7.2% in those over 3 years old. Outdoor cats showed higher positive rate (14.5%) than that (7.0%) in indoor ones. The rate (13.5%) in flea-infested cats was significantly higher than that (7.4%) in flea-negative cats. The positive rates in southern and urban sites were more likely to be higher than those in northern and suburban sites, suggesting that warm and humid environments, density of cat population, and raising status, including hygienic condition and flea infestation in cats may correlate to higher seroprevalence of B. henselae infection. For T. gondii, FIV and FeLV infections, the seroprevalence also tended to be higher in outdoor, flea-infested cats and advanced age groups. For FIV infection, the positive rates in male (14.3%) and outdoor cats (15.0%) were significantly higher than those in female (5.0%) and indoor cats (4.6%). On the other hand, no significant difference in seropositivities was observed in FeLV and T. gondii infections concerning to both genders and raising status.

PMID: 12680718 [PubMed - indexed for MEDLINE]

499. Clin Infect Dis. 2003 Apr 15;36(8):1089.

Urban trench fever and cat scratch disease.

La Via WV.

Comment on Clin Infect Dis. 2002 Dec 15;35(12):1577.

PMID: 12684929 [PubMed - indexed for MEDLINE]

500. Vet Rec. 2003 Mar 22;152(12):366-9.

Prevalence of Bartonella henselae in young, healthy cats in Sweden.

Engvall EO, Brändström B, Fermér C, Blomqvist G, Englund L.

Swedish Zoonosis Centre, National Veterinary Institute, Uppsala, Sweden.

PMID: 12678262 [PubMed - indexed for MEDLINE]

501. Recenti Prog Med. 2003 Apr;94(4):177-85.

[Bartonellosis].

[Article in Italian]

Mansueto P, Di Lorenzo G, Rizzo M, Mazzola G, Affronti M, Battista Rini G, Mansueto S.

Dipartimento di Medicina Clinica e delle Patologie Emergenti, Università degli Studi di Palermo. pamansu@libero.it

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]

502. Wien Klin Wochenschr. 2003 Feb 28;115(3-4):88.

Primary lesion of cat-scratch disease and inguinal cat-scratch disease.

Krause R, Wenisch C, Reisinger EC.

Abteilung für Infektiologie, Medizinische Universitätsklinik, Auenbruggerplatz 15, A-8036 Graz, Austria. robert.krause@uni-graz.at

PMID: 12674683 [PubMed - indexed for MEDLINE]

503. Gastroenterol Clin Biol. 2003 Feb;27(2):225-9.

[Hepatosplenic localization of cat scratch disease in immunocompetent adults. Two cases].

[Article in French]

Le Tallec V, Abgueguen P, Pichard E, Chennebault JM, Bellec V, Delbos V, Rousselet MC, Dib N, Boyer J.

Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire, 4, rue Larrey, 49033 Angers cedex 01.

The infective agent responsible for cat scratch disease, Bartonella henselae, is a rare cause of hepatic granulomatosis in immunocompetent adults. Clinical features include a prolonged fever or more typical symptoms such as lymphadenopathy associated with painful hepatomegaly and a fever following a cat scratch or bite. Images of micronodular hepatosplenic lesions on abdominal ultrasonography or computed tomography scan along with epithelioid granulomas in a liver biopsy can suggest this diagnosis. It is established with a serology by indirect immunofluorescence or by ELISA and/or the presence of Bartonella henselae DNA evidenced by PCR in the liver biopsy. We report two cases of hepatosplenic localizations of cat scratch disease in a 41-year-old woman and a 44-year-old man presenting asthenia and fever associated with a biological inflammatory syndrome and elevated liver enzymes.

PMID: 12658133 [PubMed - indexed for MEDLINE]

504. Nihon Ganka Gakkai Zasshi. 2003 Feb;107(2):99-104.

[Cat scratch disease with posterior segment involvement].

[Article in Japanese]

Kobayashi K, Koga T, Oki T, Iwao K, Okumura A, Okinami S.

Department of Ophthalmology, Saga Medical School, 5-1-1 Nabeshima, Saga 849-8501, Japan.

PURPOSE: To describe the clinical characteristics of patients with cat scratch disease during the last 2 years. METHODS: Clinical characteristics and anterior and posterior segment manifestations were reviewed in five patients who were serologically diagnosed as having cat scratch disease. RESULTS: Four women and one man were examined. Their ages ranged from 7 to 60 years. Each patient had a markedly elevated serum anti-Bartonella henselae antibody titer. Visual symptoms developed 2 weeks or less after the onset of systemic symptoms. Lymphadenopathy was detected in one of five patients. Neuroretinitis was found in 4 patients, and papillitis in 1 patient. Seven eyes showed retinochoroidal exudates. Anterior uveitis was observed in three eyes. Four patients received systemic corticosteroids. CONCLUSION: The ocular manifestations of cat scratch disease include neuroretinitis, papillitis, retinochoroidal exudates, and anterior uveitis.

PMID: 12647335 [PubMed - indexed for MEDLINE]

505. Emerg Infect Dis. 2003 Mar;9(3):338-42.

Molecular detection of Bartonella quintana, B. koehlerae, B. henselae, B. clarridgeiae, Rickettsia felis, and Wolbachia pipientis in cat fleas, France.

Rolain JM, Franc M, Davoust B, Raoult D.

Université de la Méditerranée, Marseille, France.

The prevalences of Bartonella, Rickettsia, and Wolbachia were investigated in 309 cat fleas from France by polymerase chain reaction (PCR) assay and sequencing with primers derived from the gltA gene for Rickettsia, the its and pap31 genes for Bartonella, and the 16S rRNA gene for Anaplasmataceae. Positive PCR results were confirmed by using the Lightcycler and specific primers for the rOmpB of Rickettsia and gltA of Bartonella. R. felis was detected in 25 fleas (8.1%), W. pipientis, an insect symbiont, in 55 (17.8%), and Bartonella in 81 (26.2%), including B. henselae (9/81; 11.1%), B. clarridgeiae (55/81; 67.9%), B. quintana (14/81; 17.3%), and B. koehlerae (3/81; 3.7%). This is the first report of the amplification of B. quintana from fleas and the first description of B. koehlerae in fleas from an area outside the United States. Cat fleas may be more important vectors of human diseases than previously reported.

PMID: 12643829 [PubMed - indexed for MEDLINE]

506. Acta Derm Venereol. 2003;83(1):67-8.

Detection of Bartonella henselae DNA using polymerase chain reaction assay in patient with cat scratch disease.

Hara H, Ito K, Akimoto M, Suzuki H, Asai S, Maruyama S.

PMID: 12636034 [PubMed - indexed for MEDLINE]

507. Clin Pediatr (Phila). 2003 Jan-Feb;42(1):71-3.

Oral corticosteroids in cat-scratch disease.

Lerdluedeeporn P, Krogstad P, Roberts RL, Stiehm ER.

Division of Immunology/Allergy/Rheumatology, Mattel Children's Hospital at UCLA, UCLA Medical Center, Los Angeles, CA 90095, USA.

PMID: 12635985 [PubMed - indexed for MEDLINE]

508. Microbiology. 2003 Mar;149(Pt 3):621-9.

Phase variation in Bartonella henselae.

Kyme P, Dillon B, Iredell J.

Centre for Infectious Diseases and Microbiology, Level 3 ICPMR Building, University of Sydney, Westmead Hospital, Institute Road, Westmead, NSW 2145, Australia.

Bartonella henselae is a fastidious, Gram-negative bacterial pathogen of cats and humans. Previous workers have shown that serial passage in vitro leads to attenuation of virulence-associated attributes such as expression of pili, invasion of human epithelial cell lines and the stimulation of endothelial cell proliferation. In contrast to the published data, it was found that pilin expression is frequently preserved in organisms which have undergone phase variation in vitro. Transition from a slow-growing, dry agar-pitting (DAP) to a faster-growing, smooth non-agar-pitting (SNP) form appears to occur predictably and may reflect competition between two populations growing at different rates. Better survival of the slower-growing (DAP) form may explain its relatively easy retrieval from piliated SNP populations allowed to age on solid media. Pilin expression is associated with auto-agglutination in liquid suspension or broth cultures, and appears to be necessary but not sufficient for expression of the agar-pitting phenotype and for the formation of biofilms. Outer-membrane protein variation is seen in association with phase variation, but lipopolysaccharide expression is preserved in piliated as well as extensively passaged non-piliated isolates. The EagI/HhaI infrequent restriction site-PCR fingerprint, which has been previously used to discriminate between serotypes Marseille and Houston, is shown to alter with phase variation in vitro, and there is evidence that genetic change accompanies these events. The extent of genetic and phenotypic variability of phase-variant B. henselae has previously been underestimated. It may lead to new insights into the pathogenicity of this organism, and must be considered when interpreting data arising from such studies.

PMID: 12634331 [PubMed - indexed for MEDLINE]

509. Przegl Epidemiol. 2002;56(3):399-407.

[Seroprevalence of Bartonella henselae and Bartonella quintana infections in Poland in 1998-2001].

[Article in Polish]

Podsiadły E, Sokołowska E, Tylewska-Wierzbanowska S.

epodsiadly@pzh.gov.pl

Bartonella henselae and Bartonella quintana infections result in illnesses with symptoms of severity ranging from mild lymphadenopathy (CSD) to systemic disease. The aim of the study was to estimate a prevalence of B. henselae and B. quintana infections in human in Poland. Serum samples collected from 265 patients in 1998-2001 were tested for the presence of antibodies specific to B. henselae and B. quintana. Levels of serum IgM and IgG antibodies to Bartonella henselae and Bartonella quintana were measured with indirect microimmunofluorescence test (MRL Diagnostic, USA). Cats' sera were assessed with indirect microimmunofluorescence test (MRL Diagnostic, USA) and goat immune serum anti-cat IgG FITC conjugate (Sigma, USA). Bartonella henselae specific antibodies were detected in 146 (57.0%) patients with lymphadenopathy. From that number 11.3% have shown specific Bartonella henselae IgM serum antibodies. Bartonella quintana infection was detected with serological methods in 4 patients. It has been found that CSD is a seasonal infection, with most cases occurring in autumn. Most cases of the disease have been recognized in children 8-16 years old. Most of CSD cases (30.1%) were detected in Mazowieckie voivodeship. There were no cases of CSD in Pomorskie, Podkarpackie, Lubuskie and Opolskie voivodeship. The seroprevalence of Bartonella sp. infections in cats was estimated on 86% (31/36). The highest titer of specific Bartonella henselae antibodies detected in cats was 1024. The number of detected Bartonella henselae infections in Poland is very low. It is very probable that the number of cases is underestimated in our country. Cat scratch disease is the most frequently clinically and serologically identified bartonellosis.

PMID: 12608089 [PubMed - indexed for MEDLINE]

510. Br J Ophthalmol. 2003 Mar;87(3):371.

Unusual presentation of cat scratch disease in HIV+ patient.

Curi AL, Campos WR, Barbosa L, Lana-Peixoto MA, Oréfice F.

PMCID: PMC1771529 PMID: 12598467 [PubMed - indexed for MEDLINE]

511. J Pediatr Gastroenterol Nutr. 2003 Feb;36(2):227, 265.

Clinical quiz: cat scratch disease.

Troncone R, Ventura A, Facchini S, Zennaro F, Bussani R, Lenhardt A, Dal Molin G.

Clinica Pediatrica, Serviuzio di Radiologia, UCO di Igiene e Medicina Preventiva IRCCS Burlo Garafalo, Universita' di Trieste, Trieste, Italy.

PMID: 12593397 [PubMed - indexed for MEDLINE]

512. Otolaryngol Pol. 2002;56(6):727-31.

[Cat scratch disease--diagnostic problems].

[Article in Polish]

Rydzewski B, Lemańska-Kwiatkowska K, Lipińska M.

Oddział Otolaryngologiczny Szpitala im. F. Raszei w Poznaniu.

Etiology, epidemiology and clinical symptoms of Mollaret's disease, also known as Cat-scratch disease, were described. Four cases of treated patients were presented. One patient with a history of type I Diabetes mellitus presented clinical symptoms of Mollaret's disease, however, after investigation he was finally diagnosed with malignant lymphoma and was given chemotherapy. In other cases some symptoms were also doubtful, but the final diagnoses were made upon positive results of serological reactions and all patients recovered completely after a few week antibiotic treatment. All patients had frequent contacts with cats. A significant divergence between the results of histopathological, serological and ultrasonographic findings lead to a conclusion that a certain diagnosis of Cat-scratch disease can only be made with the use of positive results of serological reactions.

PMID: 12577490 [PubMed - indexed for MEDLINE]

513. Bull Soc Belge Ophtalmol. 2002;(286):41-6.

Cat scratch disease (CSD) in patients with stellate neuroretinitis: 3 cases.

De Schryver I, Stevens AM, Vereecke G, Kestelyn P.

Department of Ophthalmology, University Hospital Ghent, Belgium.

This case series describes three patients with a similar clinical picture: unilateral abrupt visual loss, optic nerve edema, and a macular star exudate. In all cases we found significant antibody titers to Bartonella henselae, the causative agent of cat scratch disease. Cat scratch disease seems to be the most common cause of stellate neuroretinitis, formerly known as Leber's idiopathic stellate retinopathy. A review of the pertinent literature shows that serologic evidence of B. henselae is sufficient to confirm the diagnosis given the low incidence of significant titers in the general population. Cat scratch disease is usually a self limiting disorder in immunocompetent patients, but treatment with doxycycline is recommended.

PMID: 12564316 [PubMed - indexed for MEDLINE]

514. Eur J Obstet Gynecol Reprod Biol. 2003 Feb 10;106(2):175-8.

Cat-scratch disease presenting as a solitary tumour in the breast: report of three cases.

Markaki S, Sotiropoulou M, Papaspirou P, Lazaris D.

Histopathology Department, Alexandra General District Hospital, 7 Paparounas Str., 145 78 Ekali, Athens, Greece.

Cat-scratch disease (CSD) may appear as a solitary mass in the breast and give the impression of a breast carcinoma. In this case, further clinical and laboratory investigation is required to rule out malignancy. We present three cases of CSD of the breast in women of 64, 31 and 61 years old. Each presented with enlarged lymph-nodes in the breast, which were clinically mistaken for solitary tumours. In the first two patients, the mammography was negative. The third patient had a mammogram which indicated a well-defined solid mass in the parenchyma without calcifications. We discuss the clinical, histological and histochemical findings, analyze the differential diagnosis and review the literature.

PMID: 12551788 [PubMed - indexed for MEDLINE]

515. Intern Med J. 2003 Jan-Feb;33(1-2):55-6.

Bartonella henselae infective endocarditis in north Queensland.

Oman K, Norton R, Gunawardane K.

PMID: 12534881 [PubMed - indexed for MEDLINE]

516. Ann Ital Med Int. 2002 Oct-Dec;17(4):256-60.

[Three cases of bartonellosis (cat scratch disease)].

[Article in Italian]

Di Lorenzo G, Rizzo M, Mansueto P, Falci C, Mazzola G, Affronti M, Rini GB, Mansueto S.

Dipartimento di Medicina Clinica e delle Patologie Emergenti, Università degli Studi di Palermo.

In the last years the number of Bartonella species has conspicuously increased, with better clinical and diagnostic definitions of the different related illnesses. We report, in the present article, 3 cases of cat-scratch disease, a particular bartonellosis mainly caused by Bartonella henselae which is transmitted by the cat. After an incubation period, cat-scratch disease clinically manifests as a regional lymphoadenitis, with the appearance of a small cutaneous lesion at the site of inoculation of the germ. The pathogenetic agent is susceptible to a number of antibacterial agents, such as penicillin, cephalosporins, aminoglycosides, tetracyclines, macrolides, quinolones, trimethoprim combined with sulphamethoxazole and rifampicin. The prognosis is usually favorable.

PMID: 12532565 [PubMed - indexed for MEDLINE]

517. Rev Inst Med Trop Sao Paulo. 2002 Nov-Dec;44(6):325-30.

A prospective study of Cat-Scratch Disease in Lima-Peru.

Huarcaya E, Maguiña C, Merello J, Cok J, Birtles R, Infante B, Vidal J, Tello A, Ventosilla P.

Alberto Hurtado School of Medicine, Universidad Peruana Cayetano Heredia, Peru.

Cat-Scratch Disease (CSD) is a benign lymphadenitis that may progress to severe or recurrent forms, and it is occasionally associated with morbidity. Between January of 1998 and March of 1999, forty-three suspected CSD patients were assessed in the Hospital Cayetano Heredia and the Instituto de Salud del Niño, in Lima, Peru. Twelve patients had a confirmed diagnosis, 8 of whom were women, and the mean age was 10 years old. The majority (53%) of the cases were encountered in the summer. All patients reported having had contact with cats. Fever, malaise, lymphadenopathy and skin lesions were the most frequent clinical features. Twelve patients had indirect immunofluorescence antibody test titers of between 1/50 and 1/800 for Bartonella henselae and Bartonella clarridgeiae. Two lymph node biopsies were histologically compatible with CSD. No positive blood cultures could be obtained. This is the first Peruvian prospective study able to identify B. henselae and B. clarridgeiae in pediatric patients.

PMID: 12532216 [PubMed - indexed for MEDLINE]

518. J Infect Chemother. 2002 Dec;8(4):349-52.

Cat scratch disease: analysis of 130 seropositive cases.

Murakami K, Tsukahara M, Tsuneoka H, Iino H, Ishida C, Tsujino K, Umeda A, Furuya T, Kawauchi S, Sasaki K.

Department of Pathology, Yamaguchi University School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8554, Japan. k.mura@yamaguchi-u.ac.jp

To clarify the clinical manifestations of cat scratch disease (CSD), we evaluated a total of 130 seropositive patients with CSD. The patients' ages ranged from 1 to 68 years; 103 (79.2%) were under 18 years of age. CSD occurred predominantly in the fall and winter months. Regional lymphadenopathy was noted in 110 (84.6%) of the cases, and the most common sites were the neck (33%), axillary (27%), and inguinal (18%) regions. One hundred of the patients (77%) had general symptoms, such as fever, headache, and malaise. The clinical manifestations of CSD showed a wide spectrum from typical or classical CSD, with regional lymphadenopathy, to atypical or systemic CSD. Of the 130 cases, 103 (79.2%) were typical CSD and 27 (20.8%) were atypical CSD. Atypical cases of CSD were commonly reported as fever of unknown origin (37.0%), neuroretinitis (22.2%), encephalopathy (14.8%), hepatosplenic granuloma (11.1%), and Parinaud's oculoglandular syndrome (7.4%). Fever of unknown origin or prolonged fever lasting more than 14 days was evident in 27 (20.8%) of the 130 cases in this study. Eleven of the 27 cases lacked lymphadenopathy. Our findings suggest that CSD is not a rare disease in Japan. The indirect fluorescent antibody (IFA) test to detect Bartonella species may provide a prompt diagnosis of CSD and facilitate appropriate therapy.

PMID: 12525897 [PubMed - indexed for MEDLINE]

519. J Infect Chemother. 2002 Dec;8(4):321-5.

Cat scratch disease in Japan.

Tsukahara M.

Faculty of Health Sciences, Yamaguchi University School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8554, Japan. masato@yamaguchi-u.ac.jp

PMID: 12525891 [PubMed - indexed for MEDLINE]

520. Clin Diagn Lab Immunol. 2003 Jan;10(1):95-102.

Western immunoblotting for Bartonella endocarditis.

Houpikian P, Raoult D.

Unité des Rickettsies, CNRS-UPRES-A 6020, Faculté de Médecine de Marseille, 13385 Marseille cedex, France.

To differentiate infectious endocarditis (IE) from other Bartonella infections and to identify infecting Bartonella bacteria at the species level on a serological basis, we used Western immunoblotting to test sera from 51 patients with Bartonella IE (of which 27 had previously benefited from species identification by molecular techniques), 11 patients with chronic Bartonella quintana bacteremia, and 10 patients with cat scratch disease. Patients with IE were Western blot positive in 49 of 51 cases, and significant cross-reactivity with three heterologous Bartonella antigens was found in 45 of 49 cases. Sera from bacteremic patients did not react with more than one heterologous antigen, and sera from patients with cat scratch disease gave negative results. Sera reacted only with B. henselae in four cases of IE, including one with a positive PCR result for valve tissue. Western blot and cross-adsorption performed on serum samples from patients with IE (the identity of the causative species having been determined by PCR) were demonstrated to identify efficiently the causative species in all cases. When applied to patients diagnosed on the basis of serological tests only, this technique allowed identification of the causative species in 20 of 22 cases. The results were in accordance with epidemiological features. Six reactive bands of B. quintana (of molecular sizes from 10 to 83 kDa) demonstrated significant association with sera from patients with B. quintana endocarditis. Overall, Western blotting and cross-adsorption made it possible to identify the causative species in 49 of 51 (96%) IE cases.

PMCID: PMC145273 PMID: 12522046 [PubMed - indexed for MEDLINE]

521. Vet Res. 2002 Nov-Dec;33(6):669-84.

Experimental infection of specific pathogen free (SPF) cats with two different strains of bartonella henselae type I: a comparative study.

Yamamoto K, Chomel BB, Kasten RW, Hew CM, Weber DK, Lee WI.

Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.

Domestic cats are the reservoir of Bartonella henselae, the main causative agent of cat scratch disease. We compared B. henselae type I infection characteristics in 6 SPF cats infected with a feline strain (4.8 x 10(7) colony-forming units (CFU)/mL) and in 6 SPF cats infected with the reference Houston I strain (6.6 x 10(6) CFU/mL to 9.6 x 10(7) /mL). All the cats inoculated with the feline strain, but none of the cats inoculated with B. henselae Houston I, developed a fever within 2-12 days (mean: 5.8 days) post inoculation (PI), which lasted for 1-2 weeks. However, all 12 cats became bacteremic. The duration of bacteremia was significantly longer in the cats inoculated with the feline strain (mean: 237 days) than in the cats inoculated with Houston I strain (mean: 60 days) (p < 0.01). Five (83%) cats inoculated with the feline strain and none of the six cats inoculated with B. henselae Houston I had relapsing bacteremia (p = 0.02). IgG antibodies were detected by IFA within 1-2 weeks for both strains, but peaked later (week 10 versus week 3 PI) for the feline strain. By ELISA, using antigens of each B. henselae strain, all 12 cats developed Bartonella specific IgM and IgG antibodies, but the cats infected with B. henselae Houston I antigen yielded significantly lower optical density values (p < 0.05). By SDS-PAGE, PFGE and Western blotting, protein profile differences (84 to 89% homology) were observed between the two strains. If a feline vaccine is to be developed in order to prevent human infection, the choice of the vaccine strain will be critical, since major differences were identified even between strains belonging to the same sero/genotype.

PMID: 12498568 [PubMed - indexed for MEDLINE]

522. J Med Entomol. 2002 Nov;39(6):915-9.

Studies on the growth of Bartonella henselae in the cat flea (Siphonaptera: Pulicidae).

Finkelstein JL, Brown TP, O'Reilly KL, Wedincamp J Jr, Foil LD.

Department of Entomology, Louisiana State University Agricultural Center, Baton Rouge, LA 70803, USA.

Two out of three pools of cat fleas, Ctenocephalides felis (Bouche), that were fed Bartonella henselae-positive cat blood for 3 d and then bovine blood for 3 d, were polymerase chain reaction (PCR) positive for B. henselae. In a second experiment, three cats were inoculated with a streptomycin-resistant strain of B. henselae. After the cats were inoculated, caged cat fleas were fed on the cats during three different periods, and then pooled and transferred to noninfected recipient cats. In the first trial, the bacteria in the flea feces were below level of detection when the fleas were transferred from the infected cats to the recipient cat. After the fleas had fed on the recipient cat for 6 d, a bacteria level of 4.00 x 10(3) CFU/ mg was detected in the flea feces. Subsequently, the bacteria level increased for 4 d and then declined. In another experiment, the bacteria level in the flea feces was 1.80 x 10(3) CFU/mg at 2 h after collection and 3.33 x 10(2) CFU/mg at 72 h after collection. These data indicated that this strain of B. henselae can persist in flea feces in the environment for at least 3 d, and that B. henselae can multiply in the cat flea.

PMID: 12495192 [PubMed - indexed for MEDLINE]

523. Clin Infect Dis. 2003 Jan 1;36(1):e10-3. Epub 2002 Dec 10.

Isolated splenic cat scratch disease in an immunocompetent adult woman.

Gilad J, Wolak A, Borer A, Benharroch D, Avidor B, Giladi M, Schlaeffer F.

Department of Internal Medicine E, Soroka University Medical Center, and Faculty for Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. giladk@hotmail.com

Comment in Clin Infect Dis. 2003 Sep 15;37(6):860; author reply 860-1.

We report a case of isolated splenic cat scratch disease in an immunocompetent woman. The clinical presentation of prolonged fever, night sweats, weakness, and intrasplenic lesions was highly suggestive of lymphoma. This is the second reported case of isolated splenic cat scratch disease in an adult and the first in a healthy adult.

PMID: 12491224 [PubMed - indexed for MEDLINE]

524. Vet Microbiol. 2003 Mar 20;92(1-2):73-86.

Infection and re-infection of domestic cats with various Bartonella species or types: B. henselae type I is protective against heterologous challenge with B. henselae type II.

Yamamoto K, Chomel BB, Kasten RW, Hew CM, Weber DK, Lee WI, Koehler JE, Pedersen NC.

Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.

Four Bartonella species have been isolated from domestic cats, of which two serotypes/genotypes of Bartonella henselae and possibly B. clarridgeiae are human pathogens, causing cat scratch disease (CSD).Our objectives were to evaluate infection and potential cross-protection during re-infection in domestic cats with various Bartonella species or types.Thirty-six cats were primarily inoculated with B. henselae type I (n=16), B. henselae type II (n=10), B. clarridgeiae (n=6) or B. koehlerae (n=4). They were challenged with B. henselae type I (n=15), B. henselae type II (n=13) or B. clarridgeiae (n=8). All 36 cats became bacteremic (1.25x10(2)-1.44x10(6)CFU/ml) and bacteremia lasted from 37 to 582 days. Duration of bacteremia for cats inoculated with B. henselae type I was shorter than for cats inoculated with either B. henselae type II (P=0.025) or B. clarridgeiae (P=0.011). After challenge, 26 cats became bacteremic. Among the nine cats primarily inoculated with B. henselae type I and challenged with B. henselae type II, six cats stayed abacteremic. The three bacteremic cats had a transient low-level bacteremia. No bacteremia was observed in three cats primarily inoculated with B. henselae type I and challenged with another strain of B. henselae type I. Bacteremia levels in the 26 cats were significantly lower than for primary inoculation (P=0.022) and its duration was shorter (P=0.012). Among the eight cats challenged with B. clarridgeiae, duration of bacteremia in the four cats primarily inoculated with B. henselae type I was shorter than in the four cats primarily inoculated with B. henselae type II (P=0.01). Bartonella clarridgeiae inoculated cats were more likely to have relapses for both primary and secondary infections. This is the first demonstration of cross-protection, evidenced by absence of bacteremia, in cats primarily infected with B. henselae type I and challenged with B. henselae type II, whereas no cross-protection was previously shown for cats primarily infected with B. henselae type II and challenged with B. henselae type I. Such results are of major importance for future feline Bartonella vaccine development.

PMID: 12488072 [PubMed - indexed for MEDLINE]

525. Clin Infect Dis. 2002 Dec 15;35(12):e141-4. Epub 2002 Nov 20.

Vertebral osteomyelitis due to Bartonella henselae in adults: a report of 2 cases.

Verdon R, Geffray L, Collet T, Huet H, Parienti JJ, Debruyne M, Vergnaud M, Bazin C.

Service de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire Côte-de-Nacre, 14033 Caen Cedex, France. verdon-r@chu-caen.fr

We describe 2 adult patients (1 of whom was infected with human immunodeficiency virus) with osteomyelitis due to Bartonella henselae. Diagnosis was established on the basis of direct identification of the microorganism in one case and seroconversion in the other. Both patients recovered completely within 3 months.

PMID: 12471592 [PubMed - indexed for MEDLINE]

526. Clin Pediatr (Phila). 2002 Nov-Dec;41(9):711-3.

Vertebral osteomyelitis in 2 children.

Del Santo M, Malorgio C, Not T, Maranzana G, Cerasoli G, Facchini S, Zennaro F, Ventura A.

Department of Pediatrics, IRCCS Burlo Garofolo, University of Trieste, Italy.

PMID: 12462322 [PubMed - indexed for MEDLINE]

527. J Clin Microbiol. 2002 Dec;40(12):4691-9.

Limited diversity among human isolates of Bartonella henselae.

Dillon B, Valenzuela J, Don R, Blanckenberg D, Wigney DI, Malik R, Morris AJ, Robson JM, Iredell J.

Centre for Infectious Diseases and Microbiology, Westmead Hospital, University of Sydney, New South Wales 2145, Australia.

A study of 59 isolates of Bartonella henselae reveals relatively limited diversity among those of human origin (n = 28). Either of two distinct alleles of both gltA and 16S ribosomal DNA (rDNA) was found in all isolates, with a high level of congruity between 16S and gltA inheritance among proven human pathogens. Human isolates from all over Eastern Australia were most commonly 16S rDNA (Bergmans) type I, with the same gltA allele as the type strain (Houston-1). Comparable feline isolates were more commonly 16S type II, with less congruity of inheritance between 16S and gltA alleles. Previously described arbitrarily primed PCR and EagI-HhaI infrequent restriction site PCR fingerprinting techniques separated Bartonella species effectively but lacked discriminating power within B. henselae. Examination of the 16-23S intergenic spacer region revealed for several strains several point mutations as well as a repeat sequence of unknown significance which is readily detected by HaeIII restriction fragment length polymorphism analysis. The bacteriophage-associated papA gene was present in all isolates. Enterobacterial repetitive intergenic consensus PCR proved to be a useful and robust typing tool and clearly separated human isolates (including imported strains) from the majority of feline isolates. Our data are consistent with published evidence and with previous suggestions of intragenomic rearrangements in the type strain and suggest that human isolates come from a limited subset of B. henselae strains. They strengthen arguments for careful exploration of genotype-phenotype relationships and for the development of a multilocus enzyme electrophoresis and multilocus sequence typing-based approach to the phylogeny of B. henselae.

PMCID: PMC154592 PMID: 12454174 [PubMed - indexed for MEDLINE]

528. J Infect Dis. 2002 Dec 15;186(12):1733-9. Epub 2002 Nov 22.

Molecular epidemiology of Bartonella henselae infection in human immunodeficiency virus-infected patients and their cat contacts, using pulsed-field gel electrophoresis and genotyping.

Chang CC, Chomel BB, Kasten RW, Tappero JW, Sanchez MA, Koehler JE.

Department of Public Health, China Medical College, Taichung, Taiwan, Republic of China.

Bartonella henselae causes severe disease in immunocompromised individuals. B. henselae was isolated from 12 human immunodeficiency virus (HIV)-infected individuals with bacillary angiomatosis and/or peliosis hepatis and from their 15 cat contacts. Specific associations between the 2 B. henselae genotypes, individual pulsed-field gel electrophoresis (PFGE) patterns, and different clinical syndromes and pathogenicity were investigated. The role of cat contacts as the source of human infection was also examined. Three of the 4 patients with B. henselae genotype I infection, but none of the 8 patients with genotype II infection, had hepatosplenic vascular proliferative lesions (P=.018). Four of 5 human-cat pairs had closely-related PFGE patterns and concordant results by 16S rDNA typing, which strongly suggests that human infection was caused by the cat contact. These results corroborate the major role of cats in the transmission of B. henselae to humans and suggest that B. henselae genotypes may induce different pathological features in HIV-infected patients.

PMID: 12447758 [PubMed - indexed for MEDLINE]

529. J Pathol. 2002 Dec;198(4):534-40.

Activation and apoptosis of macrophages in cat scratch disease.

Schweyer S, Fayyazi A.

Department of Pathology, University of Göttingen, Göttingen, Germany. sswyer@med.uni-goettingen.de

Cat scratch disease is an infectious disease usually caused by Bartonella henselae. Within 1-3 weeks after inoculation, patients typically develop regional self-limited lymphadenopathy. Lymph nodes reveal granulomas consisting of central necrosis, an inner rim of palisading macrophages, and an outer rim of lymphocytes and non-palisading macrophages. In animals, cat-scratch disease leads to an interferon-gamma (IFNgamma)-mediated T-helper 1 immune response, resulting in macrophage recruitment, stimulation, and thereby granuloma formation. The present study has sought to find in situ evidence for macrophage migration, activation, and cell death in human cat scratch disease. By non-radioactive in situ hybridization and immunohistochemistry on serial sections, it was demonstrated that IFNgamma+ T lymphocytes and S100A8+, S100A9+ macrophages embrace granulomas, which consisted of S100A8-, S100A9-, HLA-DR+, CD40+, TNFalpha+ macrophages. Combination of in situ end-labelling and immunofluorescence revealed large numbers of DNA-fragmented CD68+ cells with intact plasma membranes corresponding to apoptotic macrophages. On the basis of these data, it was hypothesized that in human cat scratch disease, S100A8+, S100A9+ macrophages continuously migrate to the granulomas. During this process, they may be activated by IFNgamma T-helper 1 lymphocytes and be differentiated to S100A8-, S100A9-sessile, HLA-DR+, CD40+ antigen-presenting, TNFalpha+ pro-inflammatory macrophages forming granulomas. In parallel, macrophages undergo apoptosis in the centre of granulomata, a phenomenon that may restrict the destructive potential of macrophages and contribute to self-limitation of cat scratch disease.

Copyright 2002 John Wiley & Sons, Ltd.

PMID: 12434424 [PubMed - indexed for MEDLINE]

530. Enferm Infecc Microbiol Clin. 2002 Dec;20(10):538-9.

[Vertebral osteomyelitis associated with cat scratch disease].

[Article in Spanish]

Pocheville I, Morteruel E, Alvarez J, Pérez-Irezabal J.

PMID: 12433360 [PubMed - indexed for MEDLINE]

531. J Clin Microbiol. 2002 Nov;40(11):4397-8.

Antigenic and genotypic relationships between Bartonella henselae strains.

Iredell J, McHattan J, Kyme P, Dillon B, Blanckenberg D.

PMCID: PMC139719 PMID: 12409443 [PubMed - indexed for MEDLINE]

532. Adv Nurse Pract. 2002 Sep;10(9):55-6.

Cat scratch disease. Transmission and treatment. Answers still unfolding.

Smith DR.

Community Outreach Clinic in Menomonee Falls, Wis., USA.

PMID: 12400315 [PubMed - indexed for MEDLINE]

533. J Infect. 2002 Oct;45(3):206-7.

Co-infection with Esptein-Barr virus and Bartonella henselae resulting in systemic bartonellosis.

Signorini L, Simeone F, Tonegatti L, Colombini P, Cadeo B, Cristini F, Matteeli A, Viale P.

Clinic of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy. amatteelli@bsnet.it

PMID: 12387781 [PubMed - indexed for MEDLINE]

534. Enferm Infecc Microbiol Clin. 2002 Oct;20(8):415-7.

[Endocarditis due to Bartonella henselae on a native valve. A new case with some notable aspects].

[Article in Spanish]

Aguirrebengoa K, Blanco R, Llorente A, Pérez-Irezabal J, Montejo M, Anda P.

PMID: 12372243 [PubMed - indexed for MEDLINE]

535. Am J Med. 2002 Sep;113(4):344-6.

Cases from the Osler Medical Service at Johns Hopkins University. Bartonella henselae infection of the liver and spleen.

Estrella M, Cosgrove SE.

PMID: 12361825 [PubMed - indexed for MEDLINE]

536. J Clin Microbiol. 2002 Oct;40(10):3620-4.

Improved culture from lymph nodes of patients with cat scratch disease and genotypic characterization of Bartonella henselae isolates in Australia.

Fournier PE, Robson J, Zeaiter Z, McDougall R, Byrne S, Raoult D.

Unité des Rickettsies, CNRS UMR 6020, IFR 48, Faculté de Médecine, 27 Boulevard Jean Moulin, 13385 Marseille, France.

Over a 4-year period we detected Bartonella henselae isolates in 104 of 297 specimens (35.1%) from Australian patients clinically suspected of having cat scratch disease by amplification of a fragment of the htrA gene. We isolated 17 B. henselae strains (20.5%) from the 83 PCR-positive human specimens available for culture. Our culture method was based on prolonged incubation in a moist atmosphere of blood agar to which hemin was added. We obtained more B. henselae isolates than the number of all other isolates from lymph nodes reported in the literature. In order to identify and study the genetic variation of Australian B. henselae isolates, we determined the sequence of a fragment of the pap31 gene from our 17 human isolates and also from 8 Australian cat isolates. Thirteen of the human B. henselae isolates belonged to the Houston genotype, variant Houston-1 (76.5%), and four belonged to the Marseille genotype, variant CAL-1 (23.5%). In contrast, seven cat isolates were classified as B. henselae Marseille, variant CAL-1 (87.5%), and one was classified as B. henselae Houston, variant Houston-1 (12.5%). Our study describes an efficient culture method for the diagnosis of cat scratch disease and contributes to the description of the genotypic distribution of B. henselae in Australia.

PMCID: PMC130866 PMID: 12354855 [PubMed - indexed for MEDLINE]

537. Vet Microbiol. 2002 Oct 22;89(2-3):211-21.

Genomic variations among Bartonella henselae isolates derived from naturally infected cats.

Kabeya H, Maruyama S, Irei M, Takahashi R, Yamashita M, Mikami T.

Laboratory of Veterinary Public Health, Department of Veterinary Medicine, College of Bioresource Science, Nihon University, 1866 Kameino, Fujisawa, Kanagawa 252-8510, Japan. kabeya@brs.nihon-u.ac.jp

The purpose of this study was to understand the mechanisms of persistent infection with Bartonella henselae in cats. Blood samples were collected from three naturally infected cats for 24 months. These cats were confirmed to be persistently infected with B. henselae by serological and bacteriological examination. Relapsing bacteremia was found in all three cats with intervals of 3-19 months. Following the peaks of bacteremia, increases of specific antibody titer were observed in these cats. To examine the genetic differences among the isolates derived from the first and following bacteremia, the genome DNA patterns of the restriction enzyme fragment length polymorphism (RFLP) of the isolates were examined by pulsed field gel electrophoresis. The isolates derived from the first bacteremia showed an identical RFLP pattern in each of the three cats. The isolates derived from the following peaks, however, showed 1-3 of different RFLP patterns in these cats. Furthermore, the isolates showing different RFLP patterns from those of the first bacteremia were also detected at the following bacteremic peaks in all three cats examined. The 16S ribosomal RNA (rRNA) gene type of all isolates was found to be 16S rRNA type I. The emergence of genetically distinct organisms at various peaks of bacteremia may contribute to the establishment of persistent infection in the naturally infected cats.

PMID: 12243898 [PubMed - indexed for MEDLINE]

538. Pediatr Transplant. 2002 Aug;6(4):327-31.

Cat scratch disease and acute rejection after pediatric renal transplantation.

Dharnidharka VR, Richard GA, Neiberger RE, Fennell RS 3rd.

The Division of Pediatric Nephrology, Shands Children's Hospital and University of Florida College of Medicine, Gainesville, Florida 32610, USA. vikasmd@ufl.edu

Cat scratch disease (CSD) can lead to unexplained fever, generalized lymphadenopathy and organomegaly in immunocompetent individuals. CSD has rarely been reported in immunocompromised transplant recipients, where its clinical features would mimic the more common post-transplant lymphoproliferative disease (PTLD). We report three cases of CSD seen recently in children who had received prior kidney transplants. The three children were between 7 and 9 yr old, and had received kidney transplants 2-4 yr prior, with stable renal function. In each case, there was unexplained fever with either lymphadenopathy or organomegaly. The diagnosis of CSD was suggested by a history of new cats being introduced into each household and confirmed in all cases by the serological presence of a significant titer (> 1 : 64) of IgM antibodies to Bartonella henselae. Tests for other bacterial infections, cytomegalovirus and Epstein-Barr virus infections were negative. All the patients showed a clinical improvement with anti-microbial therapy. In patients A and B, the CSD was associated with an acute rejection episode shortly after diagnosis. The rejection episodes were reversed by intravenous steroid pulse therapy. Only four cases of CSD have been previously reported following solid organ transplantation. Acute rejection following CSD has not been previously reported. CSD should be included in the differential diagnosis of fever in the post-transplant setting, especially where PTLD is suspected.

PMID: 12234274 [PubMed - indexed for MEDLINE]

539. Vet Rec. 2002 Aug 24;151(8):225-9.

Prevalence of Bartonella species causing bacteraemia in domesticated and companion animals in the United Kingdom.

Birtles RJ, Laycock G, Kenny MJ, Shaw SE, Day MJ.

Department of Pathology and Microbiology, School of Medical Sciences, University of Bristol.

Between October 1999 and February 2000, 691 blood samples examined routinely for either haematological or virological assessment were screened by culture for the presence of Bartonella species. They came from 615 animals: 360 cats, 211 dogs, 27 horses, 16 cattle and a gorilla. The samples were incubated for long periods on 10 per cent horse blood agar at 37 degrees C in an atmosphere containing 5 per cent carbon dioxide. Isolates were obtained from 35 samples from 34 (9.4 per cent) of the cats, but not from any of the other animals. Comparison of citrate synthase gene sequences from the isolates indicated that they were all Bartonella henselae. Analysis of 16S rRNA gene fragments indicated that 30 of the cats were infected solely with B henselae genotype II, two were infected solely with B henselae genotype I and two were infected with both genotypes.

PMID: 12219899 [PubMed - indexed for MEDLINE]

540. Int J Dermatol. 2002 Aug;41(8):461-6.

Skin manifestations of Bartonella infections.

Chian CA, Arrese JE, Piérard GE.

Department of Pathology, Universidad Peruana Cayetano Heredia, Lima, Peru.

PMID: 12207759 [PubMed - indexed for MEDLINE]

541. Clin Diagn Lab Immunol. 2002 Sep;9(5):1004-9.

Comparison of in-house and commercial slides for detection by immunofluorescence of immunoglobulins G and M against Bartonella henselae and Bartonella quintana.

Maurin M, Rolain JM, Raoult D.

Unité des Rickettsies, CNRS UMR 6020, IFR 48, Faculté de Médecine, Université de la Méditerranée, 13385 Marseille Cedex 05, France.

We compared the sensitivities and specificities of indirect fluorescent antibody tests developed in our laboratory and commercially available from Focus Technologies (FT; formerly MRL Diagnostic) for detection of serum antibodies to Bartonella spp. Serum samples tested were from patients with culture- or PCR-confirmed Bartonella quintana or B. henselae infections causing cat scratch disease (CSD), chronic bacteremia, or endocarditis. At a cutoff titer of 64, the FT test had higher sensitivity than our in-house test in detecting anti-B. henselae immunoglobulin G (IgG) antibodies in CSD patients (91.2 versus 52.9%; P < 0.001). The specificity in serum samples from 85 control patients was, however, lower with the FT test (87%) than with the in-house test (98.8%) (P = 0.002). A cutoff titer of 128 improves the specificity for the FT test but lowers the sensitivity to 85%. For patients infected with B. henselae, our in-house test, but not the FT test, enabled endocarditis to be detected more reliably. With the in-house test, titers of IgG against B. henselae of >/=1,024 were found only in endocarditis patients and not in CSD patients. With the FT test, 19.1% of CSD patients had titers of IgG against B. henselae of >/=1,024 (P < 0.001). Our in-house technique also improved detection of anti-B. quintana antibodies in homeless patients with endocarditis. IgG titers of >/=1,024 were present in 75% of serum samples, but only in 16.7% of serum samples with the FT test (P = 0.004). Since each test has advantages over the other, the serological diagnosis of Bartonella infections would benefit if both tests were used concurrently.

PMCID: PMC120066 PMID: 12204950 [PubMed - indexed for MEDLINE]

542. Clin Infect Dis. 2002 Sep 15;35(6):643-9. Epub 2002 Aug 14.

Role of cat-scratch disease in lymphadenopathy in the head and neck.

Ridder GJ, Boedeker CC, Technau-Ihling K, Grunow R, Sander A.

Department of Otorhinolaryngology-Head and Neck Surgery, University of Freiburg, Freiburg, Germany.

Bartonella henselae is the causative agent of cat-scratch disease (CSD), which usually manifests as acute regional lymphadenopathy. The causes of cervical lymphadenopathy, with special regard to CSD, were investigated in a study of 454 patients who presented with unclear masses in the head and neck from January 1997 through January 2001. Sixty-one patients (13.4%) experienced CSD; 54 (11.9%) had primary lymphadenopathy due to other infectious agents, and 41 (9.0%) had lymphadenopathy that occurred in association with primary infections of other organs. For 171 patients (37.7%), the cause of the cervical lymph node enlargement could not be found. B. henselae DNA was detected in extirpated lymph nodes only during the first 6 weeks of lymphadenopathy, which indicates that the results of polymerase chain reaction strongly depend on the duration of illness. CSD should be included in the differential diagnosis of adenopathy in the otorhinolaryngologic patient population, to avoid unnecessary treatment.

PMID: 12203159 [PubMed - indexed for MEDLINE]

543. New Microbiol. 2002 Jul;25(3):307-13.

Cat scratch disease. Survey on the presence of Bartonella henselae among cats of Tuscany.

Ebani VV, Cerri D, Andreani E.

Department of Animal Pathology, Prophylaxis and Food Hygiene, Faculty of Veterinary Medicine, University of Pisa, Italy.

To verify the presence of Bartonella henselae-infection in cats living in Tuscany (central Italy) serological and bacteriological surveys were carried out. The blood serum samples of 427 cats, 254 living in private houses and gardens and 173 in public or private catteries, were tested for anti-B. henselae antibodies by indirect immunofluorescence assay (IFA). Among these samples, 35 were examined by IFA to detect antibodies against Bartonella quintana. Bacteriological examinations were performed on the blood samples, collected in EDTA (ethylene diaminetetraacetic acid), of 18 cats (10 seropositive to B. henselae and 8 negative). From each of the same 18 specimens DNA was extracted and used as template in polymerase chain reaction (PCR). The primers p24E and p12B were employed in the PCR assay to amplify a 296 bp fragment of the Bartonella 16S rRNA gene. IFA detected 98 (22.95%) B. henselae-positive serum samples (40-40.82% from cats living in houses and gardens and 58-59.18% from cats of catteries) at different antibody titers (70 at 1:64 titer, 4 at 1:128, 22 at 1:256, 2 at 1:512). Among the 35 sera tested to detect antibodies against B. quintana, 9 (25.71%) resulted positive at 1:64 titer; all these samples showed higher antibody titers to B. henselae. Out of the 26 negative sera, 20 were negative to B. henselae too and 6 had antibodies against B. henselae at 1:64. Hemocultures gave negative results. PCR scored positive with DNA of 4 B. henselae-seropositive cats, two of which belonged to two children with cat scratch disease (CSD).

PMID: 12173772 [PubMed - indexed for MEDLINE]

544. Korean J Ophthalmol. 2002 Jun;16(1):43-6.

Unilateral neuroretinitis and periparillary serous retinal detachment in cat-scratch disease.

Saatci AO, Oner FH, Kargi A, Kavukcu S.

Department of Ophthalmology, Dokuz Eylül University, Izmir, Turkey.

Cat-scratch disease is a self-limited infection characterized by subacute regional lymphadenitis, which is usually preceded by a history of being scratched by a cat infected with the Bartonella species. Neuroretinitis, retinochoroiditis, isolated papillitis and peripapillary angiomatosis are features of posterior segment involvement. However, vision loss is very rare. We report a patient with cat-scratch disease associated with unilateral neuroretinitis and peripapillary serous retinal detachment, and discuss its fluorescein and indocyanine green angiographic features.

PMID: 12162517 [PubMed - indexed for MEDLINE]

545. Biomedica. 2002 Jun;22(2):141-54.

[Bacillary angiomatosis].

[Article in Spanish]

Rodríguez G, Torres BE, Motta A.

Laboratorio de Patología, Instituto Nacional de Salud, Bogotá, D.C., Colombia. grodriguez@hemagogus.ins.gov.co

Erratum in Biomedica (Bogota) 2002 Sep;22(3):319.

Bacillary angiomatosis is a bacterial disease which affects mainly immunosuppressed patients. It may compromise any tissue, especially the skin, presenting papules, nodules or angiomatous tumors. We studied three young men with AIDS, all of them with 1-2 papules, nodules or subcutaneous tumors suggesting telangiectatic granuloma, sarcoma and lipoma. Microscopically, they were misdiagnosed as telangiectatic granuloma, Kaposi's sarcoma and "angioma with secondary inflammation". After reviewing the histopathology, we saw them to be composed by vessels with prominent endothelium and stroma rich in leukocytoclastic polymorphonuclears. Fibrinoid deposits were observed in the neighborhood of vessels as well as minute eosinophilic granular interstitial masses corresponding to Bartonella aggregates, criteria which answer to the diagnosis of bacillary angiomatosis with HE staining. The Warthin-Starry stain was not useful; using resin embedded tissue from paraffin-embedded material, bacterial clusters, both in semithin section stained with toluidine blue and in thin sections observed under the electron microscope, were clearly seen, confirming bacillary angiomatosis diagnosis. Patients were successfully treated with surgery and either erythromycin or doxycycline. We reviewed the entity as well as its differential diagnoses with telangiectatic granuloma, Kaposi's sarcoma, Carrión's disease, and cat-scratch disease. In conclusion, we showed the presence of bacillary angiomatosis in three patients, illustrated its typical histopathological appearance with HE staining and demonstrated the causal bacteria in thick sections and with the electron microscope. It is essential to recognize bacillary angiomatosis, as it can be cured with antibiotics.

PMID: 12152480 [PubMed - indexed for MEDLINE]

546. Microbiol Immunol. 2002;46(5):313-6.

Serological investigation of Bartonella henselae infections in clinically cat-scratch disease-suspected patients, patients with cardiovascular diseases, and healthy veterinary students in Japan.

Kikuchi E, Maruyama S, Sakai T, Tanaka S, Yamaguchi F, Hagiwara T, Katsube Y, Mikami T.

Department of Veterinary Medicine, College Bioresource Sciences, Nihon University, Fujisawa, Kanagawa, Japan.

Seroprevalence of Bartonella henselae was investigated in Japan in 48 individuals clinically suspected of having cat-scratch disease (CSD), 159 patients with cardiovascular diseases, and 129 healthy veterinary students. Of 48 CSD-suspected patients examined, 19 (39.6%) were positive for B. henselae-IgG and 4 (8.3%) for B. henselae-IgM. Of 159 patients with cardiovascular diseases, 5 (3.1%) were positive for B. henselae-IgG. In healthy veterinary students, 14 of 129 (10.9%) were positive for B. henselae-IgG and 1 (0.8%) for B. henselae-IgM. The positive rates of B. henselae-IgG and -IgM in CSD-suspected patients were significantly higher than in other sources. Most CSD-suspected and healthy individuals who were positive for B. henselae antibody had had some contacts with cats. In CSD-suspected patients, the B. henselae positive rate in females was significantly higher than in males, and high seropositive rates to B. henselae were found in younger age groups.

PMID: 12139390 [PubMed - indexed for MEDLINE]

547. Comp Immunol Microbiol Infect Dis. 2002 Jul;25(4):217-28.

Characterization of the first Bartonella henselae strain isolated from a cat in Italy.

Ciceroni L, Fabbi M, Ciarrocchi S, Pinto A, Ciervo A, Kasten RW, Chomel BB.

Department of Bacteriology and Medical Mycology, Istituto Superiore de Sanita, Rome, Italy. ciceroni@iss.it

Bartonella henselae has been identified and characterized for the first time in Italy. A strain, designed Pavia-1, was isolated from the blood of a cat whose owner developed cat scratch disease (CSD). Pavia-1 and two American B. henselae strains (Houston-1, ATCC 49882, type I and strain 269608, UC Davis, type II) were compared by whole-cell fatty analysis (CFA), sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) for protein profiles, Western immunoblotting (WB) for reactivity with polyclonal antibodies, polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), type-specific 16S rRNA PCRs, and pulsed-field gel electrophoresis (PFGE). Bartonella clarridgeiae (ATCC 51734) was also included for comparison. Pavia-1 was identified as a B. henselae type I. PFGE allowed differentiation between B. clarridgeiae and B. henselae and furthermore, between all the B. henselae strains. The fingerprints of PFGE observed for Pavia-1 were distinct from those of B. henselae type II and also of Houston-1, suggesting that the two type I strains derived from two different clones. These results show the capability of B. henselae to develop genotypic variability between genetically related strains.

PMID: 12135236 [PubMed - indexed for MEDLINE]

548. Cornea. 2002 Aug;21(6):625-7.

Positive polymerase chain reaction and histology with borderline serology in Parinaud's oculoglandular syndrome.

Starck T, Madsen BW.

Cornea and Refractive Surgery Services, Department of Ophthalmology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, U.S.A. Starck@uthscsa.edu

PURPOSE: To report a case of Parinaud's oculoglandular syndrome (POS) in which, despite a borderline serology, polymerase chain reaction (PCR) testing for a conjunctival biopsy was positive for Bartonella henselae, a source of cat-scratch disease. A Steiner silver stain demonstrated the organism. METHODS: Case Report. RESULTS: A 65-year-old man was seen for a foreign body in his left eye (OS) associated with chemosis and a preauricular node. CONCLUSION: B. henselae is a known cause of POS. This gram-negative pleomorphic rod has been more frequently discovered in connection with this syndrome due to improved diagnostic testing such as indirect immunofluorescence antibody and PCR testing. Frequently, serology is positive if the organism is present. This report describes a patient with clinical findings of POS who, despite borderline serology, had pleomorphic rods on Steiner silver stain and positive PCR testing compatible with Bartonella henselae.

PMID: 12131048 [PubMed - indexed for MEDLINE]

549. Rev Med Chir Soc Med Nat Iasi. 2001 Jul-Sep;105(3):486-9.

[Bartonella infection].

[Article in Romanian]

Miftode E, Luca V.

Facultatea de Medicină, Clinica de Boli Infecţioase, Universitatea de Medicină şi Farmacie Gr.T. Popa Iaşi.

Bartonella species have been recently recognized as an important human pathogen associated with a wide spectrum of diseases. Four members of the genus are known to cause human infection: Bartonella baciliformis, B. henselae, B. quintana and B. elizabethae. B. baciliformis, the first identified Bartonella species, is the agent of two disease entities, Oroya fever and verruga peruana., B. henselae and B. quintana are two species involved in producing bacteremic syndromes (relapsing fever, trench fever, endocarditis), chronic lymphadenopathy in immunocompetent patients (cat-scrath disease) and chronic vascular lesions in immunocompromised hosts (bacillary angiomatosis and bacillary peliosis hepatis-recognized as new opportunistic infections in HIV-infected patients).

PMID: 12092178 [PubMed - indexed for MEDLINE]

550. Clin Pediatr (Phila). 2002 Jun;41(5):357-9.

Gross hematuria in a young child with axillary lymphadenopathy.

Cramm KJ, Silverstein DM.

Department of Pediatrics, Louisiana State University Health Sciences Center, New Orleans 70118, USA.

PMID: 12086202 [PubMed - indexed for MEDLINE]

551. Clin Microbiol Infect. 2002 Jun;8(6):345-51.

Lack of correlation between Bartonella DNA detection within fleas, serological results, and results of blood culture in a Bartonella-infected stray cat population.

La Scola B, Davoust B, Boni M, Raoult D.

Unité des Rickettsies, CNRS UPRESA 6020, Faculté de Médecine, Marseille, France. Didier.Raoult@medecine.univ-mrs.fr

OBJECTIVE: To correlate the presence of different Bartonella species in the blood of a stray cat population trapped on a French military base with specific antibodies and species detected in cat fleas. METHODS: The prevalence of Bartonella bacteremia was investigated in 61 cats by plating frozen whole blood on blood agar plates. Identification of isolates and detection of Bartonella DNA from cat flea batches from ten cats was achieved by PCR amplification and sequencing. Antibody detection was performed by microimmunofluorescence. RESULTS: We obtained 38 isolates of Bartonella from blood. Sixteen were identified as B. clarridgeiae, 15 as B. henselae genotype/serotype Houston 1 (type I), and seven as B. henselae genotype/serotype Marseille (type II). B. henselae was detected in five fleas, and B. clarridgeiae in one flea. Sixty-one per cent of the cats had detectable antibodies against at least one species or serotype. Sixteen cats had antibodies against only one antigen. For each species, the distribution of bacteremia among the cats could not be correlated with either the distribution of infected fleas or the distribution of specific antibodies. CONCLUSIONS: The lack of correlation between Bartonella DNA detection within fleas, serological results, and results of blood culture is probably due to a lack of natural heterologous protection between species or serotypes. Cats suffer bacteremia with three Bartonella species and should therefore be considered the reservoirs of at least three human pathogens.

PMID: 12084102 [PubMed - indexed for MEDLINE]

552. Med Pregl. 2001;54 Suppl 1:39-42.

[Treatment of bite wounds and cat-scratch disease].

[Article in Croatian]

Jovanović J, Lalosević V.

Klinicki centar Novi Sad, Klinika za infektivne bolesti, 21000 Novi Sad, Hajduk Veljkova 1-7.

Although rabies is the most serious consequence of animal bite injuries, in urban rabies-free countries the risk of rabies is far lower than the risk of bacterial infections of the wound. The most frequent etiologic cause of the wound infections after dog bites is Pasteurella multocida, as well as in the case of bites by cats, after which cat-scratch disease may also develop, its main cause being Bartonella henselae. All bite injuries must be carefully cleaned and disinfected; it is necessary to estimate the need of antirabies and antitetanus protection, and to introduce antibiotic treatment for prevention, particularly in the case of deep sting wounds caused mostly by cats.

PMID: 12078126 [PubMed - indexed for MEDLINE]

553. APMIS. 2002 Apr;110(4):309-14.

Low prevalence of Bartonella henselae infections in Norwegian domestic and feral cats.

Bergh K, Bevanger L, Hanssen I, Løseth K.

Department of Laboratory Medicine, Norwegian University of Science and Technology, Trondheim, Norway. kare.bergh@medisin.ntnu.no

Bartonella henselae is the causative agent of cat scratch disease (CSD). This clinical entity is very rarely encountered in human medical practice in Norway. B. henselae infections including bacteraemia in cats have been frequently reported. The objective of the present study was to investigate the seroprevalence rate and the degree of B. henselae bacteraemia in Norwegian domestic and feral cats. One hundred cats investigated at a small animal veterinary practice in the middle of Norway were included in the study. Blood collected in Isolator blood-lysis tubes and lysates of erythrocytes after freezing and thawing were cultured. PCR analysis of whole blood was also performed. Serology was performed by indirect fluorescence assay (IFA) and enzyme immunoassay (EIA) using immobilised B. henselae Houston-1 strain as antigen. None of the 100 cats investigated was found to be bacteraemic. All 100 cats were seronegative when analysed by IFA; one cat was positive by EIA. The discrepancy between IFA and EIA of this particular cat is probably due to cross-reactive antibodies. Contrary to findings reported from several geographic regions, B. henselae infections in Norwegian cats appear to be virtually absent. This in turn may explain why CSD has not been reported in human medical practice in Norway.

PMID: 12076266 [PubMed - indexed for MEDLINE]

554. J Forensic Sci. 2002 May;47(3):640-4.

Fatal meningitis and encephalitis due to Bartonella henselae bacteria.

Gerber JE, Johnson JE, Scott MA, Madhusudhan KT.

Forensic Medical, Nashville, TN 37216, USA.

Bacterial infection due to Bartonella henselae commonly develops in children and young adults following cat/dog contacts and/or cat/dog scratches. Regional lymphadenopathy is its most common clinical expression. However, encephalitis and Parinaud's syndrome (oculoglandular syndrome) have also been reported as has systemic illness. A review of the international literature in all languages revealed no fatal complications in immunocompetent hosts. A four-year-old white child with no underlying illness began to have seizure-like activity. She was taken to a local hospital and subsequently transferred to a medical center. The child was treated aggressively for seizures and fever of unknown origin. However, her condition rapidly declined and she died without a specific diagnosis. At autopsy there was marked cerebral edema with no gross evidence of acute meningitis. Microscopic exams revealed multiple granulomatous lesions as well as a meningitis and encephalitis. A variety of cultures and stains were negative for acid fast and fungal organisms. Warthin-Starry stains of involved tissue including brain and liver revealed pleomorphic rod shaped bacilli consistent with Barronella henselae. Analysis of brain tissue with polymerase chain reaction (PCR) and Southern blot for the deoxyribonucleic acid (DNA) was definitive for DNA of Bartonella henselae bacteria.

PMID: 12051353 [PubMed - indexed for MEDLINE]

555. J Clin Microbiol. 2002 Jun;40(6):2002-8.

Genotypic characteristics of two serotypes of Bartonella henselae.

La Scola B, Liang Z, Zeaiter Z, Houpikian P, Grimont PA, Raoult D.

Unité des Rickettsies, CNRS UMR 6020, 13385 Marseille Cedex 5, France.

The study of 16S rRNA gene sequences of all isolates of Bartonella henselae obtained in our laboratory and others from human patients or cats has revealed two genotypes according to the sequence of the 16S rRNA gene. Two isolates of these genotypes have previously been related to two different serotypes, and lack of cross-protection of the two serotypes has been demonstrated in cats. We investigated the grouping of eight strains of B. henselae on the basis of 16S ribosomal DNA, 35-kDa protein, Pap 31 protein, and internal transcribed spacer (ITS) gene sequencing; sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) profiles; and monoclonal antibody reactivity studies. Houston-1, 90-615, and SA2 strains showed the same patterns in SDS-PAGE, but they differed from the patterns of B. henselae isolates URBHLLY8, URBHLIE9, Cat6, Fizz, and CAL-1. Nine monoclonal antibodies derived from BALB/c mice immunized with B. henselae Houston-1 strain reacted only with strains Houston-1, 90-615, and SA2, and not with any other Bartonella strains. The two serogroups corresponded with two genotypes based on differences in the sequences of the genes encoding 16S rRNA, 35-kDa protein, and Pap 31 protein. Sequences of ITS genes were highly divergent among strains, as each had a unique sequence and the subdivision was not supported by DNA-DNA relatedness study. Study of 22 additional strains of B. henselae isolated from French bacteremic cats demonstrated that they all belong to one or the other of the proposed serotype or genotype.

PMCID: PMC130690 PMID: 12037055 [PubMed - indexed for MEDLINE]

556. JAMA. 2002 May 22-29;287(20):2647-9.

From the Centers for Disease Control and Prevention. Cat-Scratch Disease in children--Texas, September 2000-August 2001.

[No authors listed]

PMID: 12035788 [PubMed - indexed for MEDLINE]

557. Scand J Infect Dis. 2002;34(3):192-6.

Prevalence of antibodies to Bartonella henselae, B. elizabethae and B. quintana in Swedish domestic cats.

Hjelm E, McGill S, Blomqvist G.

Department of Medical Sciences, Uppsala University, Sweden. eva.hjelm@microbe.clm.uas.lul.se

Sera from 292 cats were analyzed by means of indirect immunofluorescence for antibodies to Bartonella henselae, B. quintana and B. elizabethae. The sera were sent to the Swedish National Institute of Veterinary Medicine for health monitoring and were tested retrospectively for antibodies to Bartonella. The most prevalent antibodies (25%) reacted with the B. elizabethae antigen. Cats with such antibodies were older than those without antibodies. The prevalence of antibodies to B. elizabethae was higher in the south of Sweden than in the north, with the highest prevalence (46%) being found in cats living in the Stockholm region. There was no difference in sex distribution. A low prevalence (1%) of antibodies to B. henselae was found and no sera reacted with B. quintana. The high prevalence of antibodies to B. elizabethae is consistent with previous findings in Swedish patients. The small number of cats with B. henselae antibodies observed in this study could be due to the cold climate and the low occurrence of cat fleas in Sweden.

PMID: 12030392 [PubMed - indexed for MEDLINE]

558. J Feline Med Surg. 2002 Jun;4(2):107-10.

Inoculation with Bartonella henselae followed by feline herpesvirus 1 fails to activate ocular toxoplasmosis in chronically infected cats.

Powell CC, Kordick DL, Lappin MR.

Department of Clinical Sciences, Colorado State University, 300 W. Drake, Fort Collins, Colorado, 80523-1620, USA.

Infection by Toxoplasma gondii is very common in cats although most remain disease free. The factors that trigger development of uveitis in some cats infected with T gondii have not been elucidated, but infection by more than one organism may be contributory. In this study, cats chronically infected with T gondii were inoculated with Bartonella henselae followed by FHV-1 to test the hypothesis that immune stimulation by multiple infections will reactivate ocular toxoplasmosis. Anterior uveitis and chorioretinitis were not detected in the cats with chronic T gondii infection thus allowing rejection of the hypothesis using this experimental design.

Copyright 2002 ESFM and AAFP. Published by Elsevier Science Ltd. All rights reserved.

PMID: 12027509 [PubMed - indexed for MEDLINE]

559. BMJ. 2002 May 18;324(7347):1199-200.

Cat scratch disease.

Williams A, Sheldon CD, Riordan T.

St Thomas Health Centre, Exeter EX4 1HJ. su1838@eclipse.co.uk

Erratum in BMJ 2002 Aug 24;325(7361):435.

PMCID: PMC1123162 PMID: 12016189 [PubMed - indexed for MEDLINE]

560. New Microbiol. 2002 Apr;25(2):253-7.

Isolation of Bartonella henselae from domestic cats in an Italian urban area.

Cabassi CS, Farnetti E, Casali B, Taddei S, Donofrio G, Galvani G, Cavirani S.

Dipartimento di Salute Animale, Facoltà di Medicina Veterinaria, Università di Parma, Italy.

Bartonella henselae is the causative agent of Cat Scratch Disease (CSD) in humans. Cat is considered the reservoir of the bacterium. Identification of bacteriemic cats is the basic tool in the prophylaxis of CSD. Blood samples were collected between January 1999-December 2000 from 248 domestic cats living in an urban area (Reggio Emilia) in Northern Italy and tested for Bartonella henselae bacteriemia. Cultural and PCR methods were used. PCR was used directly on cat blood as well as to identify the Bartonella strain growth in culture. 24 (9.7 %) cats were found bacteriemic, most of which aged <1 year. A higher sensitivity was demonstrated by cultural method compared with PCR.

PMID: 12019735 [PubMed - indexed for MEDLINE]

561. Can Commun Dis Rep. 2002 Apr 15;28(8):64-7.

Cat-scratch disease in children--Texas, September 2000 to August 2001.

[Article in English, French]

[No authors listed]

PMID: 11974428 [PubMed - indexed for MEDLINE]

562. Vet Res. 2002 Mar-Apr;33(2):205-13.

Prevalence of Bartonella infection in domestic cats in Denmark.

Chomel BB, Boulouis HJ, Petersen H, Kasten RW, Yamamoto K, Chang CC, Gandoin C, Bouillin C, Hew CM.

Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis 95616, USA. bbchomel@ucdavis.edu

Whole blood and serum from 93 cats (44 pets and 49 shelter/stray cats) from Denmark were tested for the presence of feline Bartonella species by culture and for the presence of Bartonella antibodies by serology. Bartonella henselae was isolated from 21 (22.6%) cats. Bacteremia prevalence was not statistically different between shelter/stray cats (13/49, 26.5%) and pet cats (8/44, 18.2%), but varied widely by geographical origin of the cats, even after stratification for cat origin or age (p < 0.001). All isolates but one were B. henselae type II. The only cat bacteremic with B. henselae type I was not co-infected with B. henselae type II. None of the cats was harboring either B. clarridgeiae or B. koehlerae. Almost half (42/92, 45.6%) of the cats were seropositive for B. henselae and antibody prevalence was similar in shelter/stray cats (23/49, 46.9%) and pet cats (19/43, 44.2%). This is the first report of isolation of B. henselae from domestic cats in Denmark. This study also indicates that domestic cats, including pet cats, constitute a large Bartonella reservoir in Denmark.

PMID: 11944808 [PubMed - indexed for MEDLINE]

563. Clin Pediatr (Phila). 2002 Mar;41(2):117-8.

Severe thrombocytopenic purpura as a complication of cat scratch disease.

Borker A, Gardner R.

LSU Health Sciences Center and Childrens Hospital of New Orleans, LA 70118, USA.

PMID: 11931328 [PubMed - indexed for MEDLINE]

564. MMWR Morb Mortal Wkly Rep. 2002 Mar 15;51(10):212-4.

Cat-scratch disease in children--Texas, September 2000-August 2001.

Centers for Disease Control and Prevention (CDC).

Cat-scratch disease (CSD), a bacterial infection caused by Bartonella henselae, has emerged as a relatively common and occasionally serious zoonotic disease among children and adults. To illustrate the spectrum of clinical manifestations of CSD observed during a 1-year period, Texas Children's Hospital (TCH) in Houston reviewed the medical records of 32 children evaluated at TCH during September 2000-August 2001 whose antibody titers indicated recent Bartonella infection. This report summarizes the evaluations of these cases and highlights four manifestations of infection with this pathogen in children. The findings emphasize that although CSD is generally a mild, self-limited illness, the differential diagnosis often includes more serious conditions (e.g., lymphoma, carcinoma, mycobacterial or fungal infection, or neuroblastoma) that might result in protracted hospital stays and lengthy treatments before diagnosis. Timely assessment of CSD is important, particularly when invasive diagnostic measures are being considered.

PMID: 11922191 [PubMed - indexed for MEDLINE]

565. J Feline Med Surg. 1999 Sep;1(3):171-80.

Vegetative endocarditis in six cats.

Malik R, Barrs VR, Church DB, Zahn A, Allan GS, Martin P, Wigney DI, Love DN.

Veterinary Cardiovascular Unit, Department of Veterinary Clinical Sciences, The University of Sydney, New South Wales, Australia.

Between 1990 and 1997 vegetative endocarditis was diagnosed in six neutered cats (three males, three females) aged between 3 and 9 years. Two cats were purebred (one Persian and one Tonkinese), the remaining four being domestic short haired cats. The diagnosis was made using echocardiography (five cases) or at necropsy (one case). Concurrent involvement of the aortic and mitral valve was noted in four cats, the aortic valve alone was affected in one case, and the tricuspid valve in another. A likely microbiological diagnosis was obtained in three cats: a Bartonella species in two cats based on positive blood culture and a Streptococcus species in one cat based on Gram stain of valve lesions at necropsy. In another cat, Gram-positive cocci were demonstrated histologically in tricuspid vegetations. Invariably, cats had signs of congestive heart failure (left-sided in five cats, right-sided in one), and this was the major factor contributing to mortality in four cases. Signs referable to sepsis were prominent in only two patients. Appropriate medical therapy, consisting of antimicrobials and drugs to treat congestive heart failure, resulted in survival for 5 and 11 months, respectively, in two cases. The other cats died within 2 weeks of diagnosis, including two which received aggressive treatment in hospital.

Copyright 1999 W.B. Saunders Company Ltd.

PMID: 11919032 [PubMed - indexed for MEDLINE]

566. Kansenshogaku Zasshi. 2002 Feb;76(2):113-7.

[A case of cat scratch disease with encephalopathy].

[Article in Japanese]

Touyama M, Uezu K, Nakamoto A, Shinzato T, Higa F, Tateyama M, Saito A, Nakamura M, Tsuneoka H, Tsukahara M.

First Department of Internal Medicine, Faculty of Medicine, University of the Ryukyus.

We report an atypical case of cat scratch disease (CSD), accompanied with encephalopathy that is a rare complication of CSD. A 17-year old man consulted a doctor for his right axillary lymphadenopathy. The history of his contact with cats and the sign of lymphnode swelling and fever suggested a suspect of cat scratch disease. Administration of ampicillin improved his clinical symptoms, but a few days later he suddenly fell into coma after an episode of convulsion. The CT scan of the brain and laboratory tests showed no significant findings except the slightly elevated cell counts and concentration of protein in his cerebrospinal fluid. He was referred to our hospital on the next day for further examinations and treatments for his coma of unknown cause. The physical examination on admission revealed slight neck stiffening and hypertonicity of his right lower limb, but radiological and laboratory tests showed no significant findings. He gradually recovered from his coma without apparent sequelae in three weeks. Indirect fluorescence antibody titers for CSD in his serum showed a significant elevation to 1:160 of IgM and 1:512 of IgG, and his clinical features were compatible to these of CSD with complications of the central nervous system.

PMID: 11904996 [PubMed - indexed for MEDLINE]

567. Int J Med Microbiol. 2002 Feb;291(6-7):555-60.

Bacterial persistence within erythrocytes: a unique pathogenic strategy of Bartonella spp.

Seubert A, Schulein R, Dehio C.

Department of Molecular Microbiology, Biozentrum of the University of Basel, Switzerland.

The genus Bartonella comprises human-specific and zoonotic pathogens responsible for a wide range of clinical manifestations, including Carrion's disease, trench fever, cat scratch disease, bacillary angiomatosis and peliosis, endocarditis and bacteremia. These arthropod-borne pathogens typically parasitise erythrocytes in their mammalian reservoir host(s), resulting in a long-lasting haemotropic infection. We have studied the process of Bartonella erythrocyte parasitism by tracking green fluorescent protein-expressing bacteria in the blood of experimentally infected animals. Following intravenous infection, bacteria colonise a yet enigmatic primary niche, from where they are seeded into the blood stream in regular intervals of approximately five days. Bacteria invade mature erythrocytes, replicate temporarily and persist in this unique intracellular niche for the remaining life span of the infected erythrocytes. A triggered antibody response typically results in an abrogation of bacteremia within 3 months of infection, likely by blocking new waves of bacterial invasion into erythrocytes. The recent establishment of genetic tools for Bartonella spp. permitted us to identify several putative pathogenicity determinants. Application of differential fluorescence induction technology resulted in the isolation of bacterial genes differentially expressed during infection in vitro and in vivo, including an unknown family of autotransporter proteins as well as a novel type IV secretion system homologous to the conjugation system of E. coli plasmid R388. Mutational analysis of a previously described type IV secretion system displaying homology to the virB locus of Agrobacterium tumefaciens provided the first example of an essential pathogenicity locus in Bartonella. Though required for establishing haemotropic infection, it remains to be demonstrated if this type IV secretion system is necessary for colonisation of the primary niche or for the subsequent colonisation of erythrocytes.

PMID: 11890558 [PubMed - indexed for MEDLINE]

568. Med Sci Monit. 2002 Mar;8(3):CS26-9.

Cat-scratch disease in an immunocompromised host.

Harsch IA, Schahin SP, Schmelzer A, Hahn EG, Konturek PC.

1st Department of Medicine, Friedrich-Alexander University, Erlangen-Nuremberg, Erlangen, Germany.

BACKGROUND: The main causative agents of cat-scratch disease are Bartonella henselae, tiny, gram-negative bacilli. The disease usually has a benign course with the development of a papule at the inoculation site, followed by regional lymphadenopathy. In most cases, complete resolution occurs, but in immunocompromised hosts, the course of the disease can be aggravated. CASE REPORT: A patient received methotrexate and corticosteroids for 3 months due to rheumatoid arthritis. He developed fever, exanthema and leukopenia under methotrexate therapy. Dark red indurations with central ulcerations at his right thigh revealed a further problem apart from the methotrexate-induced leucopenia and immunosuppression. The ulcerations were the remainders of recurrent scratches from the patient's cat. The patient's antibody titers against Bartonella henselae remained low and inguinal lymph node swelling was only for a short time to be observed, this reaction obviously weakened as a result of the immunosuppression. However, the typical course, the exclusion of other reasons for the exanthema and the rapid improvement of the patient's condition after antibiotic treatment ascertained the diagnosis. CONCLUSIONS: In immunocompromised hosts, diseases with a typically benign course can become severe and life-threatening illnesses. Ownership of pets should be taken into consideration before onset of an immunosuppressive therapy.

PMID: 11887039 [PubMed - indexed for MEDLINE]

569. Rofo. 2002 Mar;174(3):363-4.

[Adult, afebrile patient with rapidly growing tumor of the upper arm: Bartonella henselae as the etiology].

[Article in German]

Stoob K, Beer G, Weishaupt D.

PMID: 11885017 [PubMed - indexed for MEDLINE]

570. J Clin Microbiol. 2002 Mar;40(3):1023-30.

Genomic variation of Bartonella henselae strains detected in lymph nodes of patients with cat scratch disease.

Zeaiter Z, Fournier PE, Raoult D.

Unité des Rickettsies, CNRS UPRES-A 6020, Faculté de Médecine, Marseille, France.

Bartonella henselae is the primary agent of cat scratch disease (CSD). In order to study the genetic variation of B. henselae and the correlation of the various genotypes with epidemiological and clinical findings, two seminested, groEL- and pap31-based PCR assays were carried out with specimens from 273 patients. Amplicons were sequenced to determine the genotype of the causative Bartonella species. Compared to our reference intergenic spacer region-based PCR, the groEL- and pap31-based assays were 1.7 and 1.9 times more sensitive, respectively. All 107 positive patients were infected with B. henselae; neither Bartonella clarridgeiae nor other species were detected. Based on the groEL and pap31 sequences, B. henselae amplicons were classified into two genogroups, Marseille and Houston-1, and into four variants, Marseille, CAL-1, Houston-1, and a new variant, ZF-1. Patients infected with either one or the other genogroup did not exhibit different epidemiological or clinical characteristics. Our study highlights the genotypic heterogeneity of B. henselae in patients with CSD.

PMCID: PMC120271 PMID: 11880432 [PubMed - indexed for MEDLINE]

571. Clin Diagn Lab Immunol. 2002 Mar;9(2):496-8.

Cervical cat scratch disease lymphadenitis in a patient with immunoglobulin M antibodies to Toxoplasma gondii.

Arvand M, Kazak I, Jovanovic S, Foss HD, Liesenfeld O.

Department of Hygiene and Medical Microbiology, Institute for Hygiene, University of Heidelberg, Heidelberg, Germany. mardjan_arvand@med.uni-heidelberg.de

We report on a young patient with chronic cervical lymphadenopathy and serological and histological evidence for infection with Bartonella henselae and Toxoplasma gondii. Serological follow-up studies, including testing for avidity of Toxoplasma-specific immunoglobulin G antibodies, assisted in the determination of the cause of the acute lymphadenitis. Our results suggest that the clinical symptoms were most likely due to cat scratch disease rather than to acute toxoplasmosis.

PMCID: PMC119959 PMID: 11874902 [PubMed - indexed for MEDLINE]

572. Scand J Infect Dis. 2001;33(12):935-6.

Bartonella henselae infection mimicking a splenic lymphoma.

Ghez D, Bernard L, Bayou E, Bani-Sadr F, Vallée C, Perronne C.

Service des Maladies Infectieuses et Tropicales, Hĵpital Raymond Poincaré, Université Paris Ouest, Garches, France.

We report a Bartonella henselae infection in a 40-y-old patient who presented with fever, weight loss, night sweats, elevated lactate dehydrogenase and multinodular splenomegaly with multiple abdominal lymphadenopathies. Splenic cat-scratch disease is an exceptional diagnosis in adults and can easily be mistaken for a splenic lymphoma, thereby leading to an unnecessary splenectomy.

PMID: 11868771 [PubMed - indexed for MEDLINE]

573. Br J Haematol. 2001 Dec;115(4):924-5.

Autoimmune haemolytic anaemia triggered by Bartonella henselae infection: a case report.

Van Audenhove A, Verhoef G, Peetermans WE, Boogaerts M, Vandenberghe P.

Department of Haematology, Internal Medicine, University Hospital Leuven, 49 Herestraat, B3000 Leuven, Belgium.

Bartonella henselae is a hitherto unidentified cause of autoimmune haemolytic anaemia. Here we report a case of Coombs-negative autoimmune haemolytic anaemia. The episode was preceded by exposure to a cat and a non-specific infectious syndrome. Concomitant serum titres of B. henselae antibodies were indicative of a recent infection. The case report suggests that B. henselae infection can trigger secondary autoimmune haemolytic anaemia.

PMID: 11843827 [PubMed - indexed for MEDLINE]

574. J Feline Med Surg. 2001 Dec;3(4):193-209.

Arthropod-transmitted infectious diseases of cats.

Shaw SE, Birtles RJ, Day MJ.

Department of Clinical Veterinary Science, University of Bristol, Langford House, Langford, Bristol, BS40 5DU, UK.

PMID: 11795958 [PubMed - indexed for MEDLINE]

575. Vestn Ross Akad Med Nauk. 2001;(11):8-11.

[New and emerging rickettsial and bartonella infections].

[Article in Russian]

Tarasevich IV.

There have been recently reports on over 10 new and resurgent rickettsioses and bartonelloses in different countries, which reflects both socioeconomic processes in society and a higher methodological level of indication and identification of causative agents. In 1991, the author' laboratory, N. F. Gamaleya Research Institute of Experimental Medicine, Russian Academy of Medical Sciences, established the etiology of the new rickettsiosis Astrakhan spotted fever. It separated and studied 2 strains of Rickettsia sp. nov. from patients and 8 ones from the carrier the Ixodes tick Rhipicephalus pumilio. It is suggested that the natural focus has transformed to the anthropurgic one due to technogenic environmental pollution. The annual increase in morbidity rates (2000 cases in 1983 to 2000) and its area are a challenge to public health care and medical science. The paper presents data on the new bartonellosis cat-scratch disease (caused by Bartonella henselae) detected not only in Russia. There is also information on tick-borne rickettsiosis, epidemic typhus, and trench fever as resurgent infections.

PMID: 11837209 [PubMed - indexed for MEDLINE]

576. J Clin Microbiol. 2002 Feb;40(2):466-74.

Experimental infection of domestic cats with Bartonella koehlerae and comparison of protein and DNA profiles with those of other Bartonella species infecting felines.

Yamamoto K, Chomel BB, Kasten RW, Hew CM, Weber DK, Lee WI, Droz S, Koehler JE.

Department of Population Health and Reproduction, Center for Companion Animal Health, School of Veterinary Medicine, University of California, Davis, California 95616, USA.

Bartonella koehlerae, a recently described feline Bartonella species, was isolated from two naturally infected cats in northern California. We experimentally infected domestic cats with B. koehlerae to establish the microbiological and immunological characteristics of this infection in cats and to compare it to infections with those caused by B. henselae and B. clarridgeiae. Four cats were inoculated intradermally with B. koehlerae (8.6 x 10(7) to 3.84 x 10(8) CFU/ml). None of the cats presented any obvious clinical signs, but all cats developed bacteremia, which peaked at 3.36 x 10(4) to 1.44 x 10(6) CFU/ml of blood between day 14 and day 36 postinoculation. B. koehlerae-inoculated cats had a bacteremia duration (mean, 74 days) shorter than did cats inoculated with B. clarridgeiae (mean, 324 days) (P = 0.03). None of the four cats inoculated with B. koehlerae had bacteremia relapse. As shown by enzyme-linked immunosorbent assay (ELISA) using B. koehlerae outer membrane protein (OMP) antigens, the four cats developed a species-specific antibody response, and ELISA testing using other feline Bartonella OMP antigens showed statistically lower optical density values. All four cats developed similar antibody reactivity patterns to B. koehlerae OMP antigens as seen by Western blotting, each with at least 20 seroreactive protein bands. Using sodium dodecyl sulfate-polyacrylamide gel electrophoresis, protein profile differences were observed for both whole-cell lysate and OMPs from B. koehlerae, compared with B. henselae and B. clarridgeiae. B. koehlerae was more closely related to B. henselae than to B. clarridgeiae by protein profile, and this relatedness was also confirmed by analysis of the genomic DNA profiles by pulsed-field gel electrophoresis.

PMCID: PMC153398 PMID: 11825958 [PubMed - indexed for MEDLINE]

577. Am J Trop Med Hyg. 2001 Dec;65(6):783-7.

Prevalence of Bartonella species and 16s rRNA gene types of Bartonella henselae from domestic cats in Thailand.

Maruyama S, Sakai T, Morita Y, Tanaka S, Kabeya H, Boonmar S, Poapolathep A, Chalarmchaikit T, Chang CC, Kasten RW, Chomel BB, Katsube Y.

Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa, Japan. maruyama@brs.nihon-u.ac.jp

Prevalence of Bartonella infection among 275 cats in 9 sites from 4 geographical regions (northern area: Chiang Mai; central area: Kanchanaburi, Ratchaburi, and Bangkok; northeastern area: Khon Kaen, Roi Et, Ubon Ratcharthani, and Nakhonratchasima; southern area: Songkhla) of Thailand was investigated. Overall, Bartonella species were isolated from 27.6% (76 of 275) of the cats. The isolation rate varied from 12.8% (5 of 39) in Songkhla (southern area) to 50.0% (26 of 52) in Khon Kaen (northeastern area). Bartonella henselae and B. clarridgeiae were isolated from 82.9% (63 of 76) and 11.8% (9 of 76) of the Bartonella-positive cats, respectively. Coinfection with both species was found in 5.3% (4 of 76) of the bacteremic cats. Of the 67 bacteremic cats from which B. henselae was isolated, 48 (71.6%) and 13 (19.4%) were infected with only Type I and Type II, respectively. Coinfection with both types was observed in 9.0% (6 of 67) of the B. henselae-positive cats. To our knowledge, this is the first report on the presence of Bartonella infection in domestic cats from Thailand, which constitute a large reservoir of Bartonella infection in this country.

PMID: 11791975 [PubMed - indexed for MEDLINE]

578. Pediatr Infect Dis J. 2002 Jan;21(1):28-31.

Role of Bartonella henselae in the etiology of Henoch-Schönlein purpura.

Ayoub EM, McBride J, Schmiederer M, Anderson B.

Department of Pediatrics, University of Florida, Gainesville 32610, USA. ayoubem@peds.ufl.edu

Comment in Pediatr Infect Dis J. 2009 Dec;28(12):1142-3.

BACKGROUND: The etiology of Henoch-Schönlein purpura (HSP) has been ascribed to a variety of infectious and noninfectious agents. Because we encountered a patient with HSP who had evidence of Bartonella henselae infection and a prior report of a patient with systemic cat-scratch disease presenting as leukoclastic vasculitis, we investigated the association of B. henselae infection with HSP. METHODS: We determined the antibody titers to B. henselae on the sera of 18 patients with HSP and on 57 controls. All patients presented with the characteristic leukoclastic rash of HSP. About one-half of the patients had joint or abdominal symptoms, and four had hematuria at presentation. An indirect immunofluorescent assay was used to determine serum antibody titers to B. henselae. Sera that were reactive at a dilution of 1/64 were considered positive. RESULTS: Eight of the 57 (14%) control sera and 12 of the 18 (67%) patient sera were positive for B. henselae antibody (P < 0.0001). CONCLUSION: The results of this study indicate a significant association of antecedent B. henselae infection with HSP. The frequency of this association (67%) exceeds that of previously ascribed etiologic agents for this disease, such as the group A Streptococcus.

PMID: 11791094 [PubMed - indexed for MEDLINE]

579. Lupus. 2001;10(12):883-5.

Cat scratch disease (bartonellosis) mimicking an SLE flare.

Gaubitz M, Herrmann M, Shahin M, Schotte H, Willeke P, Domschke W.

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

Only recently Bartonella species have been recognized as important human pathogens. Cat scratch disease (CSD), caused by infection with Bartonella henselae, shows a steady increase in the number of cases throughout the world. We report a case of an 18-year-old woman with systemic lupus erythematosus (SLE) who presented with ongoing fever, arthralgias and loss of weight which did not respond to increasing doses of corticosteroids. After exclusion of common infections a photograph of her cat in combination with scratch marks on her arms finally led to the suspicion of CSD. This tentative diagnosis was confirmed serologically. Under clarithromycin treatment the patient rapidly responded and her temperature dropped within 2 days.

PMID: 11787880 [PubMed - indexed for MEDLINE]

580. Clin Diagn Lab Immunol. 2002 Jan;9(1):8-18.

Natural history of Bartonella infections (an exception to Koch's postulate).

Jacomo V, Kelly PJ, Raoult D.

Unité des Rickettsies, CNRS, UPRESA 6020, Faculté de Médecine, Université de la Méditerranée, 27 Blvd. Jean Moulin, 13385 Marseille cedex 05, France.

PMCID: PMC119901 PMID: 11777823 [PubMed - indexed for MEDLINE]

581. Eur J Clin Microbiol Infect Dis. 2001 Oct;20(10):732-3.

Cat scratch disease due to Bartonella henselae infection mimicking parotid malignancy.

Kempf VA, Petzold H, Autenrieth IB.

Institut für Medizinische Mikrobiologie, Eberhard-Karls-Universität, Tübingen, Germany. volkhard.kempf@med.uni-tuebingen.de

An unusual Bartonella henselae infection presenting clinically as a putative parotid cancer was diagnosed based on serological tests, histomorphology and amplification of a 16S-rDNA sequence of Bartonella henselae. The patient improved greatly upon antibiotic treatment and did not require surgery. Although uncommon, infection with Bartonella spp., particularly Bartonella henselae, should be included in the differential diagnosis of parotid tumors.

PMID: 11757975 [PubMed - indexed for MEDLINE]

582. J Feline Med Surg. 2000 Mar;2(1):61-8.

Bartonella spp antibodies and DNA in aqueous humour of cats.

Lappin MR, Kordick DL, Breitschwerdt EB.

Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA.

Bartonella spp antibodies were measured in the serum and aqueous humour of cats with and without uveitis and polymerase chain reaction (PCR) for Bartonella spp DNA was performed on aqueous humour from most of the cats. Serum and aqueous humour were assayed from 49 client-owned cats with uveitis, 49 healthy shelter cats, and nine cats experimentally inoculated with either B henselae or B clarridgeiae, 454 days after inoculation. An aqueous antibody coefficient (C value) was calculated for cats positive for Bartonella spp antibodies in the aqueous humour. Ocular production of Bartonella spp IgG (C value >1) was detected in seven of 49 cats with uveitis, none of 49 healthy shelter cats, and four of nine experimentally inoculated cats. The organism was detected by PCR in the aqueous humour of three of 24 cats with uveitis, one of 49 healthy shelter cats, and four of nine experimentally inoculated cats. Bartonella spp infect the eyes of some cats following natural exposure or experimental inoculation and may cause uveitis in some cats.

Copyright 2000 European Society of Feline Medicine.

PMID: 11716593 [PubMed - indexed for MEDLINE]

583. Hautarzt. 2001 Oct;52(10 Pt 2):980-4.

[Acute generalized cat scratch disease in myelodysplastic syndrome].

[Article in German]

von Kobyletzki G, Nordmeier R, Stücker M, Sandmann M, Respondek M, Baier J, Altmeyer P.

St. Josef Hospital, Dermatologische Klinik der Ruhr-Universität Bochum. Gregor.vonKobyletzki@ruhr-uni-bochum.de

In patients with normal immunity, cat scratch disease typically develop a papule at the portal of entry and no other cutaneous features. A 73 year old male patient with a myelodysplastic syndrome developed generalized petechial, papular and, vasculitic skin lesions in association with cat scratch disease. After the diagnosis was established by identifying the causative organism in a lymph node biopsy, the patient was treated with erythromycin for three weeks resulting in progressive clearance of the skin lesions. Apart from the soluble IL-2 receptor, no other serologic inflammatory parameters were elevated. IgG antibodies against Bartonella henselae and Bartonella quintana increased only slightly during acute exacerbation of the disease, but significantly increased some months later. The diagnosis was established by the positive staining of the lymph node biopsy using the Warthin-Starry stain.

PMID: 11715399 [PubMed - indexed for MEDLINE]

584. Orv Hetil. 2001 Oct 7;142(40):2197-200.

[Unusual manifestations of Bartonella infections].

[Article in Hungarian]

Tokodi I, Máj C, Deák J, Gyetvai B, Lakatos B, Simon G.

Fejér Megyei Szent Gyögy Kórház, Székesfehérvár, Perinatális Intenzív Centrum Csecsemó-gyermekosztály.

The authors review the cases of two patients with an atypical form of cat scratch disease. The first case exhibited ileocoecal and hepatoportal lymphadenitis, and the second case the emerging symptoms of a non-specific granulomatous process in the middle third of the right forearm, which caused a differential-diagnostic problem. Establishment of a diagnosis was possible only on the basis of the disease process and the pathological, serological and histopathological pictures of the lymphatic glands after other causes of the lymphadenopathy had been excluded. Following two weeks of antibiotic treatment, the patients were free of complaints- and symptoms. Bartonella antibody tests were performed on 5 cats living in the neighbourhood of the patients with titer determinations too in 3 cases.

PMID: 11706512 [PubMed - indexed for MEDLINE]

585. Rev Inst Med Trop Sao Paulo. 2001 Sep-Oct;43(5):257-61.

Experimental infection and horizontal transmission of Bartonella henselae in domestic cats.

de Souza Zanutto M, Mamizuka EM, Raiz R Jr, de Lima TM, Diogo CL, Okay TS, Hagiwara MK.

Departamento de Clínica Médica, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, SP, Brasil. mszanutto@hotmail.com

In order to study B. henselae transmission among cats, five young cats were kept in confinement for two years, one of them being inoculated by SC route with B. henselae (10(5) UFC). Only occasional contact among cats occurred but the presence of fleas was observed in all animals throughout the period. Blood culture for isolation of bacteria, PCR-HSP and FTSZ (gender specific), and BH-PCR (species-specific), as well as indirect immunofluorescence method for anti-B. henselae antibodies were performed to confirm the infection of the inoculated cat as well as the other naive cats. Considering the inoculated animal, B. henselae was first isolated by blood culture two months after inoculation, bacteremia last for four months, the specific antibodies being detected by IFI during the entire period. All contacting animals presented with bacteremia 6 months after experimental inoculation but IFI did not detect seroconversion in these animals. All the isolates from these cats were characterized as Bartonella (HSP and FTSZ-PCR), henselae (BH-PCR). However, DNA of B. henselae could not be amplified directly from peripheral blood by the PCR protocols used. Isolation of bacteria by blood culture was the most efficient method to diagnose infection compared to PCR or IFI. The role of fleas in the epidemiology of B. henselae infection in cats is discussed.

PMID: 11696847 [PubMed - indexed for MEDLINE]

586. Clin Infect Dis. 2001 Dec 1;33(11):1852-8. Epub 2001 Oct 23.

Enzyme immunoassay for the diagnosis of cat-scratch disease defined by polymerase chain reaction.

Giladi M, Kletter Y, Avidor B, Metzkor-Cotter E, Varon M, Golan Y, Weinberg M, Riklis I, Ephros M, Slater L.

Bernard Pridan Laboratory for Molecular Biology of Infectious Diseases, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, Israel. giladi@tasmc.health.gov.il

Whole-cell immunofluorescent antibody (IFA) tests for detection of anti-Bartonella henselae immunoglobulin (Ig) G are commonly used to diagnose cat-scratch disease (CSD). The need to cultivate B. henselae in Vero cells for antigen preparation and the absence of routinely applied IFA assays for IgM constitute the major disadvantages of this form of test. We describe the results of an enzyme immunoassay (EIA) for IgM and IgG that used N-lauroyl-sarcosine-insoluble outer membrane antigens from agar-grown B. henselae performed in 84 patients with definite CSD (regional lymphadenitis, cat contact, and > or =1 confirmatory test: polymerase chain reaction, skin test, or B. henselae culture). Although this method has been used as a diagnostic tool in several case reports, it has not previously been evaluated in a large study of definitively proven CSD cases. Results of this study indicate that the EIA described herein can play an important role in the serodiagnosis of CSD, although improvement of the sensitivity, particularly that of the IgM, would be desirable.

PMID: 11692296 [PubMed - indexed for MEDLINE]

587. Am J Surg Pathol. 2001 Sep;25(9):1211-4.

Chronic active myocarditis following acute Bartonella henselae infection (cat scratch disease).

Meininger GR, Nadasdy T, Hruban RH, Bollinger RC, Baughman KL, Hare JM.

Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland, USA.

An association between Bartonella infection and myocardial inflammation has not been previously reported. We document a case of a healthy young man who developed chronic active myocarditis after infection with Bartonella henselae (cat scratch disease). He progressed to severe heart failure and underwent orthotopic heart transplantation. Bartonella henselae, therefore, should be included among the list of infectious agents associated with chronic active myocarditis.

PMID: 11688584 [PubMed - indexed for MEDLINE]

588. Rinsho Byori. 2001 Sep;49(9):906-10.

Survey of veterinary professionals for antibodies to Bartonella henselae in Japan.

Kumasaka K, Arashima Y, Yanai M, Hosokawa N, Kawano K.

Department of Clinical Pathology, Nihon University School of Medicine, Itabashi-ku, Tokyo 173-8610.

The seroprevalence of Bartonella henselae among veterinary professionals in Japan was investigated by means of an immunoperoxidase (IP) test that used protein A-horseradish peroxidase conjugate. Sera were obtained from 233 veterinary professionals in the Tokyo and Chiba areas. As negative control group, sera from 155 healthy individuals (all medical students) were used. As positive control group, sera from 5 patients highly suspected of cat scratch disease (CSD) by clinical symptoms were tested. Serum antibody titers of > or = 200 to B. henselae were presumed seropositive, because the titer at which about 95.5% of all healthy individuals (148 of the 155) were negative, and 2 of the 5 suspected CSD patients' serum antibody titers were > or = 200. Of the individuals in the veterinary professionals group tested, 35 of the 233 (15.0%) were seropositive for B. henselae. Females were nearly twice as likely as males to have antibodies to B. henselae in the veterinary professionals group. Our data suggest that Japanese veterinary professionals, and in particular younger females who are veterinary assistants and animal beauticians are more often infected by B. henselae.

PMID: 11685779 [PubMed - indexed for MEDLINE]

589. Aust Fam Physician. 2001 Aug;30(8):751-4.

Cat scratch disease. A cause of regional lymphadenitis.

Branley J.

Nepean and Blue Mountains Hospitals, New South Wales. branlej@wahs.nsw.gov.au

BACKGROUND: In the last decade, the microbiological cause of cat scratch disease (CSD) has been determined using a combination of traditional culture and modern molecular techniques. A bacterium known as Bartonelia henselae is responsible for the vast majority of cases. The natural history of the disease is being reinterpreted in the light of more sophisticated diagnostic tools. OBJECTIVE: To enable practitioners to have a sound basis for the diagnosis and treatment of cat scratch disease. DISCUSSION: Bartonelia henselae is ubiquitous in the domestic feline and causes zoonotic infection in humans. Although this infection is usually self limiting and benign, it may cause more extensive disease in the immunosuppressed. Antibiotic therapy may hasten recovery.

PMID: 11681146 [PubMed - indexed for MEDLINE]

590. J Child Neurol. 2001 Oct;16(10):762-3.

Possible role of high-dose corticosteroids in the treatment of cat-scratch disease encephalopathy.

Weston KD, Tran T, Kimmel KN, Maria BL.

Department of Pediatrics, University of Florida College of Medicine, Gainesville 32610, USA.

Approximately 2% of the estimated 24,000 patients in the United States who contract cat-scratch disease annually develop neurologic complications. Between 1989 and 1999, 36 patients were admitted to our hospital with cat-scratch disease; 25% had neurologic complications, and the majority experienced lengthy hospital stays. We describe a case of cat-scratch disease encephalopathy in a 4-year-old girl who responded to high-dose corticosteroid therapy. Further studies are warranted to determine if corticosteroid therapy shortens the duration of symptoms, lessens the severity of disease, and ultimately improves the outcome for patients with cat-scratch disease encephalopathy.

PMID: 11669351 [PubMed - indexed for MEDLINE]

591. Pediatr Infect Dis J. 2001 Oct;20(10):1006-7.

Cat-scratch disease presenting as multifocal osteomyelitis with thoracic abscess.

Modi SP, Eppes SC, Klein JD.

Department of Pediatrics, Alfred I. duPont Hospital for Children, Wilmington, DE, USA.

The case of a 4-year-old girl who presented with fever and back pain after being scratched by a kitten is presented. The diagnosis of cat scratch disease osteomyelitis was made by the detection of Bartonella henselae DNA by PCR analysis of a rib abscess aspirate.

PMID: 11642619 [PubMed - indexed for MEDLINE]

592. Kansenshogaku Zasshi. 2001 Sep;75(9):808-11.

[Two patients with Bartonella henselae infection from a dog].

[Article in Japanese]

Murano I, Tsuneoka H, Iino H, Kamei T, Nakamura I, Tsukahara M.

Department of Pediatrics, Yamaguchi Prefectural Central Hospital.

Two patients were reported as having been infected with Bartonella henselae after having contact with a dog. Both of the patients owned a dog, but had no contact with cats. One patient was a 10-year-old boy who had experienced a fever of 38-39 degrees C for 11 days, as well as having bilateral cervical lymphadenopathy. The boy's serum IgM antibodies to B. henselae were negative on the 6th and 16th day of his illness, whereas his IgG value, using indirect fluorescence antibody (IFA) method, was found to be elevated from 1:256 to 1:1,024. B. henselae DNA was detected, by PCR method, in swabs from the gingiva and buccal membrane of the dog with which the boy had been in contact. The boy was first treated with cefdinir (300 mg daily) for 6 days without beneficial effect. He responded, however, to minocycline (100 mg daily) with symptom resolution in four days. The other patient was a 64-year-old man who had experienced a fever of 38-39 degrees C for 27 days, as well as having right inguinal lymphadenopathy. The man's serum IgM antibody to B. henselae was negative, although his IgG value, determined by IFA, was 1:1,024. In addition, B. henselae DNA was detected, by PCR method, in parafin-embedded tissue obtained from the biopsied inguinal lymph nodes. The man was treated with cefazolin (2 g daily). His fever resolved, but his lymph nodes remained swollen. After a regimen of erythromycin (1,200 mg daily), the swelling in his inguinal lymphnodes gradually disappeared. Careful review of suspected CSD victims' history of contact with animals is important in making a prompt diagnosis of B. henselae infection.

PMID: 11605190 [PubMed - indexed for MEDLINE]

593. Ann Biol Clin (Paris). 2001 Sep-Oct;59(5):593-604.

[Infections caused by Bartonella spp].

[Article in French]

Piémont Y, Bermond D.

Institut de bactériologie de la Faculté de médecine et Hôpitaux universitaires de Strasbourg, 3, rue Koeberlé, 67000 Strasbourg.

PMID: 11602390 [PubMed - indexed for MEDLINE]

594. Otolaryngol Head Neck Surg. 2001 Oct;125(4):414-6.

Atypical presentations of cat scratch disease in the head and neck.

Chiu AG, Hecht DA, Prendiville SA, Mesick C, Mikula S, Deeb ZE.

Department of Otolaryngology-Head and Neck Surgery, Georgetown University Medical Center, Washington, DC, USA. Alexchiu11@hotmail.com

PMID: 11593185 [PubMed - indexed for MEDLINE]

595. Am J Ophthalmol. 2001 Oct;132(4):575-6.

Cat-scratch disease neuroretinitis diagnosed by a polymerase chain reaction approach.

Labalette P, Bermond D, Dedes V, Savage C.

Department of Ophthalmology, Lille University Hospital, 2 Oscar Lambret Ave, 59037 Lille cedex, France. p-labalette@chru-lille.fr

PURPOSE: To assess the value of polymerase chain reaction in the diagnosis of cat-scratch disease neuroretinitis without conclusive serology. METHODS: Interventional case report. A 13-year-old girl developed a right neuroretinitis 2 months after a cat scratch. Despite the lack of accompanying features, an infection by Bartonella henselae was suspected and a systemic check-up was performed. RESULTS: Serologic results excluded other proposed origins but were insufficient in making the diagnosis because of low B. henselae specific IgG level in serum. A polymerase chain reaction analysis for B. henselae DNA in a small axillary lymphadenopathy aspirate enabled us to achieve a definitive diagnosis of cat-scratch disease. CONCLUSION: Polymerase chain reaction is a valuable method of diagnosing cat-scratch disease when serology is considered negative or borderline.

PMID: 11589885 [PubMed - indexed for MEDLINE]

596. N Z Med J. 2001 Aug 10;114(1137):360-1.

Bartonella henselae neuroretinitis in cat scratch disease.

Dai S, Best S, St John M.

Department of Ophthalmology, Auckland Public Hospital. shuandai@hotmail.com

PMID: 11587306 [PubMed - indexed for MEDLINE]

597. An Esp Pediatr. 2001 Oct;55(4):365-8.

[Splenic abscess and cat-scratch disease].

[Article in Spanish]

Valdesoiro Navarrete L, Pineda Solas V, Martín Martín C, Sanfeliu Sala I, Cabezas Maspoch RM, Sánchez Oespina M.

Servicio de Pediatría. Hospital de Sabadell. Barcelona. elisenda.valdesoiro@psdf.icnet.es

Cat-scratch disease is caused by a Gram-negative bacillus known as Bartonella henselae. This disease is usually benign and causes regional adenitis that does not require treatment. However, some patients develop more serious atypical forms of the disease including prolonged systemic illness with hepatic and splenic abscesses.A 14-year-old girl was admitted to hospital with a 12-day history of persistent high fever and abdominal pain. Ultrasonography and computerized tomography of the abdomen revealed splenic abscesses. These findings, together with an antecedent of cat exposure, led to the suspicion of cat-scratch disease, which was confirmed by serology. The girl was treated with intramuscular ceftriaxone and clinical evolution was favorable. Splenic cat-scratch disease is infrequent. Cat-scratch disease sometimes presents as fever of unknown origin and consequently this disease should be considered in the differential diagnosis of prolonged fever. Although evolution is usually favorable, antibiotic therapy is recommended in systemic manifestations of cat-scratch disease.

PMID: 11578546 [PubMed - indexed for MEDLINE]

598. J Clin Microbiol. 2001 Oct;39(10):3548-54.

Aortic valve endocarditis in a dog due to Bartonella clarridgeiae.

Chomel BB, Mac Donald KA, Kasten RW, Chang CC, Wey AC, Foley JE, Thomas WP, Kittleson MD.

Department of Population Health and Reproduction, University of California, Davis, California 95616, USA. bbchomel@udavis.edu

We report the first documented case of endocarditis associated with Bartonella clarridgeiae in any species. B. clarridgeiae was identified as a possible etiological agent of human cat scratch disease. Infective vegetative valvular aortic endocarditis was diagnosed in a 2.5-year-old male neutered boxer. Historically, the dog had been diagnosed with a systolic murmur at 16 months of age and underwent balloon valvuloplasty for severe valvular aortic stenosis. Six months later, the dog was brought to a veterinary hospital with an acute third-degree atrioventricular block and was diagnosed with infective endocarditis. The dog died of cardiopulmonary arrest prior to pacemaker implantation. Necropsy confirmed severe aortic vegetative endocarditis. Blood culture grew a fastidious, gram-negative organism 8 days after being plated. Phenotypic and genotypic characterization of the isolate, including partial sequencing of the citrate synthase (gltA) and 16S rRNA genes indicated that this organism was B. clarridgeiae. DNA extraction from the deformed aortic valve and the healthy pulmonic valve revealed the presence of B. clarridgeiae DNA only from the diseased valve. No Borrelia burgdorferi or Ehrlichia sp. DNA could be identified. Using indirect immunofluorescence tests, the dog was seropositive for B. clarridgeiae and had antibodies against Ehrlichia phagocytophila but not against Ehrlichia canis, Ehrlichia ewingii, B. burgdorferi, or Coxiella burnetii.

PMCID: PMC88387 PMID: 11574571 [PubMed - indexed for MEDLINE]

599. Arch Neurol. 2001 Sep;58(9):1357-63.

Concurrent infection of the central nervous system by Borrelia burgdorferi and Bartonella henselae: evidence for a novel tick-borne disease complex.

Eskow E, Rao RV, Mordechai E.

Hunterdon Medical Center, Flemington, NJ, USA.

Comment in Arch Neurol. 2001 Sep;58(9):1345-7.

OBJECTIVES: To investigate Bartonella henselae as a potential human tick-borne pathogen and to evaluate its role as a coinfecting agent of the central nervous system in the presence of neuroborreliosis. DESIGN: Case report study. SETTING: A primary health care center in Flemington, NJ, and the Department of Research and Development at Medical Diagnostic Laboratories LLC in Mt Laurel, NJ. SUBJECTS: Two male patients (aged 14 and 36 years) and 2 female patients (aged 15 and 30 years, respectively) with a history of tick bites and Lyme disease. MAIN OUTCOME MEASURES: Laboratory and diagnostic findings before and after antimicrobial therapy. RESULTS: Patients residing in a Lyme-endemic area of New Jersey with ongoing symptoms attributed to chronic Lyme disease were evaluated for possible coinfection with Bartonella species. Elevated levels of B henselae-specific antibodies were found in these patients using the immunofluorescent assay. Bartonella henselae-specific DNA was detected in their blood. None of these patients exhibited the clinical characteristics of cat-scratch disease. Findings of cerebrospinal fluid analysis revealed the presence of both B henselae- and Borrelia burgdorferi-specific DNA. Bartonella henselae-specific DNA was also detected in live deer ticks obtained from the households of 2 of these patients. CONCLUSIONS: Our data implicate B henselae as a potential human tick-borne pathogen. Patients with a history of neuroborreliosis who have incomplete resolution of symptoms should be evaluated for B henselae infection.

PMID: 11559306 [PubMed - indexed for MEDLINE]

600. Arch Neurol. 2001 Sep;58(9):1345-7.

Of fleas and ticks on cats and mice...

Halperin JJ, Wormser GP.

Comment on Arch Neurol. 2001 Sep;58(9):1357-63.

PMID: 11559304 [PubMed - indexed for MEDLINE]

601. Infect Immun. 2001 Oct;69(10):5974-80.

Interaction of Bartonella henselae with the murine macrophage cell line J774: infection and proinflammatory response.

Musso T, Badolato R, Ravarino D, Stornello S, Panzanelli P, Merlino C, Savoia D, Cavallo R, Ponzi AN, Zucca M.

Department of Public Health and Microbiology, University of Turin, Turin, University of Brescia, Brescia, Italy. tiziana.musso@unito.it

Bartonella henselae is the causative agent of cat scratch disease (CSD), a self-limiting condition characterized by a subacute regional lymphadenopathy that may develop into disseminated bartonellosis in immunocompromised subjects. Mice experimentally infected with B. henselae display typical liver and spleen granulomas rich in T cells and macrophages. So far there are no data on the interaction between bartonellae and macrophages. In order to clarify this topic, we investigated the interaction of B. henselae with J774, a mouse macrophage cell line. Analysis of bacterial uptake by functional assays and transmission electron microscopy indicates that bartonellae can enter and survive inside J774. Entry occurred within 30 min postinfection and reached a plateau at 160 min. Infection of J774 was followed by a dose-dependent release of the proinflammatory cytokines tumor necrosis factor alpha, interleukin 1beta (IL-1beta), and IL-6. Bartonellae persisted intracellularly without loss of viability for at least 8 h, and their number slightly decreased 24 h postinfection. Gamma interferon (IFN-gamma) treatment of J774 significantly decreased the number of recoverable bacteria at 8 and 24 h. This enhancement of macrophage bactericidal activity was associated with nitric oxide (NO) release and was prevented by the addition of the competitive inhibitor of NO synthesis N(G)-monomethyl L-arginine. These findings suggest that IFN-gamma-mediated activation of macrophages may be important for the clearing of B. henselae infection and that anti-B. henselae microbicidal activity of IFN-gamma-activated macrophages is mediated to a large extent by NO production.

PMCID: PMC98724 PMID: 11553533 [PubMed - indexed for MEDLINE]

602. Recenti Prog Med. 2001 Sep;92(9):540.

[Hepatosplenic cat-scratch disease in the immunocompetent adult].

[Article in Italian]

Zaccala G, Rizzo G, Boldorini R, Garavelli PL, Campanini M.

Strutture Complesse di Medicina Interna II, Azienda Ospedaliera Maggiore della Carità, Novara.

Atypical manifestations of cat-scratch disease have been described in children and immunosuppressed adults. We report the first case of hepatosplenic cat-scratch disease in an immunocompetent subject, demonstration of diversity of this infection. A 33-year-old man presented with prolonged fever, lymphadenopathy and multiple hypodense lesions of liver and spleen in ultrasonographic imaging. The hepatic biopsy showed non-specific inflammatory reactions including granulomata and stellate necrosis. Anti-Bartonella antibodies have been found. The therapy with clarithromycin and doxycycline for many weeks was effective for hepatic lesions. A month ago a history of a cat contact with the presence of a skin lesion has been reported.

PMID: 11552311 [PubMed - indexed for MEDLINE]

603. Clin Microbiol Infect. 2001 Jul;7(7):387-8.

Bartonella henselae neuroretinitis.

Messina F, Doria R, Gabriellini G, Sartini MS, Tascini C, Menichetti F.

U. O. Malattie Infettive, Azienda Ospedaliera Pisana, Pisa, Italy.

PMID: 11531989 [PubMed - indexed for MEDLINE]

604. J Clin Microbiol. 2001 Sep;39(9):3417-9.

Native valve endocarditis due to Bartonella henselae in a middle-aged human immunodeficiency virus-negative woman.

De La Rosa GR, Barnett BJ, Ericsson CD, Turk JB.

Department of Infectious Diseases, The University of Texas Medical School, Houston, Texas 77030, USA.

We report the case of a human immunodeficiency virus-negative woman who developed native valve endocarditis of the aortic valve due to Bartonell henselae infection. The diagnosis was established using serology and PCR analysis of excised aortic valve tissue.

PMCID: PMC88362 PMID: 11526194 [PubMed - indexed for MEDLINE]

605. Scand J Infect Dis. 2001;33(8):599-603.

Unsuspected extralymphocutaneous dissemination in febrile cat scratch disease.

Fretzayas A, Papadopoulos NG, Moustaki M, Bossios A, Koukoutsakis P, Karpathios T.

2nd Department of Pediatrics, P & A Kyriakou Children's Hospital, University of Athens, Greece.

Cat scratch disease (CSD) commonly manifests as regional self-limited lymphadenitis. However, dissemination of the infection to distant multiple sites may occur even in immunocompetent patients. We report a series of 11 children with fever and extralymphocutaneous manifestations of CSD, in order to highlight potential multiorgan involvement in patients with febrile CSD. To be eligible for enrollment, patients had to present with involvement of sites other than regional lymph nodes. The diagnosis was based on suggestive clinical criteria, histological findings and positive serology. The utilization of ultrasound imaging revealed hepatic lesions in 3 children and splenic lesions in 8 children, whereas osteolytic lesions were observed in 4 children by bone scan. Hepatic or splenic involvement was not suggested by clinical signs or biochemical investigation in 2/3 and 6/8 children, respectively. Bone involvement was supported either by relative symptoms or signs. Our findings indicate that, in the presence of fever, extralymphocutaneous manifestations have to be anticipated in patients with clinically suspected CSD. The systematic use of imaging modalities in patients with serologically documented Bartonella henselae infection could contribute to a better understanding of the clinical spectrum of CSD.

PMID: 11525355 [PubMed - indexed for MEDLINE]

606. Kansenshogaku Zasshi. 2001 Jul;75(7):557-61.

[Longitudinal study of serological response to Bartonella henselae by indirect fluorescence assay in cat scratch disease].

[Article in Japanese]

Kusaba N, Yoshida H, Sumino M, Sata M.

Department of Medicine, Yame General Hospital.

Sequential serologic testing for IgG and IgM titers to Bartonella henselae were evaluated by an indirect fluorescence assay (IFA) in patients with CSD. The IFA test for the detection of IgG and IgM antibodies to B. henselae in 52 CSD patients showed that 40 (76.9%) were positive for IgG antibody and 9 (17.3%) were positive for IgM antibody. Two or more consecutive serum samples from 30 patients with CSD were assessed. In regard to the detection of IgG antibody, 5 patients had rapidly elevated titers in the acute phase, 12 patients had high titers from the acute phase, and 5 patients had a positive titer 24 weeks after the onset. B. henselae IgM antibody kinetics varied widely between patients with CSD. The seropositive rate for the antibody to B. henselae was analyzed at overtime after the onset and we found that the IgG-seropositive rate was high from 2 weeks after the onset and low after 25 weeks. The sensitivity of the IgM IFA was low, and IgM antibody to B. henslelae was not detected from 9 weeks. The detection from consecutive serum samples of antibodies to B. henselae by IFA is very useful for diagnosis in the case of clinically suspected CSD.

PMID: 11521278 [PubMed - indexed for MEDLINE]

607. Kekkaku. 2001 Jul;76(7):545-8.

[Cat scratch disease showing clinical picture resembling tuberculous lymphadenitis: a case report].

[Article in Japanese]

Machi T.

Department of Internal Medicine, Keiju General Hospital.

On February 18th, 1997, a 61-year-old woman visited our hospital because of a left inguinal mass. On physical examination, the mass was soft without inflammatory sign. About one month later, the node was excised. Pathological examination revealed granulomas with caseous necrosis and Langhans giant cells, suggesting tuberculosis, although acid fast stain was negative. Thereafter, re-history taking in detail disclosed that a kitten had often scratched her. We reexamined the pathology and checked her for serum antibodies to Bartonella henselae, the etiological microbe of cat scratch disease (CSD), using enzyme immunoassay. Histopathological reexamination of the excised mass revealed suppurative granulomas in addition to caseous ones. The level of IgG (negative: < 12 units) to B. henselae was 78 units on March 25th, 138 units on April 19th, and 18 units on July 18th, while the level of IgM (negative: < 12 units) was negative at each determination. These serological results strongly suggested current infection of B. henselae. The diagnosis of CSD could be established based on the history and the laboratory findings. When one encounters a case of granulomatous lymphadenitis, CSD should be considered for the differential diagnosis, and in this regard, anamnesis about contact with cats should be asked.

PMID: 11517562 [PubMed - indexed for MEDLINE]

608. Clin Infect Dis. 2001 Sep 15;33(6):e54-6. Epub 2001 Aug 13.

Circulating cytokines in patients with cat scratch disease.

Papadopoulos NG, Gourgiotis D, Bossios A, Fretzayas A, Moustaki M, Karpathios T.

Research Laboratories, Second Department of Pediatrics, School of Medicine, University of Athens, Athens, Greece. ngp@clubmember.org

Levels of circulating interleukin (IL)-2, IL-6, and IL-10, measured by enzyme-linked immunosorbent assay, were significantly higher in patients with cat scratch disease (CSD) than in healthy control subjects; no induction of IL-12 was observed, and levels of interferon-gamma and IL-4 were generally not detectable. This is the first report showing increased circulating cytokine levels in patients with CSD. The induction of these mediators can partly explain some clinical and pathological features of the disease.

PMID: 11512109 [PubMed - indexed for MEDLINE]

609. Clin Infect Dis. 2001 Sep 15;33(6):912-4. Epub 2001 Aug 21.

Probable atypical cat scratch disease presenting as isolated posterior pancreatic duodenal lymphadenitis and abdominal pain.

Dzelalija B, Petrovec M, Avsic-Zupanc T.

Department of Infectious Diseases, General Hospital Zadar, Zadar, Croatia. boris.dzelalija@zd.tel.hr

We report a case involving a 15-year-old girl with atypical, clinically unsuspected cat scratch disease (CSD) presenting as isolated posterior pancreatic duodenal lymphadenitis, fever, and abdominal pain. The serological, abdominal ultrasonographic, and CT findings, as well as clinical and epidemiological data, indicate that B. henselae was likely an etiologic agent of CSD in our patient.

PMID: 11512100 [PubMed - indexed for MEDLINE]

610. An Med Interna. 2001 May;18(5):255-8.

[Bartonella henselae endocarditis. Report of a case and review of the literature].

[Article in Spanish]

Cilla Eguiluz G, Montes Ros M, López García D, Iraola Sierra B, Aramburu Soraluce V.

Servicio de Microbiología, Laboratorio Unificado de San Sebastián.

Bartonella spp are small Gram-negative rods, aerobic and highly fastidious. They are difficult to culture, in the routine bacterial cultures. They are considered as emergent human pathogens. Since 1993, three species of Bartonella (B. quintana, B. henselae, and B. elizabethae) have been described as causative agents of infectious endocarditis. In this paper we describe the case of a 43 year-old woman with a previous valvular heart disease, probably of rheumatic origin, owner of cats, that suffered an infectious endocarditis by Bartonella henselae in the aortic valve. This patient presented IgG titers against B. henselae of 1/4096 and against B. quintana of 1/256. She also had low IgM titers against B. henselae and B. quintana: 1/64 and 1/32, respectively. The patient received antibiotics for 12 weeks and suffered a valvular replacement due to the severe lesion on the aortic valve. On the endocardiac tissue of the removed valve DNA of B. henselae was detected (polymerase chain reaction-based assay). Clinical evolution of the patient was good. Diagnosis of Bartonella spp infection must be considered in every patient with infectious endocarditis and negative blood cultures, and particularly B. henselae in patients with previous valvular heart disease and regular contact with cats.

PMID: 11496560 [PubMed - indexed for MEDLINE]

611. Kansenshogaku Zasshi. 2001 Jun;75(6):499-503.

[An adult case of systemic cat-scratch disease with hepatosplenic involvement].

[Article in Japanese]

Okamoto M, Murai K, Okayama A, Sekiya R, Kataoka H, Iino H, Tsuneoka H, Tsukahara M, Tsubouchi H.

Second Department of Internal Medicine, Miyazaki Medical College.

A previously healthy 25-year-old female was admitted to our hospital in November, 1997, for treatment of a spike-fever of 2 weeks' duration. She had a cat in her house but reported no history of cat bites or scratches. No peripheral lymphadenopathy was detected. White blood cell count was within normal limits, but an increased C-reactive protein level of 11.4 mg/dl was noted. Infectious disease was suspected but ruled out as blood cultures were negative. Empiric therapy with clarithromyoin, isoniazid, and rifampicin was ineffective. In January, 1998, abdominal ultrasonogram revealed multiple hypoechoic mass lesions in the spleen and liver, and a splenectomy was performed in March. Histopathologic examination showed numerous necrotizing and caseating granulomas, which tested positive for Bartonella henselae DNA by PCR. Furthermore, the patient tested positive for B. henselae antibody by immunofluorescence assay. A diagnosis of systemic cat-scratch disease with hepatospnenic involvement was made. Combination therapy with minocycline, sulbactam/cefoperazone, and tosufloxacin was administered and her inflammatory findings improved gradually. We report an adult case of systemic cat-scratch disease with liver and spleen involvement in the non-immunocompromised host.

PMID: 11494569 [PubMed - indexed for MEDLINE]

612. Clin Infect Dis. 2001 Sep 1;33(5):718-21. Epub 2001 Jul 30.

Acute endogenous endophthalmitis due to Bartonella henselae.

Goldstein DA, Mouritsen L, Friedlander S, Tessler HH, Edward DP.

Department of Ophthalmology, University of Illinois at Chicago, Chicago, IL, USA. debrgold@uic.edu

A 45-year-old man presented with progressively worsening vitreitis of 1 week's duration. Treatment for cat-scratch disease 3 years prior to presentation and persistent vitreitis led to vitrectomy, and analysis of the vitrectomy specimen revealed inflammatory cells and necrotic debris; polymerase-chain-reaction analysis of the vitreous fluid sample, done by use of a novel heminested protocol, demonstrated the presence of Bartonella henselae DNA. Treatment with doxycycline led to improvement in the intraocular inflammation but resulted in a poor visual outcome.

PMID: 11486295 [PubMed - indexed for MEDLINE]

613. J Vet Diagn Invest. 2001 May;13(3):219-29.

Differential detection of Bartonella species and strains in cat scratch disease diagnostics by polymerase chain reaction amplification of 16S ribosomal RNA gene.

Tapp RA, Roy AF, Corstvet RE, Wilson VL.

Institute of Environmental Studies, School of Veterinary Medicine, Louisiana State University, Baton Rouge 70803, USA.

Cat scratch disease (CSD) has been difficult to diagnose in animals because of the protracted clinical course of infection and the quiescent phases when the microbial culprit lies dormant. The causative agent in CSD appears to be multiple species and strains of Bartonella. Using polymerase chain reaction (PCR) techniques for amplification of highly variable regions of the 16S ribosomal RNA (rRNA) gene sequence, a very sensitive species- and strain-specific assay for CSD-causing Bartonella species was developed. PCR primers were designed to specifically amplify the 16S rRNA gene of Bartonella species but not of other microbial pathogens. This initial PCR was multiplexed with a universal primer set, based on conserved sequence regions in the 16S rRNA gene, that provides a 162-bp fragment in all species tested. Subsequently, 3 distinct nested PCR primer sets enabled the individual amplification and specific detection of Bartonella henselae type 1, B. henselae type II, and B. clarridgeae. Thus, this 2-step PCR procedure enabled the sensitive detection and identification of these species and the B. henselae genotype by exploiting minor sequences differences. Verification of these results were demonstrated with both sequencing and ligase chain reaction techniques. The diagnostic usefulness of this CSD test has been demonstrated by the analysis of specimens from control and infected cats. The diagnosis was confirmed and the specific B. henselae strain was correctly identified in peripheral blood specimens obtained from control and strain-specific CSD-infected cats. Such an accurate and sensitive diagnostic tool for the detection and identification of CSD causative agents should be a useful for the medical, veterinary, and scientific communities.

PMID: 11482599 [PubMed - indexed for MEDLINE]

614. J Am Dent Assoc. 2001 Jul;132(7):911-4.

Cat-scratch disease: considerations for dentistry.

Mandel L, Surattanont F, Miremadi R.

Salivary Gland Center, Columbia University School of Dental and Oral Surgery, New York, NY 10032, USA.

BACKGROUND: Cat-scratch disease, or CSD, results from inoculation of the gram-negative bacillus Bartonella henselae via a cat's scratch. A regional lymphadenitis, which usually is cervical, develops and may progress to suppuration. It is necessary to differentiate CSD from other lymphadenopathies. CASE DESCRIPTION: A patient who had close contact with a cat subsequently developed a localized, suppurative cervical lymphadenitis. As B. henselae was identified in 1992, the authors were able to confirm the existence of CSD serologically. Surgical drainage resulted in a successful resolution of the disease process. CLINICAL IMPLICATIONS: As patients with CSD may be seen in the dental office, an awareness of its symptomatology can prevent unnecessary dental intervention and facilitate early treatment.

PMID: 11480644 [PubMed - indexed for MEDLINE]

615. J Vet Diagn Invest. 2001 Jul;13(4):312-22.

Evaluation and use of a nested polymerase chain reaction assay in cats experimentally infected with Bartonella henselae genotype I and Bartonella henselae genotype II.

Roy AF, Corstvet RE, Tapp RA, Oreilly KL, Cox HU.

Department of Microbiology and Parasitology, School of Veterinary Medicine, Louisiana State University, Baton Rouge 70803, USA.

Cats have been shown to be infected with Bartonella henselae genotype I, B. henselae genotype II, and B. clarridgeiae. Feline bartonellosis infections and the strains involved in these infections are important in both veterinary and human medicine. Nucleic acid amplification methods such as polymerase chain reaction (PCR) are being used in both research and diagnostics as tools for understanding many infectious diseases. Bartonella bacteremia in cats is detected by blood culture; however, because of the limitations of culture (delayed turnaround time and sensitivity limits), PCR may be a more efficient method for identifying infected cats. Three distinct PCR assays that could differentiate among B. henselae genotype I, B. henselae genotype II. and B. clarridgeiae were developed and used to detect as few as 3.2 organisms. Fourteen cats experimentally infected with B. henselae genotype I and B. henselae genotype II were followed by bacterial culture and PCR through the course of infection, including periods of primary and relapsing bacteremia. The PCR assay was positive in 11 of the 14 cats for periods of 1-9 weeks after culture became negative. Of the 223 blood specimens that were culture negative, the PCR assay was positive in 38 (17%) of the specimens. Two of the 14 cats developed relapsing bacteremia. The 2 B. henselae genotypes were amplified in the cats and the bacteremic phase of these infections as determined by PCR lasted for a longer period than previously determined by culture. Using laboratory assays such as PCR to understand the strains involved in feline bartonellosis and the course of the infection is important in the understanding of these zoonotic agents.

PMID: 11478603 [PubMed - indexed for MEDLINE]

616. Eur J Clin Microbiol Infect Dis. 2001 Jun;20(6):392-401.

Serodiagnosis of cat scratch disease: response to Bartonella henselae in children and a review of diagnostic methods.

Sander A, Berner R, Ruess M.

Institute for Medical Microbiology and Hygiene, University of Freiburg, Germany. sander@ukl.uni-freiburg.de

In this study, sera from 116 children without clinical evidence of cat scratch disease (CSD) and sera from 19 children with CSD were investigated by two different immunofluorescent assays (test A and test B) to evaluate the seroprevalence of Bartonella henselae antibodies in this population. Antibodies against Bartonella henselae were found in noninfected children only in low titers: 13% and 3.5% of serum samples were positive by test A and test B, respectively. IgG titers as determined by test A ranged from 1:64 to 1:256, whereas test B did not yield titers >1:64. Of the 19 children with CSD, 7 (37%) and 5 (26%) had low antibody titers (1:64-1:256) on admission by test A and test B, respectively. In such cases, IgM antibodies against Bartonella henselae and/or a titer increase in the following weeks are required to prove suspected CSD. The results indicate that the seroprevalence of Bartonella henselae antibodies in children without evidence of CSD is low, and that the results may differ depending on the tests being used. Low antibody titers, however, were found not only in healthy children but also among patients with CSD, which could be indicative of the beginning or of the end of an illness. Currently, only few data are available concerning the seroprevalence of antibodies to Bartonella spp. among children. Although children are often affected by CSD, the specificity of most tests has been evaluated by investigating blood donors, who are usually adults. Several different serological tests are used for the diagnosis of CSD, including the immunofluorescence assay, the enzyme-linked immunosorbent assay, and Western blot (WB) analysis. The sensitivities of different IFAs range from 14 to 100%, depending on the antigen used, the cut-off chosen, and the test procedures. The current diagnostic value of different serological tests for diagnosis of CSD is reviewed.

PMID: 11476439 [PubMed - indexed for MEDLINE]

617. J Clin Microbiol. 2001 Aug;39(8):2978-80.

Immunofluorescent detection of intraerythrocytic Bartonella henselae in naturally infected cats.

Rolain JM, La Scola B, Liang Z, Davoust B, Raoult D.

Unité des Rickettsies, CNRS UMR 6020, Faculté de Médecine, 13385 Marseille Cedex 05, France.

To determine the presence of Bartonella henselae bacteremia in six cats, we compared isolation using blood culture with direct immunofluorescence on blood smears. Three cats that were positive by blood culture were also positive by direct immunofluorescence, and laser confocal microscopy confirmed the intraerythrocytic location of B. henselae.

PMCID: PMC88274 PMID: 11474027 [PubMed - indexed for MEDLINE]

618. J Clin Microbiol. 2001 Aug;39(8):2768-78.

16S/23S rRNA intergenic spacer regions for phylogenetic analysis, identification, and subtyping of Bartonella species.

Houpikian P, Raoult D.

Unité des Rickettsies, CNRS-UPRES-A 6020, Faculté de Médecine de Marseille, 13385 Marseille Cedex, France.

Species of the genus Bartonella are currently recognized in growing numbers and are involved in an increasing variety of human diseases, mainly trench fever, Carrion's disease, bacillary angiomatosis, endocarditis, cat scratch disease, neuroretinitis, and asymptomatic bacteremia. Such a wide spectrum of infections makes it necessary to develop species and strain identification tools in order to perform phylogenetic and epidemiological studies. The 16S/23S rRNA intergenic spacer region (ITS) was sequenced for four previously untested species, B. vinsonii subsp. arupensis, B. tribocorum, B. alsatica, and B. koehlerae, as well as for 28 human isolates of B. quintana (most of them from French homeless people), six human or cat isolates of B. henselae, five cat isolates of B. clarridgeiae, and four human isolates of B. bacilliformis. Phylogenetic trees inferred from full ITS sequences of the 14 recognized Bartonella species using parsimony and distance methods revealed high statistical support, as bootstrap values were higher than those observed with other tested genes. Five well-supported lineages were identified within the genus and the proposed phylogenetic organization was consistent with that resulting from protein-encoding gene sequence comparisons. The ITS-derived phylogeny appears, therefore, to be a useful tool for investigating the evolutionary relationships of Bartonella species and to identify Bartonella species. Further, partial ITS amplification and sequencing offers a sensitive means of intraspecies differentiation of B. henselae, B. clarridgeiae, and B. bacilliformis isolates, as each strain had a specific sequence. The usefulness of this approach in epidemiological investigations should be highlighted. Among B. quintana strains, however, the genetic heterogeneity was low, as only three ITS genotypes were identified. It was nevertheless sufficient to show that the B. quintana population infecting homeless people in France was not clonal.

PMCID: PMC88237 PMID: 11473990 [PubMed - indexed for MEDLINE]

619. J R Soc Med. 2001 Aug;94(8):403-5.

An epitrochlear tumour.

Vögelin E, Büchler U.

Department of Orthopaedic, Plastic and Hand Surgery, Division of Hand Surgery, University of Bern, Inselspital, Freiburgstrasse, 3010 Bern, Switzerland. esther.voegelin@insel.ch

PMCID: PMC1281636 PMID: 11461986 [PubMed - indexed for MEDLINE]

620. Rev Neurol (Paris). 2001 Jul;157(6-7):698-700.

[Bartonella henselae meningoencephalitis].

[Article in French]

Tattevin P, Lellouche F, Bruneel F, Régnier B, De Broucker T.

Maladies Infectieuses, CHU Pontchaillou, Rennes. tattevin@club-internet.fr

PMID: 11458191 [PubMed - indexed for MEDLINE]

621. Infect Immun. 2001 Aug;69(8):5088-97.

Bartonella henselae induces NF-kappaB-dependent upregulation of adhesion molecules in cultured human endothelial cells: possible role of outer membrane proteins as pathogenic factors.

Fuhrmann O, Arvand M, Göhler A, Schmid M, Krüll M, Hippenstiel S, Seybold J, Dehio C, Suttorp N.

Department of Internal Medicine (Infectious Diseases), Charité, Humboldt-University of Berlin, 13353 Berlin, Germany.

The endothelium is a specific target for Bartonella henselae, and endothelial cell infection represents an important step in the pathogenesis of cat scratch disease and bacillary angiomatosis. Mechanisms of Bartonella-endothelial cell interaction as well as signaling pathways involved in target cell activation were analyzed. B. henselae strain Berlin-1, isolated from bacillary angiomatosis lesions of a human immunodeficiency virus-infected patient, potently stimulated human umbilical cord vein endothelial cells (HUVEC), as determined by NF-kappaB activation and enhanced adhesion molecule expression. These effects were accompanied by increased PMN rolling on and adhesion to infected endothelial cell monolayers, as measured in a parallel-plate flow chamber assay. Monoclonal antibodies against E-selectin significantly reduced PMN rolling and adhesion. In our hands, B. henselae Berlin-1 was substantially more active than the typing strain B. henselae ATCC 49882. E-selectin and ICAM-1 upregulation occurred for up to 9 days, as verified by Northern blotting and cell surface enzyme-linked immunosorbent assay. Induction of adhesion molecules was mediated via NF-kappaB activation and could be blocked by a specific NF-kappaB inhibitor. Additional studies indicated that B. henselae-induced effects did not require living bacteria or Bartonella lipopolysaccharides. Exposure of HUVEC to purified B. henselae outer membrane proteins (OMPs), however, reproduced all aspects of endothelial cell activation. In conclusion, B. henselae, the causative agent of cat scratch disease and bacillary angiomatosis, infects and activates endothelial cells. B. henselae OMPs are sufficient to induce NF-kappaB activation and adhesion molecule expression followed by enhanced rolling and adhesion of leukocytes. These observations identify important new properties of B. henselae, demonstrating its capacity to initiate a cascade of events culminating in a proinflammatory phenotype of infected endothelial cells.

PMCID: PMC98604 PMID: 11447190 [PubMed - indexed for MEDLINE]

622. Br J Biomed Sci. 2001;58(2):101-10.

Cat-scratch disease: epidemiology, aetiology and treatment.

Windsor JJ.

Aberystwyth Public Health Laboratory, Bronglais Hospital, Wales, UK.

Cat-scratch disease (CSD) is a clinical syndrome that usually presents as a self-limiting lymphadenopathy associated with a cat scratch or bite. Commonly affecting children and young adults, it has a worldwide distribution. In temperate climates, higher rates are reported in the autumn and winter, which can be attributed to the seasonal breeding of the domestic cat. The organism responsible was identified in 1983, having eluded detection for 50 years. Initially, Afipia felis was thought to be the cause; however, subsequent study failed to confirm a link. During the 1990s, it was demonstrated conclusively that Rochalimaea henselae, later reclassified as Bartonella henselae, was the cause of CSD. B. henselae has been isolated from bacteraemic cats, with transmission among cats thought to be via the cat flea. Although other Bartonella species are transmitted by arthropod vectors, it is unlikely that the cat flea is involved directly in human infection, but plays a role in amplifying the reservoir. B. henselae is difficult to culture, and either serology or the polymerase chain reaction are considered to be the best methods of detection. Genetic variation occurs amongst B. henselae strains, perhaps explaining the inconsistency of some diagnostic techniques. A separate serogroup (Marseilles) has been reported in a seronegative patient with CSD, and B. clarridgeiae has the potential to cause the disease. Atypical presentation is seen in up to 25% of cases, and manifests itself as ocular involvement, encephalopathy, granulomatous hepatitis, hepatosplenic infection, endocarditis and osteomyelitis. The majority of CSD cases resolve spontaneously and do not require antibiotic treatment. In complicated CSD, treatment with trimethoprim-sulphamethoxazole, ciprofloxacin or azithromycin is recommended, with gentamicin being reserved for the severely ill patient.

PMID: 11440202 [PubMed - indexed for MEDLINE]

623. Rev Med Interne. 2001 Jun;22(6):522-9.

[Cat scratch disease. Clinical study of 26 patients. Role and importance of PCR].

[Article in French]

Abgueguen P, Chennebault JM, Achard J, Cottin J, Pichard E.

Service des maladies infectieuses, CHU, 4, rue Larrey, 49033 Angers, France.

PURPOSE: Cat scratch disease is a mild pathology but diagnosis often remain difficult. METHODS: A retrospective study has been conducted by the department of infectious diseases at the University hospital in Angers. Between January 1994 and October 1998, 26 observations were recorded providing the presence of three criteria out of four among the following: contact with a cat, clinical presentation and its favorable course, absence of any other cause noticed, and the presence of either a positive serology or a positive PCR, or the examination of a suggestive pathology. RESULTS: Fourteen men and 12 women were concerned. From a clinical point of view, the inoculation lesion was observed six times, all patients showed at least one adenopathy during their illness, 12 patients showed only an adenopathy without clinical signs. A surgical biopsy was carried out on nine patients and a diagnosis established. Bartonella henselae serology was done in all patients. Six presented a significant rate of IgG antibodies as early as the first dosage. A seroconversion was observed in four cases belatedly 1 to 2 months after the beginning of the symptomatology. The method's sensitivity was approximately 38%. A PCR search was accomplished in the pus obtained from a ganglionic puncture on 12 patients. It was positive seven times, which corresponds to a sensitivity of about 58%. In associating these two diagnostic criteria a sensitivity rate of nearly 92% was reached, the diagnosis not having been confirmed only in one case. The outcome proved to be favorable in all cases, with or without an antibiotic treatment. CONCLUSION: The association of serology and PCR in the pus permits a certain diagnosis in the majority of the cases and avoids the more aggressive biopsy.

PMID: 11433560 [PubMed - indexed for MEDLINE]

624. Lancet. 2001 Jun 16;357(9272):1974-5.

Bartonella hensela in inflammatory bowel disease.

Numazaki K, Chiba S, Ueno H.

Comment on Lancet. 2000 Oct 7;356(9237):1245-6.

PMID: 11430386 [PubMed - indexed for MEDLINE]

625. Kansenshogaku Zasshi. 2001 May;75(5):406-10.

[Serological cross-reaction among Bartonella henselae, Chlamydia pneumoniae and Coxiella burnetii by indirect fluorescence antibody method].

[Article in Japanese]

Tsuneoka H, Ouchi K, Nagaoka H, Ishida C, Iino H, Murakami K, Tsujino K, Umeda A, Tsukahara M.

Department of Clinical Laboratory, Yamaguchi-ken Kouseiren Nagato General Hospital.

We studied the serological cross-reactions among Bartonella henselae, Chlamydia pneumoniae and Coxiella burnetii by indirect fluorescence antibody (IFA) method, using sera from 8 patients with cat scratch disease (CSD), 13 patients with C. pneumoniae infection and 12 patients with acute Q fever. B. henselae IgG antibody was negative in 13 patients with C. pneumoniae infection, and was positive in 3 (titers being 1:64) of 12 patients with Q fever, whereas B. henselae IgM antibody was negative in all the patients with C. pneumoniae infection or Q fever. C. burnetii IgG antibody was removed by absorption of these 3 sera with C. burnetii antigens, whereas B. henselae IgG antibody did not change. C. pneumoniae IgG antibody was positive in 3 (titers being 1:125 in two, 1:32 in one) of 8 patients with CSD. Both C. pneumoniae and B. henselae IgG antibody titers were significantly reduced by absorption of these 3 sera with B. henselae antigens. C. burnetii IgG or IgM antibodies were negative in all patients with CSD. In conclusion, no serological cross-reaction between B. henselae and C. burnetii was observed. On the other hand. B. henselae IgG antibody cross-reacted to C. pneumoniae antigens, whereas C. pneumoniae IgG antibody did not cross-react to B. henselae antigens. Our findings suggest that determination of B. henselae IgG or IgM antibodies were not influenced by C. pneumoniae and C. burnetii antigens.

PMID: 11424490 [PubMed - indexed for MEDLINE]

626. Retina. 2001;21(3):280-1.

Focal retinal phlebitis as a presenting sign of systemic Bartonella henselae infection.

Chang MS, Lee SS, Cunningham ET Jr.

Francis I. Proctor Foundation, Department of Ophthalmology, UCSF Medical Center, San Francisco, California 94143-0944, USA.

PMID: 11421028 [PubMed - indexed for MEDLINE]

627. Retina. 2001;21(3):272-3.

Pars plana vitrectomy for epiretinal membrane secondary to cat scratch neuroretinitis.

Canzano JC, Lim JI.

Doheny Eye Institute and Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, USA.

PMID: 11421023 [PubMed - indexed for MEDLINE]

628. FEMS Microbiol Lett. 2001 Jun 12;200(1):1-7.

Molecular phylogeny of the genus Bartonella: what is the current knowledge?

Houpikian P, Raoult D.

Unité des Rickettsies, CNRS-UPRES-A 6020, Faculté de Médecine de Marseille, 27, boulevard Jean Moulin, 13385 Marseille cedex, France.

Species of the genus Bartonella are involved in an increasing variety of human diseases. In addition to the 14 currently recognized species, several Bartonella strains have been recovered from a wide range of wild and domestic mammals in Europe and America. Such a high diversity of geographic distributions, animal reservoirs, arthropod vectors and pathogenic properties makes clarification of our knowledge about the phylogeny of Bartonella species necessary. Phylogenetic data have been inferred mainly from 16S rDNA, 16S--23S rRNA intergenic spacer, citrate synthase and 60 kDa heat-shock protein gene sequences, which are available in GenBank. Comparison of phylogenetic organizations obtained from various genes allowed six statistically significant evolutionary clusters to be identified. Bartonella bacilliformis and Bartonella clarridgeiae appear to be divergent species. Bartonella henselae, Bartonella koehlerae and Bartonella quintana cluster together, as well as Bartonella vinsonii subsp. vinsonii and B. vinsonii subsp. berkhoffii. The fifth group includes bacteria isolated from various rodents that belong to native species from the New World and in the sixth, Bartonella tribocorum, Bartonella elizabethae and Bartonella grahamii are grouped with several strains associated with Old World indigenous rodents. The position of the other species could not be consistently determined. As some cat- or rodent-associated Bartonella appeared to cluster together, it has been suggested that these bacteria and their reservoir hosts may co-evolve. Lack of host specificity, however, seems to be frequent and may reflect the influence of vector specificity. Host or vector specificity may also explain the current geographic distribution of Bartonella species.

PMID: 11410341 [PubMed - indexed for MEDLINE]

629. Arch Neurol. 2001 Jun;58(6):1008-9.

Macular star in neuroretinitis.

Bhatti MT, Asif R, Bhatti LB.

Department of Ophthalmology, University of Florida, Box 100284, Gainesville, FL 32610-0284, USA.

PMID: 11405817 [PubMed - indexed for MEDLINE]

630. Am J Clin Pathol. 2001 Jun;115(6):900-9.

DNA amplification for the diagnosis of cat-scratch disease in small-quantity clinical specimens.

Avidor B, Varon M, Marmor S, Lifschitz-Mercer B, Kletter Y, Ephros M, Giladi M.

Laboratory for Molecular Biology of Infectious Diseases, Ichilov Hospital, Tel-Aviv Sourasky Medical Center, 6 Weizman St, Tel-Aviv 64239, Israel.

Diagnosis of cat-scratch disease (CSD) by polymerase chain reaction (PCR) of lymph node fineneedle aspiration (FNA) and primary lesion specimens can be difficult owing to the minute amount of available material. A PCR assay specifically suited to test these specimens was developed. First, small-quantity (10 microL) samples were prepared from 17 CSD-positive and 16 CSD-negative specimens, and DNA extraction and amplification from these samples were compared using 3 methods. Sensitivity and specificity of PCR were 100% using material collected on glass microscope slides and by using Qiagen (Hilden, Germany) columns for DNA extraction. Then, this method was used to test 11 archival glass microscope slides of FNA (7 malignant neoplasms, 4 undiagnosed lymphadenitis) and 2 primary lesion specimens. Two of the 4 lymphadenitis samples and the 2 primary lesion specimens were PCR positive. The technique presented could facilitate CSD diagnosis from a wider range of clinical samples.

PMID: 11392888 [PubMed - indexed for MEDLINE]

631. Trends Microbiol. 2001 Jun;9(6):279-85.

Bartonella interactions with endothelial cells and erythrocytes.

Dehio C.

Dept of Molecular Microbiology, Biozentrum of the University of Basel, Klingelbergstrasse 70, CH-4056, Basel, Switzerland. christoph.dehio@unibas.ch

Comment in Trends Microbiol. 2001 Nov;9(11):530-2.

Bartonella species are emerging human pathogens responsible for a wide range of clinical manifestations, including Carrion's disease, trench fever, cat-scratch disease, bacillary angiomatosis-peliosis, endocarditis and bacteraemia. During infection of their human or animal reservoir host(s), these arthropod-borne pathogens typically invade and persistently colonize mature erythrocytes. However, in both reservoir and incidentally infected hosts, endothelial cells are target cells for bartonellae. Endothelial interactions involve a unique mode of cellular invasion, the activation of a proinflammatory phenotype and the formation of vasoproliferative tumours. Based on the establishment of bacterial genetics and appropriate infection models, recent work has begun to elucidate the cell and molecular biology of these unusual pathogen-host cell interactions.

PMID: 11390243 [PubMed - indexed for MEDLINE]

632. Eur J Pediatr. 2001 May;160(5):316.

Bartonella henselae bacteraemia in patients with cat scratch disease.

Tsukahara M, Iino H, Ishida C, Murakami K, Tsuneoka H, Uchida M.

Comment on Eur J Pediatr. 2000 May;159(5):356-9.

PMID: 11388603 [PubMed - indexed for MEDLINE]

633. Lijec Vjesn. 2001 Jan-Feb;123(1-2):14-5.

[Bartonella henselae as the causative agent in cat-scratch disease: case report].

[Article in Croatian]

Dzelalija B, Avsic-Zupanc T.

Opća bolnica Zadar, Ulica Boze Pericića 5, 23000 Zadar.

In this article we reported typical clinical, primary skin lesion and regional lymphadenitis, and atypical, protracted fever and algic syndrome, characteristics of cat scratch disease (CSD) in a 21-year-old man (a student) from Zadar, Croatia. Laboratory parameters were in normal range. The histopathologic findings of affected lymph nodes included stellate caseating granulomas. By using IFA method a seroconversion of specific IgG antibodies (neg/1:512) and rise of IgM antibodies (1:160/ > 1:320) to B. henselae were detected in paired sera, and these serologic findings indicate on conclusion that B. henselae is probably etiologic agent of CSD in our patient.

PMID: 11379192 [PubMed - indexed for MEDLINE]

634. Arch Pediatr. 2001 Apr;8(4):393-6.

[Pseudotumoral presentation of cat scratch disease].

[Article in French]

Eckart P, Tournade G, Amiour M, Guillot M, Courthéoux P, Rousselot P.

Service de pédiatrie, centre hospitalier Robert-Bisson, BP 7223, 14107 Lisieux, France. eckart14@aol.com

BACKGROUND: A frequent cause of chronic benign lymphadenopathy, cat-scratch disease (CSD) occurs mainly in children and young adults. Bartonella henselae is the agent responsible for CSD. The most common symptoms of the disease are regional lymphadenopathy and fever. Atypical forms occur in about 10% of patients; among them, CSD may initially present as a tumor. CASE REPORT: A 4-year-old child developed a 'tumor' of the arm with fever. The values of white blood cell count and CRP were normal. Ultrasonography, MRI and arteriography did not contribute to the diagnosis, which was established on histologic examination and serologic test for infection with B. henselae. The outcome was favorable with antibiotic treatment. CONCLUSION: In case of tumor of the limbs, cat-scratch disease should be searched for.

PMID: 11339132 [PubMed - indexed for MEDLINE]

635. Eur J Pediatr. 2001 Apr;160(4):260-1.

Asymptomatic persistent pulmonary infiltrates in an immunocompetent boy with cat-scratch disease.

Marseglia GL, Monafo V, Marone P, Meloni F, Martini A, Burgio GR.

We describe here an immunocompetent boy with fever, regional adenopathy, multifocal hepatosplenic granulomas, and high and increasing serum antibody titers for Bartonella henselae in whom diffuse bilateral reticulonodular pulmonary infiltrates developed in the absence of respiratory symptoms.

PMID: 11317652 [PubMed - indexed for MEDLINE]

636. Vet Microbiol. 2001 May 21;80(2):185-98.

Epidemiology of Bartonella infection in domestic cats in France.

Gurfield AN, Boulouis HJ, Chomel BB, Kasten RW, Heller R, Bouillin C, Gandoin C, Thibault D, Chang CC, Barrat F, Piemont Y.

UMR 956 INRA/AFSSA/ENVA, Ecole Nationale Vétérinaire d'Alfort, 94704 Maisons-Alfort, France.

Blood samples were collected between February and June 1996 from a convenience sample of 436 domestic French cats living in Paris and its environs and were tested for Bartonella bacteremia and seropositivity. Seventy-two cats (16.5%) were Bartonella bacteremic, of which 36 cats (50%) were infected with Bartonella henselae type II (B.h. II) only, 15 cats (21%) were infected with Bartonella clarridgeiae (B.c.) only, and 11 cats (15%) were infected with B. henselae type I (B.h. I) only. Eight cats (11%) were co-infected with B. henselae and B. clarridgeiae (B.h. II/B.c.: five cats; B.h. I/B.c.: three cats). Two cats (2.8%) were concurrently bacteremic with B. henselae types I and II. Risk factors associated with bacteremia included ownership for <6months (prevalence ratio (PR)=1.80; 95% confidence interval (CI)=1.13-2.85), adoption from the pound or found as a stray (PR=1.67, 95% CI=1.05-2.65), and cohabitation with one or more cats (PR=1.60, 95% CI=1.01-2.53). Bartonella antibodies to either B. henselae or B. clarridgeiae were detected in 179 cats (41.1%). Risk factors associated with seroposivity paralleled those for bacteremia, except for lack of association with time of ownership. Prevalence ratios of bacteremic or seropositive cats increased with the number of cats per household (p=0.02). The lack of antibodies to B. henselae or B. clarridgeiae was highly predictive of the absence of bacteremia (predictive value of a negative test=97.3%). Multiple logistic regression analysis indicated that bacteremia, after adjustment for age and flea infestation, and positive serology, after adjustment for age, were associated with origin of adoption and number of cats in the household. Flea infestation was associated with positive serology.

PMID: 11295338 [PubMed - indexed for MEDLINE]

637. Vet Microbiol. 2001 Apr 19;79(4):337-49.

Genomic diversity of Bartonella henselae isolates from domestic cats from Japan, the USA and France by pulsed-field gel electrophoresis.

Maruyama S, Kasten RW, Boulouis HJ, Gurfield NA, Katsube Y, Chomel BB.

Laboratory of Veterinary Public Health, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, 1866 Kameino, Fujisawa, 252-8510, Kanagawa, Japan. maruyama@brs.nihon-u.ac.jp

The genomic DNA diversity of 27 Bartonella henselae and three B. clarridgeiae isolates from 18 domestic cats from Japan, the USA and France was investigated by pulsed-field gel electrophoresis (PFGE) with NotI, AscI and SmaI restriction enzymes. A great diversity of genomic patterns was found for all B. henselae, but none for B. clarridgeiae isolates. The DNA size of B. henselae and B. clarridgeiae isolates were 1.7-2.9 and 1.7Mbp, respectively. All 13 Japanese cat isolates were identified as B. henselae type I. Furthermore, three of the four Japanese cats harbored genetically different B. henselae type I isolates, suggesting for the first time co-infection with various type I isolates. One French cat and one American cat were co-infected with B. henselae and B. clarridgeiae. B. henselae type I and type II were mainly grouped in two different clusters by PFGE using SmaI endonuclease in the dendrogram.

PMID: 11267793 [PubMed - indexed for MEDLINE]

638. Vet Rec. 2001 Feb 17;148(7):219.

Prevalence of Bartonella henselae in cats in the UK.

Laycock GM, Day MJ, Birtles RJ.

Comment on Vet Rec. 2000 Dec 9;147(24):673-7.

PMID: 11266008 [PubMed - indexed for MEDLINE]

639. Arch Mal Coeur Vaiss. 2001 Feb;94(2):157-61.

[Subacute infectious endocarditis due to the agent of cat scratch fever: Bartonella henselae].

[Article in French]

Grand A, Celard M, el Belghiti R, Ghadban W, De Gevigney G, Dabboura A, Besnard C, Ouanes K, Huret JF, Fichter P.

Service de cardiologie, centre hospitalier de Valence, 26953 Valence.

The diagnosis of severe mitral stenosis with left atrial thrombus was rectified at valvular replacement in a 48-year old immuno-competent man who was a cat owner. The mass in the left atrium was, in fact, a large endocarditic vegetation. Pre- and postoperative blood cultures were negative as was culture of the excised mitral valve. The diagnosis of infectious endocarditis (IE) due to Bartonella Henselae was made from a positive serological test (1600) and identification of the germ by genetic amplification. Antibiotic therapy was continued for 6 months and the patient was cured with a follow-up of 4 years. Bartonella Henselae IE is very rare (14 reported cases) and affects mainly the aortic valve, often giving rise to very large vegetations which, in half the cases, are complicated by systemic emboli. Germs like Batonella are sensitive to most antibiotics, especially the aminosides and macrolides. In Bartonella Henselae IE, valve replacement is the rule (13 out of 14 cases) and the prognosis is usually good. Sero-diagnosis of Bartonellosis should be part of the systematic investigation of all blood culture negative IE.

PMID: 11265556 [PubMed - indexed for MEDLINE]

640. Kansenshogaku Zasshi. 2001 Feb;75(2):133-6.

[Bartonella henselae infection in domestic cat and dog fleas].

[Article in Japanese]

Ishida C, Tsuneoka H, Iino H, Murakami K, Inokuma H, Ohnishi T, Tsukahara M.

Faculty of Health Sciences, Yamaguchi University School of Medicine.

We studied on the infection of domestic cat and dog fleas with Bartonella henselae by polymerase chain reaction (PCR). A total of 62 fleas (36 Ctenocephalidis felis from cats, 24 C. felis from dogs and 2 Ctenocephalidis canis from dogs), stored in 70% ethanol, were analyzed by PCR for B. henselae specific DNA. Of the 62 fleas, C. felis from cats and dogs were positive for B. henselae specific DNA in 12 of the 36 (33.3%) and in 5 of the 24 (20.8%), respectively, and C. canis from dogs was positive in 2 of the 2 (100%). Our results demonstrated that pet fleas were infected with B. henselae, and suggest that flea transmission of B. henselae between cats or dogs may occur, and direct transmission of B. henselae from pet fleas to human may cause cat scratch disease.

PMID: 11260879 [PubMed - indexed for MEDLINE]

641. Can J Public Health. 2001 Jan-Feb;92(1):67-71.

A serological survey of rural dogs and cats on the southwestern Canadian prairie for zoonotic pathogens.

Leighton FA, Artsob HA, Chu MC, Olson JG.

Canadian Cooperative Wildlife Health Centre, Department of Veterinary Pathology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK. ted.leighton@usask.ca

A survey for antibodies against agents of plague, tularemia, and Rocky Mountain spotted fever (RMSF), and against Sin Nombre hantavirus (SNV), Bartonella henselae and B. clarridgeiae was conducted in the summer of 1995 using serum from rural dogs and cats living in the vicinity of four public parks in southeastern Alberta and southwestern Saskatchewan. Antibodies to all pathogens were detected in all survey areas. Overall prevalence rates were 0.075 for Yersinia pestis, 0.089 for Francisella tularensis, 0.025 for Rickettsia rickettsii (dogs only), and 0.029, 0.178 and 0.186 for SNV, B. henselae and B. clarridgeiae, respectively (cats only). This serological survey of rural dogs and cats was more sensitive and efficient than previous surveys based on collection and culture of rodents and ectoparasites. All six pathogens appear endemic to the region. Surveillance for plague, tularemia, RMSF and SNV, and management of associated public risks should be done in endemic regions.

PMID: 11257996 [PubMed - indexed for MEDLINE]

642. Med Arh. 2000;54(5-6):321-2.

[Cat-scratch disease].

[Article in Croatian]

Saracević E, Sabanović S, Selimović A.

Pedijatrijska klinika, Klinicki centar Univerziteta u Sarajevu.

We report a case of fourteen years old boy with cat scratch disease. He was treated at Pediatric Clinic in January and February 2000. Cat scratch disease is benign infectious chronic disease which appears in all ages. It begins after contact with cat and its scratch. Yearly incidence of this disease for whole population is 0.77-0.86/100.000. The cause is bacillus Bartonella which is also called genus Rochalimaea. It is Gram negative, mobile, aerobe bacillus with ten flagellas on one pole. Our patient was admitted at hospital because of high temperature, paleness, fatigue, bad appetite and pains in his joint. Ultrasound and magnet resonance scans of liver and spleen showed enlarged but regulary contured liver and two focal changes with diameter 16 mm, 12 mm and 7 mm in spleen. All those focal changes were described as abscesses. Diagnose was set up according increasing titre of IF-Bartonella hensalae IgG 1:256 (positive). This diagnostic test was performed at Institute for microbiology and Immunology at Medical Faculty in Ljubljana. Disease had long lasting course, and was cured by antibiotics without surgical intervention.

PMID: 11219917 [PubMed - indexed for MEDLINE]

643. Eur J Clin Microbiol Infect Dis. 2000 Dec;19(12):964-7.

Detection of Bartonella henselae and Afipia felis DNA by polymerase chain reaction in specimens from patients with cat scratch disease.

Del Prete R, Fumarola D, Fumarola L, Miragliotta G.

Dipartimento di Clinica Medica, Immunologia e Malattie Infettive, Università degli Studi di Bari, Italy. rdelprete@midim.uniba.it

Polymerase chain reaction (PCR) amplification and colorimetric identification of amplicons were performed to detect Bartonella henselae and Afipia felis DNA in specimens from patients who were clinically and histologically suspected of having cat scratch disease. PCR products were revealed using 2% ethidium bromide agarose-gel electrophoresis and identified with specific probes in a commercial colorimetric hybridization assay (DEIA) (GEN-ETI-K; DiaSorin, Italy). Six paraffin-embedded lymph node biopsies from 18 patients as well as 18 samples of peripheral whole blood and 18 sera were investigated. Bartonella henselae DNA was recovered from the whole blood of four patients, and Bartonella henselae and Afipia felis DNA were detected in one patient's lymph node biopsy. This study suggests that PCR-DEIA is sufficiently sensitive to be considered feasible for the molecular diagnosis of cat scratch disease.

PMID: 11205638 [PubMed - indexed for MEDLINE]

644. Acta Otorhinolaryngol Belg. 2000;54(4):491-6.

Cervical lymphadenitis and cat scratch disease (CSD): an overlooked disease?

Rombaux P, M'Bilo T, Badr-el-Din A, Theate I, Bigaignon G, Hamoir M.

Department of Otolaryngology-Head and Neck Surgery, Université Catholique de Louvain, Saint-Luc University Hospital, Brussels, Belgium.

Cat Scratch Disease (CSD) is a benign disease characterized by regional lymphadenopathy affecting most frequently the head and neck region in children and young adults. In the present paper, the authors describe four cases of CSD focusing on clinical history, diagnostic management and therapy. The main germ responsible for this lymph node disease is Bartonella henselae. Diagnosis is based on history, serology and histological findings. Clinical evolution is generally favorable despite the fact that complications occur in about 5% to 13% of patients including encephalitis, hepatitis and Parinaud's oculoglandular syndrome. Antibiotic treatment is only considered for highly symptomatic patients. Surgical excision of the lymphadenopathy is useful to establish the diagnosis when serology is not available and/or when the adenopathy become fluctuating. The authors emphasize the increasing incidence of patients with CSD in the ENT population and the algorithm for CSD disease affecting the cervical lymph nodes.

PMID: 11205454 [PubMed - indexed for MEDLINE]

645. J Vet Med Sci. 2000 Dec;62(12):1321-4.

Three cases of cat scratch disease diagnosed by indirect immunofluorescence antibody assay and/or polymerase chain reaction of 16S rRNA gene of Bartonella henselae.

Maruyama S, Kabeya H, Nogami S, Sakai H, Suzuki J, Suzuki H, Sugita H, Katsube Y.

Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa, Japan.

Erratum in J Vet Med Sci 2001 Feb;63(2):following 225.

Three suspected cases of cat scratch disease were diagnosed by indirect immunofluorescence antibody assay and/or polymerase chain reaction. Patient 1 was a 10-year-old female who presented swelling of the right axillary [corrected] lymph nodes with pain and fever. She kept a kitten, and many scratches were observed on her both legs and dorsum manus. Antibody titers against Bartonella (B.) henselae were 1:32 for IgM 3 weeks after the onset of the symptoms and 1:64 for IgG 8 weeks after the onset. The DNA for 16S rRNA type I of B. henselae was detected from the blood sample obtained 3 weeks after the onset of symptoms by polymerase chain reaction for the first time in Japan. Patient 2 was a 22-year-old female veterinary student with a cat scratch at the bottom of her neck by a male kitten. She developed a papule at the scratch, slight fever, and neck pain. Although both Bartonella-specific IgG and IgM antibodies were negative before the scratch, the IgG antibody titer rose to 1:512 14 weeks after the onset. B. henselae was isolated from the kitten and its DNA found to be for 16S rRNA type I by PCR. Patient 3 was a 23-year-old female veterinary student with a cat scratch on her left forearm. A small reddish papule developed on the scratch, and she experienced swelling of the left axillary [corrected] lymph node and pain. Both the IgG and IgM antibodies against B. henselae were negative before the cat scratch, and the IgG titer rose significantly to 1:128 and 1:1,024 in 2 and 5 weeks, respectively, after the onset of the symptoms.

PMID: 11193351 [PubMed - indexed for MEDLINE]

646. Rev Sci Tech. 2000 Apr;19(1):136-50.

Cat-scratch disease.

Chomel BB.

Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.

Cat-scratch disease (CSD) was first described by Debré in 1950, yet the causative bacterial agent of CSD remained obscure until 1992, when Bartonella (formerly Rochalimaea) henselae was implicated in CSD by serological and microbiologic studies. Bartonella henselae had initially been linked to bacillary angiomatosis (BA), a vascular proliferative disease most commonly associated with long-standing human immunodeficiency virus infection or other significant immunosuppression. Bartonella henselae has also been associated with bacillary peliosis, relapsing bacteraemia and endocarditis in humans. Cats are healthy carriers of B. henselae, and can be bacteraemic for months or years. Cat-to-cat transmission of the organism by the cat flea, with no direct contact transmission, has been demonstrated. Two new Bartonella species have been identified in the cat reservoir, namely: B. clarridgeiae and B. koehlerae. The role of these species in the aetiology of CSD still needs to be confirmed by isolation or DNA identification from lesions in humans. The author discusses the present state of knowledge on the aetiology, clinical features and epidemiological characteristics of CSD/BA, in addition to diagnosis, treatment and prevention.

PMID: 11189710 [PubMed - indexed for MEDLINE]

647. Infect Immun. 2001 Mar;69(3):1880-2.

Passive antibody to Bartonella henselae protects against clinical disease following homologous challenge but does not prevent bacteremia in cats.

O'Reilly KL, Parr KA, Brown TP, Tedder-Ferguson B, Scholl DT.

Department of Veterinary Microbiology and Parasitology, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana 70803, USA. oreilly@mail.vetmed.lsu.edu

We challenged cats transfused with anti-Bartonella serum and kittens born to antibody-positive queens with Bartonella henselae to determine the contribution of antibodies to the control of B. henselae in cats. In both experiments, antibody-positive cats were protected from clinical disease but passive antibody to the homologous strain of B. henselae did not prevent bacteremia.

PMCID: PMC98096 PMID: 11179367 [PubMed - indexed for MEDLINE]

648. Curr Opin Pediatr. 2001 Feb;13(1):56-9.

Treatment of cat-scratch disease.

Conrad DA.

University of Texas Health Science Center at San Antonio, Department of Pediatrics, 78229-3900, USA. conradd@uthscsa.edu

Cat-scratch disease is an infection caused by Bartonella henselae, a fastidious gram-negative bacillus acquired from exposure to an infected kitten or cat. The most common manifestation of human disease is lymphadenitis. Atypical forms of infection include Parinaud oculoglandular syndrome, stellate neuroretinitis, persistent fever without localizing signs, hepatosplenic infection, encephalopathy, osteomyelitis, and endocarditis. Immunocompromised individuals with B. hensalae infection may develop bacillary angiomatosis, bacillary peliosis, and relapsing bacteremia with fever syndrome. The bacillus is susceptible to several antibacterial agents in vitro, including penicillins, cephalosporins, aminoglycosides, tetracyclines, macrolides, quinolones, trimethoprim and sulfamethoxazole, and rifampin. Greatest clinical efficacy has been observed following treatment with rifampin, ciprofloxacin, gentamicin, trimethoprim and sulfamethoxazole, clarithromycin, and azithromycin. In one placebo-controlled study, azithromycin therapy was associated with more rapid diminution in size of infected lymph nodes. The majority of cases of cat-scratch disease occurring in normal hosts do not require anti-infective therapy for resolution of infection.

PMID: 11176245 [PubMed - indexed for MEDLINE]

649. Klin Monbl Augenheilkd. 2000 Nov;217(5):299-302.

[Disciform keratatis caused by Bartonella henselae infection: detection of a rare ocular complication of cat-scratch disease with PCR].

[Article in German]

Gabler B, Linde HJ, Reischl U, Lohmann CP.

Universitäts-Augenklinik Regensburg, Franz-Josef-Strauss-Allee, 93042 Regensburg.

BACKGROUND: Cat scratch disease (CSD) is a common infectious disease, however its association with a disciforme keratitis is to our knowledge a previously unreported ocular complication. PATIENT: A 65-year old female was treated unsuccessfully with topical antibiotics, acyclovir and corticosteroids for several weeks because of a disciforme keratitis. Repeatedly, microbiological investigations (microscopy and culture) were negative. 16S rDNA-PCR with subsequent DNA-sequencing on material obtained by corneal scrape identified Bartonella henselae. Based on this result we have initiated a treatment with topical cephotaxim and within a short period of time the cornea healed with a paracentral scar. CONCLUSION: 16S rDNA-PCR was very helpful in identifying the intracellular sited bacterium Bartonella henselae as the causative pathogen of an unusual form of disciforme keratitis.

PMID: 11146830 [PubMed - indexed for MEDLINE]

650. Pediatr Infect Dis J. 2000 Dec;19(12):1185-7.

Diagnosis and treatment of Bartonella henselae infections.

Schutze GE.

University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, USA.

PMID: 11144381 [PubMed - indexed for MEDLINE]

651. Clin Eye Vis Care. 2000 Dec;12(3-4):155-159.

Neuroretinitis: a clinical syndrome of cat-scratch disease.

Rost Monahan S.

Kittery Ophthalmic Consultants, Kittery, ME, USA

Cat-scratch disease is usually a benign self-limited illness, characterized by regional lymphadenopathy lasting between 3 and 6 weeks. The causative organism is Bartonella henselae, a small gram-negative rod. Between 1 and 2% of patients who contract the illness experience blurred vision, metamorphopsia and scotomas as a result of neuroretinitis, an associated clinical syndrome. The classical clinical findings in cat-scratch neuroretinitis include disc edema and a stellate pattern of exudates in the macula. However, a myriad of other signs has been documented, suggesting a much wider spectrum of intra-ocular disease. The following case report presents a young patient with neuroretinitis, and a history of lymphadenopathy secondary to cat-scratch disease.

PMID: 11137430 [PubMed - as supplied by publisher]

652. Vet Rec. 2000 Dec 9;147(24):673-7.

Evidence of Bartonella henselae infection in cats and dogs in the United Kingdom.

Barnes A, Bell SC, Isherwood DR, Bennett M, Carter SD.

Department of Veterinary Clinical Science and Animal Husbandry, University of Liverpool.

Comment in Vet Rec. 2001 Feb 17;148(7):219.

Sera from cats and dogs in the UK were tested by ELISA for antibodies to Bartonella henselae. Seropositivity was confirmed in 28 of 69 pet cats (40.6 per cent), 33 of 79 feral cats (41.8 per cent) and three of 100 pet dogs. Reactivity to specific B. henselae antigens was confirmed by Western blotting and demonstrated that consistent antigenic bands were bound by sera from the cats and dogs.

PMID: 11132671 [PubMed - indexed for MEDLINE]

653. Eur J Clin Microbiol Infect Dis. 2000 Oct;19(10):781-3.

Osteomyelitis of the hip joint associated with systemic cat-scratch disease in an adult.

Krause R, Wenisch C, Fladerer P, Daxböck F, Krejs GJ, Reisinger EC.

Department of Internal Medicine, Karl-Franzens University, Graz, Austria. robert.krause@kfunigraz.ac.at

Reported here is the case of a 29-year-old male with cervical lymphadenopathy, fever and weight loss, followed by acute painful osteomyelitis of the left hip joint due to cat-scratch disease. The diagnosis was established by detection of IgG antibodies to Bartonella henselae in serum and histologic examination of a lymph node including a positive polymerase chain reaction test. Treatment consisted of clarithromycin and cefotiam for 2 weeks. Four weeks after discharge, all of the patient's symptoms had completely resolved. Magnetic resonance imaging of the left hip joint showed marked regression of bone inflammation 4 months later and normalization after 8 months. Cat-scratch disease should be considered in the differential diagnosis of osteomyelitis in an adult, especially when lymphadenitis is present.

PMID: 11117643 [PubMed - indexed for MEDLINE]

654. Braz J Infect Dis. 1998 Dec;2(6):300-303.

Baccilary Angiomatosis: Negative Results Using Normal Balb/c and Balb/c Nude Mice.

Velho PS, Moraes AM, Cintra ML, Giglioli R, Gonçalves SA, Shlessarenko N, Camargo ME.

Department of Medical Clinic, School of Medical Sciences, Estadual University of Campinas FCM/UNICAMP.

Baccilary angiomatosis has recently been described as a disease that can spread systematically and that is potentially fatal. It is caused by Bartonella henselae and B. quintana, and presents as especially pronounced signs and symptoms in patients suffering from acquired immunodeficiency syndrome (AIDS). To clarify the pathogenesis of the disease and to try to define the relationships among baccilary angiomatosis, cat scratch disease and Carrión's bartonellosis, the authors of this study have attempted to develop an experimental model using mice that were immunocompetent as well as those that had their cellular immunity genetically compromised. A known concentration of B. henselae was inoculated intradermally in Balb/c an isogenic mice or an athymic group of the same lineage. Blood samples were taken on days 0, 3, 7, 10, 14, 28, and 60 after inoculation for indirect immunofluorescence antibody testing. On the 21st and 60th day, one animal from each group was sacrificed and a post mortem carried out including histological evaluation of the liver, spleen, lymph nodes, skin and other organs. Hemocultures of the sacrificed animals were collected. All results of serologic response, cultures and histologic examination were negative. The authors discuss the methodology, especially the use of isogenic animals of the same lineage in B. henselae infection, with and without immunodeficiency, and the resources for the negative results of histopathology, serology and cultures.

PMID: 11103022 [PubMed - as supplied by publisher]

655. Curr Infect Dis Rep. 2000 Apr;2(2):141-146.

Recent Advances in Diagnosis and Treatment of Cat Scratch Disease.

Margileth AM.

Mercer University School of Medicine, Memorial Health, Baclsus Children's Hospital, Savannah, GA, USA.

The cause of cat scratch disease (CSD), first described in France in 1950 and in the United States in 1951, was unknown until 1983 when the bacterium in lymph nodes was detected using a Warthin-Starry silver stain. Afipia felis has been an infrequent cause of CSD since1988, when this gram-negative bacterium was first isolated from 10 patients with CSD. In 1992 Bartonella organisms were isolated from immunocompetent and immunocompromised patients. An indirect fluorescent antibody test to detect bartonella-specific serum immunoglobulins was developed in 1992. Since then multiple studies have shown that three Bartonella species may produce either CSD in humans, usually Bartonella henselae or Bartonella clarridgeiae, or bacteremia in healthy cats. Also, these two bacteria and Bartonella quintana cause bacillary angiomatosis, bacillary peliosis, or relapsing bacteremia in humans. Cats are healthy carriers of Bartonella organisms and may be bacteremic for months to years. Cat-to-cat transmission of Bartonella organisms involves the cat flea in absence of direct contact transmission. CSD is the most common cause of regional lymphadenitis in children and adolescents. Present knowledge on the etiology, clinical features, epidemiology, pathogenesis, diagnosis, and management of CSD are presented. Also, brief comments about the etiology, clinical presentation, and treatment of bacillary angiomatosis and bacillary peliosis are provided.

PMID: 11095849 [PubMed - as supplied by publisher]

656. Laryngorhinootologie. 2000 Oct;79(10):604-8.

[Neck abscess as primary manifestation of head and neck carcinoma: implications for diagnostic management].

[Article in German]

Ridder GJ, Eglinger CF, Sander A, Technau-Ihling K.

Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde und Poliklinik, Universitätsklinikum Freiburg. ridder@hno.ukl.uni-freiburg.de

BACKGROUND: Neck abscesses and deep neck infections are common diseases in the field of otorhinolaryngology. However, malignant lymph node metastases presenting as abscesses are uncommon and have rarely been described up to now. PATIENTS: A retrospective review between March 1997 and August 1999 was conducted of 40 patients with deep neck abscesses. RESULTS: In five patients (12.5%) the histological diagnostics revealed a malignancy. From these, in 3 cases the cervical abscess was the primary clinical symptom of an oropharyngeal as well as a hypopharyngeal carcinoma. With further 2 patients, the neck-abscess was located as first clinical sign of a metachronous lymph node metastases after oropharyngeal carcinoma. Aerobic bacteria were recovered in 18 patients, anaerobes alone in 3 and mixed aerobic and anaerobic bacteria in 6 patients. Bartonella henselae was recovered in 7, Mycobacterium tuberculosis in 3 and Actinomyces israelii in 1 patient. CONCLUSIONS: A biopsy of the abscess wall is recommended in establishing the diagnosis. The indication for a simultaneous panendoscopy--especially in patients with typical risk for malignancies--to exclude a primary tumor in the aerodigestive tract should be regarded generously. Neck abscesses should be considered in the differential diagnosis of head and neck carcinoma.

PMID: 11089210 [PubMed - indexed for MEDLINE]

657. N Engl J Med. 2000 Nov 16;343(20):1459.

Images in clinical medicine. Bartonella neuroretinitis.

Earhart KC, Power MH.

Naval Medical Center, San Diego, CA 92134-1201, USA.

PMID: 11078771 [PubMed - indexed for MEDLINE]

658. Eur J Ophthalmol. 2000 Jul-Sep;10(3):257-8.

Disciforme keratitis caused by Bartonella henselae: an unusual ocular complication in cat scratch disease.

Lohmann CP, Gabler B, Kroher G, Spiegel D, Linde HJ, Reischl U.

Department of Ophthalmology, Regensburg University, Germany. chris.lohmann@klinik.uni-regensburg.de

Cat scratch disease (CSD) is a common infectious disease, however, its association with disciforme keratitis is a previously unreported ocular complication. With the use of the 16S rDNA-PCR technique with subsequent DANN sequencing on corneal material obtained by corneal scrape we were able to identify Bartonella henselae in an unusual form of disciforme keratitis.

PMID: 11071035 [PubMed - indexed for MEDLINE]

659. Can J Microbiol. 2000 Oct;46(10):908-12.

Bartonella henselae infection in British Columbia: evidence for an endemic disease among humans.

Cimolai N, Benoit L, Hill A, Lyons C.

Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada. ncimolai@cw.bc.ca

Human bartonellosis in North America is mainly associated with Bartonella henselae, and the availability of laboratory diagnostic tools has significantly heightened awareness of the spectrum of human disease that is caused by this bacterium. We detail herein examples of illness in a pediatric population which serve to confirm that B. henselae-associated disease exists in British Columbia. Seroprevalence studies among asymptomatic adults and among children with symptomatic respiratory illness of other causation demonstrated that 36.8% and 18.5% of sera, respectively, had IFA-IgG titres > or = 1:256. IFA-IgG titres did not vary significantly whether B. henselae ATCC 49793 or a local wild-type B. henselae isolate were used as substrate. An assessment of IgM response was consistent with the proposal that endemic seroprevalence is a function of past rather than recent exposure. Both clinical and serological studies are concordant in providing evidence that B. henselae is endemic in British Columbia.

PMID: 11068677 [PubMed - indexed for MEDLINE]

660. Rheumatol Int. 2000;19(6):219-22.

Failure to detect Bartonella henselae infection in synovial fluid from sufferers of chronic arthritis.

Dillon B, Cagney M, Manolios N, Iredell JR.

University of Sydney, Westmead Hospital, Australia.

Bartonella henselae causes granulomatous and indolent infection in the immune competent human, and angioproliferation in the context of persistent infection and impaired immunity. This bacterium is found in up to 40% of household cats, from which humans acquire it by either a cat scratch or a bite (hence the name, cat-scratch disease). Approximately 5% of Australian and US blood donors have serological evidence of past infection, but most associated illnesses are mild or subclinical. A number of lines of evidence prompted us to consider a relationship between rheumatoid arthritis (RA) and Bartonella infection. These include epidemiological associations with household pet exposure; apparent responsiveness of some RA cases to tetracycline therapy; the granulomatous and angioproliferative nature of Bartonella lesions; the insidiousness and high seroprevalence of this infection in the community; and even reported Bartonella infection mimicking juvenile RA. In a small group of patients with chronic arthritides, we found no direct evidence of humoral antibodies to, nor of persistent infection with, Bartonella henselae in synovial fluid. While larger and more invasive studies are likely to provide more confident exclusions of this hypothesis, this suggests that persistent Bartonella infection is unlikely to play a major role in RA.

PMID: 11063291 [PubMed - indexed for MEDLINE]

661. Schweiz Med Wochenschr. 2000 Sep 30;130(39):1382.

[When cats scratch].

[Article in German]

Schad K, Kreyden OP, Trüeb RM.

Dermatologische Klinik, Universitätsspital Zürich.

PMID: 11059029 [PubMed - indexed for MEDLINE]

662. Crit Rev Microbiol. 2000;26(3):133-45.

Immune aspects of Bartonella.

Karem KL.

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.

Bartonella species have been recognized as important human pathogens only recently. Until the early 1990s, this genus was represented by one species, Bartonella bacilliformis. The recent identification of other Bartonella species as the agents of cat-scratch disease and bacillary angiomatosis has left little doubt of their emerging importance as opportunistic human pathogens. Over the last decade, extensive research has been performed on Bartonella species, resulting in an explosion in our knowledge of the genetic diversity of this genus. Unusual aspects of disease sequelae have fueled worldwide interest in defining the natural history, pathology, and molecular biology of Bartonella species. While much information about these interests has been presented, the advancement of immunological knowledge regarding Bartonella species has been slow. This review discusses immunological data on Bartonella species, focusing on the three primary human pathogens of this genus: B. bacilliformis, B. quintana, and B. henselae.

PMID: 11052646 [PubMed - indexed for MEDLINE]

663. Klin Padiatr. 2000 Sep-Oct;212(5):277-82.

[Peripheral lymphadenopathy in childhood--recommendations for diagnostic evaluation].

[Article in German]

Benesch M, Kerbl R, Wirnsberger A, Stünzner D, Mangge H, Schenkeli R, Deutsch J.

Universitätsklinik für Kinder- und Jugendheilkunde, Karl-Franzens-Universität Graz. martin.benesch@klinikum-graz.at

BACKGROUND: Enlargement of peripheral lymph nodes most commonly caused by a local inflammatory process is frequently seen in childhood. The aim of the present study was to analyze the most common causes of peripheral lymphadenopathy and to develop a simple algorithm for the primary diagnostic evaluation of peripheral lymph node enlargement in this age group. PATIENTS: Between April and September 1999 87 unselected children (median age: 5 1/2 years) with peripheral lymphadenopathy were referred to the Department of Pediatrics, University of Graz, for further investigation. RESULTS: EBV infection was diagnosed in 20 (23.0%) children. 19 (21.8%) patients had acute bacterial lymphadenitis. In 21 (24.1%) patients lymph node enlargement was classified as "post/parainfectious (viral)". Four patients each had toxoplasmosis and cat scratch disease. In 11 (12.6%) patients neither physical nor laboratory examinations revealed pathologic results. Among the remaining 8 children sarcoidosis and Hodgkin disease was diagnosed in one patient each. Small, soft, mobile, nontender, cervical, axillary or inguinal lymph nodes do not require further investigations. In case of enlarged, tender lymph nodes with overlying skin erythema and fever diagnostic evaluation should include complete blood count, erythrocyte sedimentation rate and/or c-reactive protein level, supplemented by appropriate antibody testing (EBV, CMV, Toxoplasma gondii, Bartonella henselae). Firm, enlarged, painless lymph nodes which are matted together and fixed to the skin or underlying tissues necessitate a more detailed diagnostic evaluation in order to exclude malignant or granulomatous diseases. CONCLUSIONS: Our study demonstrated that primary diagnostic evaluation of childhood peripheral lymphadenopathy is mainly based on clinical grounds. In most cases a small number of additionally performed laboratory tests allow to correctly identify the cause of the peripheral lymph node enlargement.

PMID: 11048289 [PubMed - indexed for MEDLINE]

664. Arch Dis Child. 2000 Nov;83(5):443-4.

Pseudoinfectious mononucleosis: a presentation of Bartonella henselae infection.

Massei F, Messina F, Massimetti M, Macchia P, Maggiore G.

Dipartimento di Medicina della Procreazione e dell'Età Evolutiva, Università di Pisa, Via Roma 67, 56100 Pisa, Italy.

Six children presented during one year with clinical features of infectious mononucleosis, but with laboratory findings of leucocytosis with neutrophilia, increased erythrocyte sedimentation rate, and hypergammaglobulinaemia. Serology for Epstein-Barr virus, cytomegalovirus, adenovirus, and Toxoplasma gondii was negative, while anti-Bartonella henselae IgM with high IgG titre (>/=1/1024) was present in all. All children had contact with kittens. No specific treatment was administered and all recovered.

PMCID: PMC1718542 PMID: 11040157 [PubMed - indexed for MEDLINE]

665. Am J Ophthalmol. 2000 Sep;130(3):340-9.

Ocular bartonellosis.

Cunningham ET, Koehler JE.

The Francis I. Proctor Foundation, Department of Ophthalmology, University of California, San Francisco, Medical Center, San Francisco, California 94143-0944, USA. emmett@itsa.ucsf.edu

PURPOSE: To review recent advances in the basic and clinical biology of Bartonella-related eye disease. METHOD: A review of the pertinent medical literature was performed. RESULTS: A number of novel Bartonella species have been identified over the past decade. Of these, Bartonella henselae, the etiologic agent in cat scratch disease, is most often associated with ocular complications, which may include Parinaud oculoglandular syndrome, neuroretinitis, and focal retinochoroiditis. Although cat and flea exposure appear to be the main risk factors for contracting cat scratch disease, the diagnosis of ocular bartonellosis relies primarily on the recognition of suggestive clinical signs in conjunction with positive serologic testing. B. henselae-associated ocular complications are usually self-limited but may be treated with doxycycline or erythromycin, with or without rifampin, when the infections are severe or sight-threatening. CONCLUSIONS: B. henselae infection is common and should be considered in patients with Parinaud oculoglandular syndrome, neuroretinitis, or focal retinochoroiditis, particularly when there is a history of cat or flea exposure.

PMID: 11020414 [PubMed - indexed for MEDLINE]

666. Am J Ophthalmol. 2000 Sep;130(3):327-34.

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.

Francis I. Proctor Foundation, University of California, San Francisco, CA 94143-0944, USA.

PURPOSE: To describe optic disk edema associated with peripapillary serous retinal detachment as an early sign of systemic Bartonella henselae infection. METHODS: Multicentered, retrospective case series. RESULTS: Five women and two men presented with optic disk edema producing peripapillary serous retinal detachment. Each patient had a markedly elevated serum anti-B. henselae antibody titer. Patient age ranged from 11 to 44 years, with a mean and median of 26.6 and 28 years, respectively. The time from the onset of systemic symptoms to the onset of visual symptoms varied from 3 days to 1 month. The peripapillary serous retinal detachment resolved within 1 to 3 weeks in each case, producing a macular star in four of seven patients. Initial vision was 20/200 or worse in five of seven patients and improved in four of these five patients to 20/30 or better. CONCLUSIONS: Systemic B. henselae infection should be considered in patients who develop optic disk edema associated with a peripapillary serous retinal detachment, even in the absence of classic neuroretinitis with a macular star.

PMID: 11020412 [PubMed - indexed for MEDLINE]

667. Pediatr Radiol. 2000 Sep;30(9):640-3.

Regional lymphadenopathy in cat-scratch disease: ultrasonographic findings.

García CJ, Varela C, Abarca K, Ferrés M, Prado P, Vial PA.

Departamento de Radiología, Hospital Clínico Universidad Católica, Santiago, Chile. famgarc@entelchile.net

BACKGROUND: Cat-scratch disease (CSD) is considered to be an emerging disease worldwide and is caused by Bartonella henselae, a gram-negative bacterium introduced by a scratch or bite of a cat. The most common clinical manifestation is regional lymphadenopathy, but clinical recognition may be difficult, as atypical manifestations may occur. The diagnosis is confirmed with serologic testing and histology is rarely needed. This paper is based on our experience with the use of ultrasonography in the diagnosis of CSD. OBJECTIVE: The aim of this study was to describe the sonographic and color Doppler appearances of regional lymphadenopathy in CSD, as this has not widely reported in the literature. MATERIALS AND METHODS: Forty-seven patients (average 9.4 years) were included who all had serologically and/or histologically proven CSD and had been studied using US early in the clinical course. All had a positive history of exposure to cats and exhibited regional lymphadenopathy. RESULTS: US showed large hypoechoic adenopathy with some transmission enhancement and high vascularization on color-flow Doppler imaging. In 30 patients, abdominal US was also performed and splenic and/or hepatic granulomata were found in 10. CONCLUSIONS: In our experience, sonography and especially color-Doppler and power-Doppler sonography was helpful in the diagnosis of CSD. We believe it should be used in the initial study of children with regional lymphadenopathy, and serologic testing should be performed when CSD is suspected.

PMID: 11009305 [PubMed - indexed for MEDLINE]

668. Microbes Infect. 2000 Aug;2(10):1193-205.

Bartonella henselae, B. quintana, and B. bacilliformis: historical pathogens of emerging significance.

Karem KL, Paddock CD, Regnery RL.

Viral and Rickettsial Zoonoses Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, US Department of Health and Human Services, Atlanta, Georgia 30333, USA.

Bartonella species were virtually unrecognized as modern pathogens of humans until the last decade. However, identification of Bartonella species as the agents of cat-scratch disease, bacillary angiomatosis, urban trench fever, and possible novel presentations of Carrion's disease has left little doubt of the emerging medical importance of this genus of organisms. The three primary human pathogenic bartonellae, Bartonella bacilliformis (Carrion's disease), B. henselae (cat-scratch disease), and B. quintana (trench fever), present noteworthy comparisons in the epidemiology, natural history, pathology, and host-microbe interaction that this review will briefly explore.

PMID: 11008109 [PubMed - indexed for MEDLINE]

669. Laryngorhinootologie. 2000 Aug;79(8):471-7.

[Parotid involvement in cat scratch disease: a differential diagnosis with increased significance].

[Article in German]

Ridder GJ, Richter B, Laszig R, Sander A.

Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde und Poliklinik, Universitätsklinikum Freiburg. ridder@hno.ukl.uni-freiburg.de

BACKGROUND: Bartonella henselae is the causative agent of cat-scratch disease (CSD), an inflammatory infection of the lymph nodes. So far, only few cases of atypical manifestations in the head and neck, especially manifestations in the parotid gland have been reported. PATIENTS AND METHODS: Between January 1997 and June 1999 seven patients with manifestations of CSD in the parotid gland were observed at the ENT-department Freiburg. The positive diagnosis was confirmed serologically by an indirect immunofluorescence assay and by detection of Bartonella henselae-DNA with PCR-amplification and subsequent hybridization or sequencing. RESULTS: An intraglandular abscessed lymphadenitis was found in five patients, two of these cases were based on a Parinaud's oculoglandular syndrome. A diffuse affection of the parotid gland, initially misinterpreted as a parotid tumor, was seen in two patients. CONCLUSIONS: Antibiotic treatment is recommended in order to reduce the duration of the disease, in cases of pain and lymph node abscesses. In uncommon manifestations of CSD, the nosological assignment can be difficult on the basis of the heterogeneous symptomatic in the individual patient and the CSD diagnosis can only be confirmed by serology or PCR-based techniques. CSD should be considered in the differential diagnosis of all equivocal masses in the head and neck, even in unusual localisations like the parotid gland.

PMID: 11006911 [PubMed - indexed for MEDLINE]

670. An Esp Pediatr. 2000 Mar;52(3):299-300.

[Neonatal papular acrodermatitis (Gianotti-Crosti) and Bartonella henselae infection].

[Article in Spanish]

Silveira Cancela M, Valdés Tascón F, Pita Carretero J, Montes Fontao M, Rico Bouza M.

PMID: 11003916 [PubMed - indexed for MEDLINE]

671. Clin Infect Dis. 2000 Aug;31(2):609-11.

Transverse myelitis associated with probable cat-scratch disease in a previously healthy pediatric patient.

Salgado CD, Weisse ME.

Department of Pediatrics, West Virginia University, Morgantown 26506, USA.

We evaluated a pediatric patient for transverse myelitis associated with Bartonella henselae infection. There was no adenopathy in our patient, but the diagnosis was made serologically. It is necessary to keep cat-scratch disease in mind even in the absence of typical findings.

PMID: 10987731 [PubMed - indexed for MEDLINE]

672. Harefuah. 2000 Jun 15;138(12):1034-6, 1086.

[Familial parinaud oculo-glandular syndrome in cat-scratch disease].

[Article in Hebrew]

Shoham N, Miron D, Raz R, Garzozi HJ.

Dept. of Ophthalmology, HaEmek Medical Center, Afula.

Cat-scratch disease is manifested by subacute, regional lymphadenitis and occurs mainly in children. The causative agent is a pleomorphic, gram-negative bacillus, Bartonella henselae carried by asymptomatic cats. Parinaud oculoglandular syndrome is the most common ocular manifestation of this disease. It is characterized by unilateral conjunctivitis with polypoid granuloma, usually of the palpebral conjunctiva, and preauricular lymphadenopathy. The diagnosis is supported by a history of exposure to cats and is confirmed by positive serologic tests or positive PCR assay. The occurrence of more than 1 case of Parinaud syndrome in a family is rare. We describe 2 sisters with Parinaud oculoglandular syndrome, proven by serologic tests. They reported that they used to cuddle with their cats, among them a kitten. Because of the refractory conjunctivitis and signs of imminent periorbital cellulitis, they were treated with oral tetracycline with apparently good responses. We recommend asking about contacts with cats in any atypical conjunctivitis accompanied by regional lymphadenopathy, especially in young patients. Systemic antibiotics should be given when there is any suspicion of significant ocular involvement, if the patient is immunosuppressed, or if there are systemic manifestations of cat-scratch disease.

PMID: 10979428 [PubMed - indexed for MEDLINE]

673. Rev Soc Bras Med Trop. 2000 May-Jun;33(3):313-7.

[Cat-scratch disease caused by Bartonella quintana in an infant: an unusual presentation].

[Article in Portuguese]

Azevedo ZM, Higa LY, Boechat PR, Boechat MB, Klaplauch F.

Departamento de Pediatria, Serviço de Pneumologia do Departamento de Pediatria/Instituto Fernandes Figueira/FIOCRUZ, Rio de Janeiro, Brasil.

This case study reports a typical clinical course of cat-scratch disease (CSD) in an infant without epidemiological data and presenting bilateral submandibular lymphadenopathy. The authors describe clinical course, ultrasound images, diagnosis and prognosis. Polymerase chain reaction (PCR) detected and identified B. quintana in lymph node samples. B. henselae currently thought to be the causative agent of CSD was not detected. The PCR assays for B. quintana and B. henselae should be available for the investigation of lymphadenopathy, even if the infant has not had either cat or dog contact.

PMID: 10967601 [PubMed - indexed for MEDLINE]

674. Kansenshogaku Zasshi. 2000 Jul;74(7):563-6.

[Evaluation of serological response to Bartonella henselae by enzyme immunoassay in cat scratch disease].

[Article in Japanese]

Yoshida H, Kusaba N, Sumino M, Sata M.

Department of Medicine, Yame General Hospital.

The IgG and IgM titers to Bartonella henselae were determined by an enzyme immunoassay (EIA). The EIA test for detection of IgG and IgM antibodies to B. henselae concerning CSD showed that 8 (40%) of 20 patients with CSD had a serum IgG antibody titer of 12 EIA unit or more and that 5 (25%) patients had a serum IgM titer of 12 EIA unit or more. Totally 12 (60%) of the 20 patients with CSD were seropositive for B. henselae. The mean age of IgG positive patients were higher than IgM positive patients. The IgM antibodies to B. henselae disappeared within 4 to 12 weeks after onset of disease. The IgG antibodies to B. henselae disappeared within 3 to 8 weeks after onset of the symptoms in 2 cases of CSD. Another 2 cases CSD produced high levels of IgG antibodies in the acute phase of the disease. Different course of IgG and IgM antibody titers were found in sera from patients.

PMID: 10965658 [PubMed - indexed for MEDLINE]

675. Infect Immun. 2000 Sep;68(9):4972-9.

Molecular cloning, sequencing, expression, and characterization of an immunogenic 43-kilodalton lipoprotein of Bartonella bacilliformis that has homology to NlpD/LppB.

Padmalayam I, Kelly T, Baumstark B, Massung R.

Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. ixp0@cdc.gov

A recombinant clone expressing an immunoreactive antigen of Bartonella bacilliformis was isolated by screening a genomic DNA library with serum from a patient with the chronic verruga phase of bartonellosis. The clone, pBIPIM-17, contained a partial open reading frame that expressed an immunoreactive fusion protein. Subsequent rescreening of the library by plaque hybridization resulted in the isolation of recombinant clones that contain the entire open reading frame. The open reading frame (ORF-401) is capable of encoding a protein of 401 amino acids with a predicted molecular mass of 43 kDa. The deduced amino acid sequence of the encoded protein was found to be highly homologous to a recently identified bacterial lipoprotein (LppB/NlpD) which has been associated with virulence. Evidence has been provided to show that the 43-kDa antigen of B. bacilliformis is a lipoprotein and that it is likely to use the same biosynthetic pathway as other bacterial lipoproteins. This is the first report to date that characterizes a lipoprotein of B. bacilliformis. The immunogenicity of the B. bacilliformis LppB homologue was demonstrated by Western blot analysis using sera from patients with clinical bartonellosis. Sera from patients who had a high titer for Bartonella henselae, the causative agent of bacillary angiomatosis and cat scratch disease, also recognized the recombinant 43-kDa antigen, suggesting that a homologue of this antigen is present in B. henselae. Using a cocktail of synthetic peptides corresponding to predicted major antigenic sites, polyclonal antiserum specific for the LppB homologue of B. bacilliformis was generated. This antiserum did not recognize the NlpD homologue of Escherichia coli or the 43-kDa antigen of B. henselae.

PMCID: PMC101713 PMID: 10948113 [PubMed - indexed for MEDLINE]

676. Med Klin (Munich). 2000 Jun 15;95(6):314-20.

[Update in infectious diseases. Part I: epidemiology].

[Article in German]

Salzberger B, Franzen C, Fätkenheuer G.

Klinik I für Innere Medizin, Universitätsklinik Köln. bernd.salzberger@uni-koeln.de

A number of infectious agents has been newly detected in the last 10 years. Climatic changes and migration have been the most important factors in the emergence of new and old infections. Additionally, new methods for the detection of DNA and RNA have played an important role in the detection of agents difficult to culture. Relevant new bacterial pathogens are Bartonella henselae (cat scratch disease, bacillary angiomatosis), Tropheryma whippeli (Whipple's disease) and new Rickettsiae. Newly detected viral pathogens include Sin-nombre virus (pulmonary Hanta virus syndrome), Nipah- and Hendra virus and avian influenza. Bovine spongiform encephalopathy has been transmitted to humans causing the newly described syndrome of variant Creuzfeldt-Jakob disease. The extent of this new epidemic is not yet clear. These trends from the last years clearly indicate, that further new infections and infectious agents will be detected in the future.

PMID: 10935415 [PubMed - indexed for MEDLINE]

677. Clin Experiment Ophthalmol. 2000 Apr;28(2):127-8.

Neuroretinitis associated with cat scratch disease in a child.

Sobha S, Reck AC, Evans A.

PMID: 10933777 [PubMed - indexed for MEDLINE]

678. Rev Med Interne. 2000 Jun;21 Suppl 3:326s-329s.

[A "diagnosis of goldsmith"].

[Article in French]

Geffray L, Poynard JP, Collet T, Armand P, Verdon R.

Service de médecine interne, centre hospitalier Robert-Bisson, Lisieux.

PMID: 10916845 [PubMed - indexed for MEDLINE]

679. J Clin Microbiol. 2000 Aug;38(8):2943-8.

Characterization of Bartonella clarridgeiae flagellin (FlaA) and detection of antiflagellin antibodies in patients with lymphadenopathy.

Sander A, Zagrosek A, Bredt W, Schiltz E, Piémont Y, Lanz C, Dehio C.

Institute for Medical Microbiology and Hygiene, University of Freiburg, Freiburg, Germany. sander@ukl.uni-freiburg.de

Cat scratch disease (CSD) is a frequent clinical outcome of Bartonella henselae infection in humans. Recently, two case reports indicated Bartonella clarridgeiae as an additional causative agent of CSD. Both pathogens have been isolated from domestic cats, which are considered to be their natural reservoir. B. clarridgeiae and B. henselae can be distinguished phenotypically by the presence or absence of flagella, respectively. Separation of the protein content of purified flagella of B. clarridgeiae by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblot analysis indicated that the flagellar filament is mainly composed of a polypeptide with a mass of 41 kDa. N-terminal sequencing of 20 amino acids of this protein revealed a perfect match to the N-terminal sequence of flagellin (FlaA) as deduced from the sequence of the flaA gene cloned from B. clarridgeiae. The flagellin of B. clarridgeiae is closely related to flagellins of Bartonella bacilliformis and several Bartonella-related bacteria. Since flagellar proteins are often immunodominant antigens, we investigated whether antibodies specific for the FlaA protein of B. clarridgeiae are found in patients with CSD or lymphadenopathy. Immunoblotting with 724 sera of patients suffering from lymphadenopathy and 100 healthy controls indicated specific FlaA antibodies in 3.9% of the patients' sera but in none of the controls. B. clarridgeiae FlaA is thus antigenic and expressed in vivo, providing a valuable tool for serological testing. Our results further indicate that B. clarridgeiae might be a possible etiologic agent of CSD or lymphadenopathy. However, it remains to be clarified whether antibodies to the FlaA protein of B. clarridgeiae are a useful indicator of acute infection.

PMCID: PMC87154 PMID: 10921956 [PubMed - indexed for MEDLINE]

680. Adolesc Med. 2000 Jun;11(2):327-58.

Infectious exanthems and unusual infections.

Vincent JM, Demers DM, Bass JW.

Pediatric Infectious Diseases Section, Tripler Army Medical Center, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii 96859, USA.

Invasive disease due to group A beta-hemolytic streptococci (GABHS) can be divided into 3 categories of disease: streptococcal toxic shock syndrome (strepTSS), necrotizing fasciitis, and other invasive GABHS disease. Patients with strepTSS may have multiorgan failure within hours of presentation. Clindamycin and penicillin G should be used in combination for treatment of invasive GABHS disease. The mortality rate for menstrual staphylococcal toxic shock syndrome has decreased with early recognition and treatment, and removal of hyperabsorbent tampons from the market. Kawasaki syndrome (KS) is the most common cause of acquired heart disease in children in the U. S., and atypical forms have a higher mortality rate than typical KS. Hantavirus pulmonary syndrome is a zoonosis with an 80% mortality rate if the diagnosis is not made on first presentation and patients return to the hospital in shock. Children and adolescents with Lyme disease have an excellent prognosis and respond well to antimicrobial therapy. Cat scratch disease (CSD) is caused by Bartonella henselae and is transmitted by flea-infested kittens. CSD lymphadenopathy typically resolves spontaneously in 2ñ3 months; however, there is a 50% likelihood of resolution in 1 month if patients receive a 5-day treatment course with azithromycin.

PMID: 10916128 [PubMed - indexed for MEDLINE]

681. FEMS Microbiol Lett. 2000 Aug 1;189(1):55-9.

Hemin-dependent growth and hemin binding of Bartonella henselae.

Sander A, Kretzer S, Bredt W, Oberle K, Bereswill S.

Abteilung Mikrobiologie und Hygiene, Institut für Medizinische Mikrobiologie und Hygiene, Klinikum der Universität Freiburg, Hermann-Herder-Str. 11, D-79104, Freiburg, Germany. sander@ukl.uni-freiburg.de

Bartonella henselae causes cat-scratch disease and bacillary angiomatosis peliosis. The bacteria reside in erythrocytes of asymptomatic cats, which represent the natural reservoir for this pathogen. B. henselae is usually grown on blood-enriched media. Growth experiments on Brucella medium without blood demonstrated that heme compounds are essential for the growth of B. henselae and can completely substitute the addition of blood components. The heme precursor protoporphyrin IX alone, or in combination with FeCl(2) or FeCl(3), as well as transferrin or lactoferrin did not support growth, indicating that B. henselae cannot synthesize heme itself. Hemin supported growth even when free iron was chelated, indicating that hemin is also used as an iron source. Binding assays showed that hemin starvation increased the binding capacity of B. henselae for hemin, providing evidence that the bacteria carry a specific hemin uptake system, which might be regulated by hemin.

PMID: 10913865 [PubMed - indexed for MEDLINE]

682. J Vet Med Sci. 2000 Jun;62(6):635-7.

Seroprevalence of Bartonella henselae and Toxoplasma gondii among healthy individuals in Thailand.

Maruyama S, Boonmar S, Morita Y, Sakai T, Tanaka S, Yamaguchi F, Kabeya H, Katsube Y.

Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa, Japan.

The seroprevalence of Bartonella henselae and Toxoplasma gondii among apparently healthy individuals, mainly blood donors, in Thailand was investigated by an indirect fluorescent antibody technique and by a latex agglutination test, respectively. Of 163 serum samples examined, 9 (5.5%) were found to be positive for B. henselae-IgG, 2 (1.2%) for B. henselae-IgM, and 5 (3.1%) for the T. gondii antibody. No significant difference was observed between male and female samples in the serological test with either B. henselae or T. gondii. The age of individuals with B. henselae-IgG was distributed from the 20s to the 70s, and B. henselae-IgM was found in the individuals of the 30s and 60s. The age of T. gondii positive samples ranged from the 20s to the 60s. In this study, the prevalence of B. henselae infection among healthy individuals in Thailand was serologically demonstrated for the first time.

PMID: 10907691 [PubMed - indexed for MEDLINE]

683. Clin Microbiol Rev. 2000 Jul;13(3):428-38.

Bartonella infection in animals: carriership, reservoir potential, pathogenicity, and zoonotic potential for human infection.

Breitschwerdt EB, Kordick DL.

Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina 27606, USA.

Recent observations have begun to support a role for Bartonella spp. as animal as well as human pathogens. Bartonella spp. are vector-transmitted, blood-borne, intracellular, gram-negative bacteria that can induce prolonged infection in the host. Persistent infections in domestic and wild animals result in a substantial reservoir of Bartonella organisms in nature that can serve as a source for inadvertent human infection. The prevalence of bacteremia can range from 50 to 95% in selected rodent, cat, deer, and cattle populations. Dogs infected with Bartonella spp. can develop lameness, endocarditis, granulomatous lymphadenitis, and peliosis hepatis, lesions that have also been reported in association with human infection. Understanding the role of Bartonella spp. as pathogens in cats and other wild or domestic animals awaits the results of additional studies. Considering the extensive animal reservoirs and the large number of insects that have been implicated in the transmission of Bartonella spp., both animal and human exposure to these organisms may be more substantial than is currently believed.

PMCID: PMC88941 PMID: 10885985 [PubMed - indexed for MEDLINE]

684. Eur J Pediatr. 2000 Jun;159(6):416-9.

Widening of the clinical spectrum of Bartonella henselae infection as recognized through serodiagnostics.

Massei F, Messina F, Talini I, Massimetti M, Palla G, Macchia P, Maggiore G.

Dipartimento di Medicina della Procreazione e della Età Evolutiva, Università di Pisa, Italy.

The recently improved diagnostics have widened, in children, the spectrum of clinical manifestations recognisable as Bartonella henselae infection. We report here the clinical features of 20 (14 males) consecutive children with serologically proved B. henselae infection observed within 12 months in the Paediatric Department of the University of Pisa. The patients had a mean age of 7 years 4 months (range 1.1-14.1 years). All children but one had a history of contact with kittens. Clinical manifestations included regional lymphadenopathy in 14 patients, representing in five the only clinical manifestation at onset, infectious mononucleosis-like syndrome in six, erythema nodosum in three, and Parinaud oculoglandular syndrome in one. In five patients a severe disorder was first suspected: fever of unknown origin in two with multiple hepatosplenic granulomatosis in one; osteolytic lesion suggesting bone neoplasm, marked inguinal lymph-node enlargement, suggesting Burkitt lymphoma, and an acute encephalopathy in one each. Bartonella henselae IgG antibody was positive in all patients with a titre ranging from 1:128 to 1:8590. IgM antibody was present in all except one child with an IgG titre of 1:2048. All patients recovered, some spontaneously. CONCLUSION: Bartonella henselae infection is frequent in Tuscany and probably underdiagnosed due to the high frequency of atypical onset of the clinical manifestations. An accurate clinical history and a reasonably wide use of the serological test may allow a rapid and accurate diagnosis, reassuring the family of the patient and avoiding invasive and expensive diagnostic procedures.

PMID: 10867845 [PubMed - indexed for MEDLINE]

685. J S Afr Vet Assoc. 1999 Dec;70(4):154-5.

Isolation of Bartonella henselae from a serologically negative cat in Bloemfontein, South Africa.

Pretorius AM, Kelly PJ, Birtles RJ, Raoult D.

Department of Medical Microbiology, Faculty of Health Sciences, University of the Orange Free State, Bloemfontein, South Africa.

Sera collected from apparently healthy 6-12-month-old cats (n = 31) presented to the Society for the Prevention of Cruelty to Animals Veterinary Clinic in Bloemfontein for neutering were tested for antibodies reactive to Bartonella henselae (Houston-1 strain) by indirect fluorescent antibody testing. Whole blood collected from the cats was used in isolation experiments and subsequent identification of Bartonella species was based on comparison of the nucleotide base sequence of polymerase chain reaction-amplified citrate synthase gene fragments. While none of the cats had antibodies reactive with B. henselae at titres > or =1/64, an organism with a partial citrate synthase gene sequence identical to that of B. henselae (Houston-1) was isolated from 1 cat.

PMID: 10855838 [PubMed - indexed for MEDLINE]

686. Kansenshogaku Zasshi. 2000 Apr;74(4):387-91.

[Clinical evaluation of commercial serological test for Bartonella infection].

[Article in Japanese]

Tsuneoka H, Fujii R, Fujisawa K, Iino H, Isida C, Murakami K, Tsukahara M.

Department of Clinical Laboratory, Yamaguchi-ken Kouseiren Nagato General Hospital.

We evaluated the usefulness of a serological diagnostic kit (Bartonella IFA IgG, IgM; MRL Diagnostics) for Bartonella henselae infection. Of the 110 healthy individuals, 107 (97.3%) were with titers being less than 1:64 for IgG antibody to B. henselae, 2 were with titers being 1:64 and 1 with 1:128, IgM antibody to B. henselae was negative in all individuals. Serological diagnosis of cat scratch disease (CSD) using indirect fluorescence antibody (IFA) methods (in-house and diagnostic kit) was made in either elevated titers of IgM (> or = 1:20) or IgG (> or = 1:256) antibodies, or a four-fold rise in IgG titer between acute and convalescent sera. Of the 18 individuals with serological diagnosis of CSD by in-house IFA method in 26 CSD clinical diagnosed patients, 15 (83%) were compatible with the results of the diagnostic kit, whereas 3 (17%) were not compatible. Of the 8 without serological diagnosis, 1 (13%) was serologically diagnosed as CSD, and the others were negative. Overall, the serological diagnosis was made in 16 of 26 (62%). The specificity and sensitivity of this kit were 100% and 62%, respectively. The cross-reaction between B. henselae and Bartonella quintana was observed in sera from controls and patients. Our results show that the diagnostic kit as well as in-house method is an useful tool for the serological diagnosis of cat scratch disease.

PMID: 10835846 [PubMed - indexed for MEDLINE]

687. J Clin Microbiol. 2000 Jun;38(6):2062-4.

Isolation in endothelial cell cultures of chlamydia trachomatis LGV (Serovar L2) from a lymph node of a patient with suspected cat scratch disease.

Maurin M, Raoult D.

Unité des Rickettsies, CNRS UPRES A 6020, Faculté de Médecine, Université de la Méditerranée, 13385 Marseille Cedex 05, France.

An inguinal lymph node, removed from a 21-year-old Romanian man suspected of having cat scratch disease, was sent to our laboratory for Bartonella culture. Lymph node specimens were inoculated on blood-enriched agar and in an endothelial cell culture system using the centrifugation shell vial technique. Bacteria were grown in cell monolayers and detected as positive with an anti-Bartonella henselae rabbit serum. However, such bacteria were identified as Chlamydia trachomatis biovar LGV serovar L2 by PCR sequencing techniques. Pathological examination of tissue biopsies was compatible with either lymphogranuloma venereum or cat scratch disease. The shell vial system is suitable for isolation of intracellular pathogens responsible for chronic lymphadenopathies, including C. trachomatis, Bartonella species, Francisella tularensis, and mycobacteria. However, care should be taken when identifying Chlamydia spp. and Bartonella spp. using polyclonal antibodies, since species of both genera have common antigens which are responsible for cross-reactions.

PMCID: PMC86728 PMID: 10834954 [PubMed - indexed for MEDLINE]

688. Eur J Pediatr. 2000 May;159(5):356-9.

Polymerase chain reaction detection of Bartonella henselae bacteraemia in an immunocompetent child with cat-scratch disease.

Del Prete R, Fumarola D, Ungari S, Fumarola L, Miragliotta G.

Department of Clinical Medicine, Immunology and Infectious Diseases, University of Bari, Italy. rdelprete@midim.uniba.it

Comment in Eur J Pediatr. 2001 May;160(5):316.

A case of Bartonella henselae bacteraemia is reported in an immunocompetent 8-year-old boy with cat-scratch disease. Serology to B. henselae, diagnosed by polymerase chain reaction, was positive. DNA was extracted from peripheral whole blood and amplified with specific primers targeting the htrA gene of B. henselae. A non-isotopic hybridization assay with a species-specific oligonucleotide probe was used to detect the amplified product. CONCLUSION: The polymerase chain reaction can be used for the rapid laboratory diagnosis of bacteraemia in cat-scratch disease.

PMID: 10834521 [PubMed - indexed for MEDLINE]

689. Ophthalmology. 2000 May;107(5):871-6.

Prevalence of serologic evidence of cat scratch disease in patients with neuroretinitis.

Suhler EB, Lauer AK, Rosenbaum JT.

Casey Eye Institute, Department of Ophthalmology, Oregon Health Sciences University, Portland 97035, USA. suhlere@ohsu.edu

OBJECTIVE: To determine the prevalence of Bartonella henselae seropositivity in patients with a clinical diagnosis of neuroretinitis. DESIGN: Retrospective, clinic-based, cross-sectional study. PARTICIPANTS: Eighteen consecutive patients seeking treatment at the Casey Eye Institute from November 1993 through November 1998 who had neuroretinitis. METHODS: The billing and photographic records of the Casey Eye Institute were searched for patients with a primary or secondary diagnosis of neuroretinitis or Leber's idiopathic stellate neuroretinitis. Charts were then reviewed to determine the results of B. henselae antibody titers and other pertinent clinical information. MAIN OUTCOME MEASURES: Results of B. henselae serologic testing. RESULTS: Fourteen of 18 patients with neuroretinitis had serologic studies. Nine of the 14 tested patients (64.3%) were found to have elevated IgM or IgG for B. henselae, suggesting current or past infection. Patients with positive serologic analysis results tended to have worse vision at presentation. There were no other obvious differences between seropositive and seronegative groups in this study, including duration or quality of recovery. CONCLUSIONS: At our tertiary care ophthalmology institution, most tested patients with neuroretinitis had evidence of past or present cat-scratch disease based on positive serologic analysis for B. henselae, a much greater prevalence than is expected to be found in the general population or in patients with idiopathic uveitis. Further study is indicated to clarify the prevalence of cat-scratch disease in neuroretinitis and the role and efficacy of antibiotics in treatment.

PMID: 10811077 [PubMed - indexed for MEDLINE]

690. Ophthalmology. 2000 May;107(5):817-8.

Cat scratch disease: posterior segment manifestations.

Eggenberger E.

Comment on Ophthalmology. 1999 Aug;106(8):1546-53.

PMID: 10811065 [PubMed - indexed for MEDLINE]

691. J Clin Microbiol. 2000 May;38(5):1717-22.

Rapid identification and differentiation of Bartonella species using a single-step PCR assay.

Jensen WA, Fall MZ, Rooney J, Kordick DL, Breitschwerdt EB.

Heska Corporation, Fort Collins, Colorado 80525, USA. jensenw@heska.com

Five species of Bartonella have been reported to infect humans and cause a variety of diseases that can be difficult to diagnose. Four species of Bartonella have been reported to infect cats and dogs, and two of these species are considered to be zoonotic pathogens. Diagnosis of Bartonella infections is hampered by the slow, fastidious growth characteristics of Bartonella species. We report on the development of a single-step PCR-based assay for the detection and differentiation of medically relevant Bartonella species. PCR-mediated amplification of the 16S-23S rRNA intergenic region resulted in a product of a unique size for each Bartonella species, thereby allowing differentiation without the necessity of restriction fragment length polymorphism analysis or sequencing of the amplified product. The ability of the single-step PCR assay to differentiate between Bartonella species was determined with characterized isolates and blood samples from animals known to be infected with either Bartonella henselae, B. clarridgeiae, or B. vinsonii subsp. berkhoffii. The sensitivity of the single-step PCR assay relative to that of in vitro culture was determined with blood samples from B. henselae-infected cats. B. henselae target DNA was amplified from 100% of samples with greater than 50 CFU/ml and 80% of samples with 10 to 30 CFU/ml. The single-step assay described in the report expedites PCR-based detection and differentiation of medically relevant Bartonella species.

PMCID: PMC86570 PMID: 10790087 [PubMed - indexed for MEDLINE]

692. Infection. 2000 Mar-Apr;28(2):116-8.

Visceral manifestation of cat scratch disease in children. A consequence of altered immunological state?

Kahr A, Kerbl R, Gschwandtner K, Heinzl B, Lackner H, Schwinger W, Stünzner D, Lindbichler F, Urban EC.

University Children's Hospital, Dept. of Pediatrics, Karl Franzens University, Graz, Austria.

A 12-year-old girl with a 2-month history of fever and abdominal pain was admitted to our hospital. Ultrasound and CT scans of the abdomen showed multiple hypoechoic lesions of liver and spleen. Screening for zoonosis revealed high positive titers to Bartonella henselae. T-cell deficiency was demonstrated and remained almost unchanged during a follow-up of 11 months. A review of the literature shows that disseminated visceral affection is a rare presentation of cat scratch disease (CSD) in childhood and adolescence. Further immunological investigations are needed in more patients with CSD to confirm whether an altered immunological state may be responsible for the atypical visceral manifestation of CSD.

PMID: 10782400 [PubMed - indexed for MEDLINE]

693. Am J Vet Res. 2000 Apr;61(4):375-9.

Clinical disease in kittens inoculated with a pathogenic strain of Bartonella henselae.

Mikolajczyk MG, O'Reilly KL.

Department of Veterinary Microbiology and Parasitology, School of Veterinary Medicine, Louisiana State University, Baton Rouge 70803, USA.

OBJECTIVE: To evaluate disease in kittens inoculated with Bartonella henselae strain LSU16. ANIMALS: Eighteen 12-week-old specific-pathogen-free kittens. PROCEDURE: Kittens were inoculated with B henselae strain LSU16 or saline (0.9% NaCl) solution. Blood samples were collected from kittens on alternate weeks, and bacteremia, clinical signs, and antibody concentrations were monitored for 6 months after inoculation. RESULTS: Kittens developed raised, erythematous areas at the site of inoculation within 72 hours. Swelling peaked at 14 days and resolved by 28 days after inoculation. Fever had a biphasic pattern, with an episode of 1- to 3-days' duration beginning 6 to 7 days after inoculation followed by an episode of 3- to 8-days' duration beginning 11 to 13 days after inoculation. Kittens were bacteremic by day 14 with peak bacteremia at days 14 to 28. Strong antibody responses to B henselae were detected. Clinical disease resolved before bacteremia became undetectable, but signs of disease correlated with the highest degree of bacteremia. Regional lymphadenopathy also was evident. CONCLUSION AND CLINICAL RELEVANCE: Clinical disease in kittens was similar to that in adult cats infected with B henselae strain LSU16, except that lethargy and anorexia were less severe in kittens, and a biphasic pattern of fever was detected in kittens. Clinical disease after inoculation with B henselae may be strain-dependent. To limit transmission of Bartonella organisms, appropriate flea prevention should be instituted. IMPACT FOR HUMAN MEDICINE: Kittens that are febrile, anorectic, lethargic, and that have lymphadenopathy should be tested for Bartonella organisms, and contact with immunocompromised owners should be discouraged.

PMID: 10772100 [PubMed - indexed for MEDLINE]

694. J Vet Med Sci. 2000 Mar;62(3):273-9.

Prevalence of Bartonella henselae, Bartonella clarridgeiae and the 16S rRNA gene types of Bartonella henselae among pet cats in Japan.

Maruyama S, Nakamura Y, Kabeya H, Tanaka S, Sakai T, Katsube Y.

Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa, Japan.

The authors investigated bacteriologically the prevalence of Bartonella infection among 690 pet cats derived from 10 private animal hospitals in six cities (Sapporo, Hokkaido Prefecture; Sendai, Miyagi Prefecture; Joetsu, Niigata Prefecture; Fujisawa, Kanagawa Prefecutre; Kyoto, Kyoto Prefecture; Sanda, Hyogo Prefecutre) and 4 counties (Mishima, Osaka Prefecture; Hikawa, Shimane Prefecture; Aira, Kagoshima Prefecture; Shimajiri, Okinawa Prefecture) located from the north to the south of Japan. Bartonella species were isolated from 7.2% (50/690) of all the cats examined. No Bartonella species were isolated from the cats in Sapporo or Sendai. The isolation rate varied from 2% in Joetsu and Sanda to 20% in Shimajiri. Bartonella clarridgeiae was isolated from two of 50 cats in Kyoto, three of 50 in Mishima and one of 50 in Shimajiri, but not in cats from the other cities or counties. Though the cats of Joetsu, Fujisawa, Kyoto, Sanda, Aira and Shimajiri were infected with either B. henselae or B. clarridgeiae, one of eight infected cats in Mishima was harboring both Bartonella species. Type I of 16S rRNA gene was the predominant type among the isolates of B. henselae, but only one isolate derived from Shimajiri was found to be of type II. Prevalence of B. clarridgeiae and the 16S rRNA gene type of B. henselae among cats in Japan was demonstrated for the first time in this investigation.

PMID: 10770599 [PubMed - indexed for MEDLINE]

695. Microbiology. 2000 Mar;146 ( Pt 3):599-609.

A bacteriophage-like particle from Bartonella bacilliformis.

Barbian KD, Minnick MF.

Division of Biological Sciences, The University of Montana, Missoula 59812-4824, USA.

Bartonella bacilliformis and Bartonella henselae, the respective agents of Oroya fever and cat-scratch disease in humans, are known to produce bacteriophage-like particles (BLPs) that package 14 kbp segments of the host chromosome. Data from this study suggest that other Bartonella species including Bartonella quintana, Bartonella doshiae and Bartonella grahamii also contain similar BLPs, as evidenced by the presence of a 14 kbp extrachromosomal DNA element in their genomes, whereas Bartonella elizabethae and Bartonella clarridgeiae do not. A purification scheme utilizing chloroform, DNase I and centrifugation was devised to isolate BLPs from B. bacilliformis. Intact BLPs were observed by transmission electron microscopy and were round to icosahedral in shape and approximately 80 nm in diameter. RFLP and Southern blot analysis of BLP DNA from B. bacilliformis suggest that packaging, while non-selective, is less than the near-random packaging previously reported for the B. henselae phage. Data also suggest that the linear, double-stranded BLP DNA molecules have blunt ends with noncovalently closed termini. Packaging of the BLP DNA molecules into a protein coat appears to be closely related to nucleic acid synthesis, as unpackaged phage DNA is not detectable within the host cell. SDS-PAGE analysis of purified BLPs from B. bacilliformis showed three major proteins with apparent molecular masses of 32, 34 and 36 kDa; values that closely correspond to proteins found in B. henselae BLPs. Western blot analysis performed with patient convalescent serum showed that BLP proteins are slightly immunogenic in humans. To determine if BLPs contribute to horizontal gene transfer, mutants of B. bacilliformis were generated by allelic exchange with an internal fragment of the 16S-23S rDNA intergenic spacer region and a suicide vector construct, termed pKB1. BLPs from one of the resultant strains were able to package the mutagenized region containing the kanamycin-resistance cassette; however, numerous approaches and attempts at intraspecies transduction using these BLPs were unsuccessful.

PMID: 10746763 [PubMed - indexed for MEDLINE]

696. Infect Dis Clin North Am. 2000 Mar;14(1):1-22, vii.

Bartonellosis. New and old.

Maguiña C, Gotuzzo E.

Alexander von Humboldt Institute of Tropical Diseases, Universidad Peruana Cayetano Heredia, Lima, Perú. cirom@upch.edu.pe

The number of species that comprise the family of Bartonellaceae, genus Bartonella, has recently increased from one to 11 species, five of which have been associated with different diseases and syndromes in humans. The rapidly growing number of human pathogens has led several investigators to regard bartonellosis and other associated syndromes as important emerging infectious diseases. This article presents the history and epidemiology, clinical features, diagnosis, and treatment of bartonellosis and associated diseases, including Carrión's disease, trench fever, endocarditis and bacteremia, bacillary angiomatosis, and cat-scratch disease.

PMID: 10738670 [PubMed - indexed for MEDLINE]

697. Clin Infect Dis. 2000 Mar;30(3):599-601.

Parapharyngeal abscess due to cat-scratch disease.

Yeh SH, Zangwill KM, Hall B, McPhaul L, Keller M.

Department of Pediatrics, Harbor-University of California Los Angeles Medical Center, Torrance, CA 90502, USA. yeh@humc.edu

Erratum in Clin Infect Dis 2000 May;30(5):841.

The spectrum of illness attributed to cat-scratch disease (CSD) continues to expand. Although a common cause of cervical adenitis in children, CSD has not been associated as a cause of deep fascial space infections of the head and neck. We describe a child with extensive parapharyngeal adenitis and abscesses due to CSD confirmed by histological and serological evaluations.

PMID: 10722453 [PubMed - indexed for MEDLINE]

698. Clin Diagn Lab Immunol. 2000 Mar;7(2):251-7.

Conservation of the 17-kilodalton antigen gene within the genus Bartonella.

Sweger D, Resto-Ruiz S, Johnson DP, Schmiederer M, Hawke N, Anderson B.

Department of Medical Microbiology and Immunology, College of Medicine, University of South Florida, Tampa, Florida 33612, USA. dsweger@com1.med.usf.edu

The 17-kDa antigen of Bartonella henselae has previously been shown to elicit a strong humoral immune response in patients with cat scratch disease (CSD) and to be useful in screening human serum samples for CSD. In this study, PCR amplification of genes homologous to the 17-kDa antigen gene of B. henselae was performed using genomic DNAs from several species of Bartonella, including the currently recognized human pathogens. Amplicons of similar size were demonstrated using the following chromosomal DNA templates: B. henselae (two strains), B. quintana (two strains), B. elizabethae, B. clarridgeiae, B. vinsonii subsp. vinsonii, and B. vinsonii subsp. berkhoffii. No evidence of a B. bacilliformis homolog of the 17-kDa antigen gene was obtained using multiple primer pairs. DNA sequencing revealed open reading frames capable of coding for proteins with sizes similar to that of the 17-kDa antigen of B. henselae in all of the amplicons; however, extensive sequence divergence across the genus was noted. Cloning of the amplified products into pUC19 resulted in recombinants that directed synthesis of homologs of the 17-kDa protein. Immunoblot analysis using human sera from CSD cases demonstrated very little cross-reactivity among different species for this protein. In contrast, immunoblots using rabbit serum raised to the recombinant B. henselae antigen showed extensive cross-reactivity with the proteins of other Bartonella species. The data suggest that the use of the 17-kDa antigen as a serologic reagent may allow the development of more specific diagnostic assays. Furthermore, the nucleotide sequences from the various versions of the 17-kDa antigen gene should be useful for rapid identification of Bartonella at the species level.

PMCID: PMC95857 PMID: 10702501 [PubMed - indexed for MEDLINE]

699. J Clin Microbiol. 2000 Feb;38(2):682-7.

Sequence variation in the ftsZ gene of Bartonella henselae isolates and clinical samples.

Ehrenborg C, Wesslén L, Jakobson A, Friman G, Holmberg M.

Section of Infectious Diseases, Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden.

In a search for methods for subtyping of Bartonella henselae in clinical samples, we amplified and sequenced a 701-bp region in the 3' end of the ftsZ gene in 15 B. henselae isolates derived from cats and humans in the United States and Europe. The ftsZ sequence variants that were discovered were designated variants Bh ftsZ 1, 2, and 3 and were compared with 16S rRNA genotypes I and II of the same isolates. There was no ftsZ gene variation in the strains of 16S rRNA type I, all of which were Bh ftsZ 1. The type II strains constituted two groups, with nucleotide sequence variation in the ftsZ gene resulting in amino acid substitutions at three positions, one of which was shared by the two groups. One 16S rRNA type II isolate had an ftsZ gene sequence identical to those of the type I strains. Variants Bh ftsZ 1 and 2 were detected in tissue specimens from seven Swedish patients with diagnoses such as chronic multifocal osteomyelitis, cardiomyopathy, and lymphadenopathy. Patients with similar clinical entities displayed either Bh ftsZ variant. The etiological role of B. henselae in these patients was supported by positive Bartonella antibody titers and/or amplification and sequencing of a part of the B. henselae gltA gene. B. henselae ftsZ gene sequence variation may be useful in providing knowledge about the epidemiology of various B. henselae strains in clinical samples, especially when isolation attempts have failed. This report also describes manifestations of atypical Bartonella infections in Sweden.

PMCID: PMC86176 PMID: 10655367 [PubMed - indexed for MEDLINE]

700. Nihon Rinsho. 1999 Nov;57 Suppl:213-5.

[Cat scratch disease].

[Article in Japanese]

Tsuneoka H, Tsukahara M.

Department of Clinical Laboratory, Yamaguchi Kouseiren Nagato General Hospital.

PMID: 10635816 [PubMed - indexed for MEDLINE]

701. Clin Diagn Lab Immunol. 2000 Jan;7(1):1-5.

Sonicated diagnostic immunoblot for bartonellosis.

Mallqui V, Speelmon EC, Verástegui M, Maguiña-Vargas C, Pinell-Salles P, Lavarello R, Delgado J, Kosek M, Romero S, Arana Y, Gilman RH.

Departamento de Patología, Universidad Peruana Cayetano Heredia, Lima Peru.

Two simple Bartonella bacilliformis immunoblot preparation methods were developed. Antigen was prepared by two different methods: sonication of whole organisms or glycine extraction. Both methods were then tested for sensitivity and specificity. Well-defined control sera were utilized in the development of these diagnostic immunoblots, and possible cross-reactions were thoroughly examined. Sera investigated for cross-reaction with these diagnostic antigens were drawn from patients with brucellosis, chlamydiosis, Q fever, and cat scratch disease, all of whom were from regions where bartonellosis is not endemic. While both immunoblots yielded reasonable sensitivity and high specificity, we recommend the use of the sonicated immunoblot, which has a higher sensitivity when used to detect acute disease and produces fewer cross-reactions. The sonicated immunoblot reported here is 94% sensitive to chronic bartonellosis and 70% sensitive to acute bartonellosis. In a healthy group, it is 100% specific. This immunoblot preparation requires a simple sonication protocol for the harvesting of B. bacilliformis antigens and is well suited for use in regions of endemicity.

PMCID: PMC95812 PMID: 10618267 [PubMed - indexed for MEDLINE]

702. Enferm Infecc Microbiol Clin. 1999 Nov;17(9):434-8.

[Seroepidemiology of Bartonella henselae infection in HIV-infected patients].

[Article in Spanish]

Blanco JR, Oteo JA, Martínez V, Ramalle E, García A, Ibarra V, Rosel L.

Servicio de Medicina Interna y Enfermedades Infecciosas, Hospital de La Rioja.

BACKGROUND: Bartonella henselae infections are closely related to numerous clinical infections of growing interest in Spain. Since immunosuppressed patients are a potential risk group for infection by this bacteria, the aim of the present was to study the seroepidemiology of B. henselae infection in a risk group (patients with HIV infection) and in a control group (donors). PATIENTS AND METHODS: In October, 1997, antibodies versus B. henselae were determined at different dilutions (cut off > or = 1:64) by immunofluorescence in 52 patients with HIV infection and 85 donors. An epidemiologic study included age, sex, smoking, alcohol intake, INVDA, HIV infection, AIDS stage, cutaneous anergy, CD4 lymphocyte count, antiretroviral treatment and chemoprophylaxis versus P. carinii. RESULTS: Nine of the patients with HIV infection (17.3%) and five donors (5.88%) presented titers > or = 1:64 with no significant differences (p = 0.06) (adjusted OR: 1.7; CI 95%: 0.34-8.54). Moreover, multiple logistic regression analysis did not show any risk or protection factor associated with B. henselae infection in patients with HIV infection. CONCLUSIONS: A high level of seroprevalence of antibodies versus B. henselae was observed in patients with HIV infection. No risk or protection factors associated with B. henselae infection in patients with HIV infection were found.

PMID: 10614075 [PubMed - indexed for MEDLINE]

703. Vet Immunol Immunopathol. 1999 Nov 30;71(3-4):233-43.

Immune response of neonatal specific pathogen-free cats to experimental infection with Bartonella henselae.

Guptill L, Slater L, Wu CC, Glickman LT, Lin TL, Welch DF, Crippen JT, HogenEsch H.

Department of Veterinary Clinical Sciences, Purdue University, W. Lafayette, IN 47907, USA. yoran@vet.purdue.edu

The purpose of this study was to determine whether neonatal cats develop and maintain a persistent bacteremia for longer than do adult cats with a normal mature immune system, and whether neonatal cats are susceptible to infection with Bartonella henselae by oral inoculation. Neonatal specific pathogen-free (SPF) cats were inoculated with B. henselae intradermally (n = 4) or orally (n = 5) or with 0.9% NaCl (n = 2). Blood was collected periodically through 16 weeks post-inoculation (PI) for serology, bacteriology and complete blood count. Cats inoculated orally or intradermally at 3-5 days of age were bacteremic through 12-16 weeks PI, similar to what is documented for adult cats inoculated intradermally or intravenously. One cat inoculated at age 2 weeks was bacteremic through 10 weeks PI; the other was not bacteremic. Intradermally inoculated neonatal cats produced serum IgG antibodies to B. henselae but orally inoculated neonatal cats did not. Infected cats with and without serum IgG antibodies to B. henselae became blood-culture negative simultaneously, suggesting that IgG is not required to clear bacteremia.

PMID: 10587303 [PubMed - indexed for MEDLINE]

704. Int J STD AIDS. 1999 Oct;10(10):694.

A case of cat scratch disease masquerading as lymphogranuloma venereum.

Philpot CR.

Comment on Int J STD AIDS. 1999 May;10(5):334-5.

PMID: 10582643 [PubMed - indexed for MEDLINE]

705. Epidemiol Infect. 1999 Oct;123(2):233-40.

Serological evidence of Bartonella spp. infection in the UK.

Harrison TG, Doshi N.

Respiratory and Systemic Infection Laboratory, PHLS Central Public Health Laboratory, London, UK.

We reviewed serological and epidemiological data relating to 1000 consecutive patients from whom specimens were submitted for estimation of bartonella antibodies, using MRL Diagnostics Bartonella IFA IgM and IgG kits. Using 289 control sera, we estimated the specificity of the kits as > or = 99.0%. Evidence of bartonella infection was found in 16.3% of patients examined. Rates varied by patient group: 20% of patients for whom a diagnosis of cat scratch disease (CSD) was considered probable had evidence of infection, as did 10.4% of patients with 'possible CSD', 8.1% of patients with possible bacillary angiomatosis, 18.2% of patients with 'culture negative' endocarditis and 17.6% of patients with possible bartonellosis with ophthalmic involvement. An IgM response was seen in 6.6% of patients and IgG in 15.1%. Cases were more frequent among males than females (18.5% vs. 13.9%). Analysis by age showed that although rates of infection were highest in the decades 0-9 years (19.4%) and 10-19 years (20.7%), they fell only slightly in the next three decades. MRL bartonella kits appears to provide a useful and specific approach to the diagnosis of these infections.

PMCID: PMC2810754 PMID: 10579442 [PubMed - indexed for MEDLINE]

706. Pediatr Med Chir. 1999 Mar-Apr;21(2):89-91.

[Hepatic and splenic micro-abscess in cat scratch disease. Report of a case].

[Article in Italian]

Luciano A, Rossi F, Bolognani M, Trabucchi C.

Cattedra di Pediatria dell'Università, Ospedale Civile Maggiore di Verona, Italia.

Cat-scratch disease (CSD) is an infection caused by a gram-negative bacillus known as Bartonella Henselae. Hepatosplenic disease occurs in only 0.3-0.7% of patients. In this report we describe a 7-year-old male presented with a 4-week history of fever, after diagnosis of CSD with regional lymphoadenitis. Ultrasonography and tomography identified hepatic and splenic abscesses. Antibiotic treatment for three months was associated with resolution of lesions. In Patients affected by CSD, ultrasonography and tomography permit to identify hepatic and/or splenic lesions, indicating systemic CSD.

PMID: 10570789 [PubMed - indexed for MEDLINE]

707. J Clin Microbiol. 1999 Dec;37(12):4045-7.

Identification of Bartonella species directly in clinical specimens by PCR-restriction fragment length polymorphism analysis of a 16S rRNA gene fragment.

Matar GM, Koehler JE, Malcolm G, Lambert-Fair MA, Tappero J, Hunter SB, Swaminathan B.

Department of Microbiology and Immunology, American University of Beirut, Beirut, Lebanon. gmatar@aub.edu.lb

It is now established that two species of Bartonella, namely, Bartonella henselae and B. quintana, cause bacillary angiomatosis in human immunodeficiency virus-infected patients. In addition, B. henselae causes cat scratch disease and B. quintana, B. henselae, and B. elizabethae can cause bacteremia and endocarditis in immunocompetent persons. We have developed a PCR-restriction fragment length polymorphism-based assay for direct detection and identification to species level of Bartonella in clinical specimens. This is accomplished by PCR amplification of Bartonella DNA using primers derived from conserved regions of the gene carrying the 16S ribosomal DNA, followed by restriction analysis using DdeI and MseI restriction endonucleases. We amplified a Bartonella genus-specific 296-bp fragment from 25 clinical samples obtained from 25 different individuals. Restriction analysis of amplicons showed that identical patterns were seen from digestion of B. henselae and B. quintana amplicons with DdeI, whereas a different unique pattern was seen by using the same enzyme with B. vinsonii and B. elizabethae. With MseI digestion, B. henselae and B. vinsonii gave nearly identical patterns while B. quintana and B. elizabethae gave a different pattern. By combining the restriction analysis data generated with MseI and DdeI, unique "signature" restriction patterns characteristic for each species were obtained. These patterns were useful in identifying the Bartonella species associated with each tissue specimen.

PMCID: PMC85877 PMID: 10565929 [PubMed - indexed for MEDLINE]

708. Curr Opin Ophthalmol. 1999 Jun;10(3):209-16.

Ocular manifestations of cat-scratch disease.

Ormerod LD, Dailey JP.

Mason Eye Institute, University of Missouri-Columbia 65212, USA.

Bartonella henselae has only recently been isolated, characterized, and found to be the principal cause of cat-scratch disease (CSD). The availability of specific serologic investigations has allowed the recognition of a spectrum of ocular CSD syndromes that previously were ill defined and considered idiopathic. The primary inoculation complex causing regional lymphadenopathy is represented in the eye by Parinaud's oculoglandular syndrome; B. henselae is the most common cause. Leber's neuroretinitis has been identified for 80 years, and new data suggest that it is commonly a manifestation of CSD; the extent of the association remains to be determined. CSD optic neuritis is also described. The vitreoretinal manifestations include anterior uveitis, vitritis, pars planitis, focal retinal vasculitis, a characteristic retinal white spot syndrome, Bartonella retinitis, branch retinal arteriolar or venular occlusions, focal choroiditis, serous retinal detachments, and peripapillary angiomatous lesions. The pattern of ocular disease in AIDS-associated B. henselae infections is poorly delineated; unusual manifestations include conjunctival and retinal bacillary angiomatosis. The benefit of antimicrobial therapy for CSD in immunocompetent individuals has been difficult to establish, partly because most infections are self limited. Empirically, azithromycin, ciprofloxacin, rifampin, parenteral gentamicin, or trimethoprim-sulfamethoxazole provide the best therapeutic choices to minimize damage to the eye.

PMID: 10537781 [PubMed - indexed for MEDLINE]

709. Kansenshogaku Zasshi. 1999 Sep;73(9):930-4.

[Two cases of suspected Bartonella henselae infection from a dog].

[Article in Japanese]

Kusaba N, Yoshida H, Shimokawa Y, Sata M.

Department of Medicine, Yame General Hospital.

A 55-year-old male was admitted to our hospital because of fever and left submaxillary, right axillary, and left inguinal lymphadenopathy. A presumptive diagnosis of rickettsiosis was made and treatment with oral doxycycline was started. Lymphadenopathy was partialy resolved after antibiotics treatment. Ablation of the left inguinal node was done and histopathological examination showed non-Hodgkin's lymphoma. Lymphadenopathy was resolved by chemotherapy. The second patient, a 40-year-old male, developed a tender submandibular node. Excisional biopsy of the node was performed to eliminate lymphoma. Histopathological examination revealed granulomatous lymphadenitis with follicular hyperplasia. The patients had no history of cat contact, but owned a dog. Diagnosis of both cases was confirmed by the detection of IgG antibodies to Bartonella henselae with an enzyme immunoassay. Our findings suggest that dogs are implicated in B. henselae infection and can serve as a reservoir of the organism as well as cats. In the abscence of other bacterial and especially after exposure to dogs, B. henselae should be included as possible cause of lymphadenopathy.

PMID: 10535269 [PubMed - indexed for MEDLINE]

710. J Am Acad Dermatol. 1999 Nov;41(5 Pt 2):833-6.

Unusual eruption as a presenting symptom of cat scratch disease.

Landau M, Kletter Y, Avidor B, Ephrat G, Ephros M, Brenner S, Giladi M.

Department of Dermatology, Tel Aviv-Elias Sourasky Medical Center, and Sackler School of Medicine, Tel Aviv University, Israel. olandau@ibm.net

Cat scratch disease (CSD) is a common infectious cause of subacute regional lymphadenopathy. Bartonella henselae is the principal etiologic agent. About 10% of CSD patients experience atypical manifestations, including rashes. The most common cutaneous manifestation of CSD is a papule at the inoculation site. We report a case of CSD presenting with an eruption on the upper trunk, reminiscent of Sweet's syndrome, accompanied by lymphadenopathy, arthralgia, and fever. Response to systemic corticosteroids was remarkable. Histopathologic findings refuted the diagnosis of Sweet's syndrome. Identification of anti-B henselae antibodies and B henselae DNA in the affected lymph node confirmed the diagnosis of CSD. This is a first report of extensive papuloedematous eruption as a cutaneous manifestation of CSD. Accurate diagnosis is possible due to the availability of serological tests and DNA amplification techniques.

PMID: 10534662 [PubMed - indexed for MEDLINE]

711. J Am Optom Assoc. 1999 Aug;70(8):525-30.

Cat-scratch neuroretinitis.

Lombardo J.

TLC Northwest Eye, Seattle, Washington, USA.

BACKGROUND: Cat-scratch disease is a subacute regional lymphadenitis, usually preceded by a history of a cat scratch or exposure to kittens. The disease is caused by Bartonella henselae, and possibly Bartonella quintana, pleomorphic gram-negative rods formerly known as Rochalimaea henselae and Rochalimaea quintana. Ocular involvement is rare and typically manifests as either Parinaud's oculoglandular syndrome or neuroretinitis. Patients with neuroretinitis resulting from cat-scratch disease may be asymptomatic or experience mild-to-severe vision loss. The clinical features, angiographic appearance, differential diagnosis, and management of cat-scratch neuroretinitis are discussed. CASE REPORT: A 30-year-old white woman reported to the eye clinic with painless, decreased vision in the right eye. A diagnosis of cat scratch neuroretinitis was made on the basis of the history of cat scratch, clinical appearance, and angiographic findings. Treatment with oral ciprofloxacin restored vision to normal in 4 weeks. CONCLUSION: Painless vision loss associated with optic nerve swelling and macular star exudate should alert suspicion of systemic disease. Additional findings--including positive history of a cat scratch, lymphadenopathy, and flu-like symptoms--may indicate Bartonella henselae or Bartonella quintana infection. While treatment remains controversial, appropriate serology testing may aid in the diagnosis and management of the underlying infection.

PMID: 10506816 [PubMed - indexed for MEDLINE]

712. J Clin Microbiol. 1999 Oct;37(10):3097-101.

Semiquantitative species-specific detection of Bartonella henselae and Bartonella quintana by PCR-enzyme immunoassay.

Sander A, Penno S.

Abteilung Mikrobiologie und Hygiene, Institut für Medizinische Mikrobiologie und Hygiene, Klinikum der Universität Freiburg, Freiburg, Germany. sander@ukl.uni-freiburg.de

Bartonella henselae is the main causative agent of cat-scratch disease, and both B. henselae and Bartonella quintana cause angioproliferative disorders such as bacillary angiomatosis. To increase the sensitivity of Bartonella detection by PCR and to improve the species differentiation, we developed a semiquantitative, species-specific PCR-based enzyme immunoassay (EIA). The 16S rRNA gene was selected as the target sequence. Internal nucleotide sequences derived from the amplified 16S rRNA region were used to develop species-specific oligonucleotide probes for B. henselae and B. quintana. Biotin-labeled PCR products were immobilized on streptavidin-coated microtiter plates, hybridized to a digoxigenin-labeled probe, and detected with antidigoxigenin peroxidase conjugate. No cross-hybridization with other Bartonella or non-Bartonella species was observed. This EIA was as sensitive as dot blot hybridization and was 10 times more sensitive than visualization of PCR products on agarose gels. Serial dilutions of B. henselae and B. quintana suspensions demonstrated that an optical density (OD) of approximately 0.200 was equivalent to 5 CFU in the reaction mixture. By comparing the OD of the bacterial dilutions with that obtained from clinical specimens we could determine that the number of CFU in clinical samples ranged from 10(3) to 10(6) CFU/ml. The PCR-EIA developed in the present study is a rapid, sensitive, and simple method for the diagnosis of B. henselae and B. quintana infections.

PMCID: PMC85502 PMID: 10488160 [PubMed - indexed for MEDLINE]

713. Eur J Epidemiol. 1999 Jul;15(6):583-7.

Prevalence of antibodies to Bartonella henselae in patients with suspected cat scratch disease (CSD) in Italy.

Del Prete R, Fumarola D, Fumarola L, Basile V, Mosca A, Miragliotta G.

Dipartimento di Clinica Medica, Immunologia e Malattie Infettive, Università degli Studi di Bari, Policlinico, Italy.

Cat scratch disease (CSD) is a relatively new diagnosed illness with clinical signs of self-limiting regional lymphadenopathy accompanied by symptoms of fever and malaise, to encephalopathy and neuropathy, occurring after a cat scratch or flea bite. Bartonella henselae is now accepted as the etiologic agent of CSD. From January 1994 to September 1998, 412 patients were evaluated for suspect CSD in Italy. Sera were tested for antibodies to B. henselae by a commercially available indirect immunofluorescent assay (IFA), based on B. henselae-infected Vero-cells as the antigen substrate. Of the 412 patients, 26 (6.3%) were considered positive having titers of immunoglobulin G (IgG) to B. henselae of 64 or higher. In these patients CSD was indeed confirmed by either histopathologic examination of lymph nodes biopsy or fourfold raise in antibody titers. Nevertheless, sera were tested by IFA for Afipia felis and one showed a double reactivity to B. henselae and A. felis. Finally, three sera, negative to B. henselae serology, were positive to A. felis. Three hundred and eighty-six patients received alternative diagnoses. One hundred and twenty-five serum samples from control subjects were negative by IFA for either B. henselae or A. felis. Moreover, a cross-reactivity with sera from patients affected by other diseases was not observed. Our study shows that the ascertained cases of CSD are etiologically determined by B. henselae, IFA assay is confirmed as a useful tool in the laboratory diagnosis and, over a 5 years period of study, the incidence of CSD in Italy has been low.

PMID: 10485354 [PubMed - indexed for MEDLINE]

714. J Med Microbiol. 1999 Sep;48(9):849-56.

Seroprevalence of Bartonella henselae in cats in Germany.

Haimerl M, Tenter AM, Simon K, Rommel M, Hilger J, Autenrieth IB.

Max von Pettenkofer-Institut für Hygiene und Medizinische Mikrobiologie, Ludwig Maximilians-Universität Müchen, Germany.

Bartonella henselae and B. quintana infections in man are associated with various clinical manifestations including cat-scratch disease, bacillary angiomatosis and bacteraemia. While cats are the natural reservoir for B. henselae, the source of B. quintana is unclear. In this study, the sera of 713 cats from Germany were examined for the presence of antibodies against B. henselae, B. quintana or Afipia felis by an indirect immunofluorescence assay (IFA). Bartonella-specific antibody titres of > or =50 were found in 15.0% of the cats. There was substantial cross-reactivity among the various Bartonella antigens, although single sera showed high titres against B. henselae but not against B. quintana and vice versa. Antibodies against A. felis were not detected in any of these cats. Statistical analysis indicated that there is no correlation between Bartonella infections and the sex, age or breed of the cat or its hunting behavior. There was also no correlation between bartonella and toxoplasma infections in cats. However, whereas 16.8% of cats from northern Germany had B. quintana-specific antibodies, only 8.0% of cats from southern Germany were seropositive for B. quintana. No statistically significant difference was found for B. henselae. IFA-positive and IFA-negative sera were used for immunoblot analysis including B. henselae and B. quintana. Marked reactivity was observed with protein bands at 80, 76, 73, 65, 37, 33 and 15 kDa. The results of this study suggest that B. henselae, and possibly a B. quintana-related pathogen, but not A. felis, are common in cats in Germany, and that there are differences in the geographic distribution of bartonella infections in cats.

PMID: 10482296 [PubMed - indexed for MEDLINE]

715. Md Med J. 1999 Jul-Aug;48(4):176-8.

Cat scratch encephalopathy.

Seals JE, Oken HA.

Howard County General Hospital, USA.

Cat scratch disease is usually a self-limited illness associated with tender lymph nodes, fever, malaise, and fatigue. Lymphadenopathy usually resolves spontaneously within three to four months. Cat scratch disease can be atypical as indicated by the presentation of our patient.

PMID: 10461442 [PubMed - indexed for MEDLINE]

716. Retina. 1999;19(4):355-6.

Bilateral Bartonella-associated neuroretinitis.

Wade NK, Po S, Wong IG, Cunningham ET Jr.

Francis I.Proctor Foundation and the Department of Ophthalmology, UCSF School of Medicine, San Francisco, California 94143-0944, USA.

PMID: 10458308 [PubMed - indexed for MEDLINE]

717. Arch Dermatol. 1999 Aug;135(8):985, 988.

An ulcerated nodule associated with lymphadenopathy.

Boyce S, Peña JR, Davis DA.

University of Alabama at Birmingham, USA.

PMID: 10456353 [PubMed - indexed for MEDLINE]

718. Clin Infect Dis. 1999 May;28(5):1156-8.

Bartonella henselae associated with Parinaud's oculoglandular syndrome.

Grando D, Sullivan LJ, Flexman JP, Watson MW, Andrew JH.

Department of Microbiology, St. Vincent's Hospital, Melbourne, Australia. danilla.grando@rmit.edu.au

Bartonella henselae was recovered from the conjunctival scraping of a 38-year-old woman who presented with a 2-week history of tender preauricular lymphadenopathy and a 1-day history of a red left eye. Dry adherent colonies were observed on agar plates at 21 days of incubation, and the isolate was identified through conventional and molecular tests. Polymerase chain reaction (PCR) amplification of a specific region of the 16S rRNA gene and confirmation by a separate PCR reaction with hybridization of the product with a B. henselae-specific probe confirmed the isolate as B. henselae. This is the first reported isolation of the causative agent of cat scratch disease from ocular tissue in a patient with Parinaud's oculoglandular syndrome.

PMID: 10452652 [PubMed - indexed for MEDLINE]

719. Immunology. 1999 Jun;97(2):352-8.

Characterization of Bartonella henselae-specific immunity in BALB/c mice.

Karem KL, Dubois KA, McGill SL, Regnery RL.

Heska Corporation, Fort Collins, Colorado, USA.

BALB/c mice were inoculated with Bartonella henselae by both systemic and mucosal routes. Culture analysis of tissues from mice infected intraperitoneally with a high dose of B. henselae yielded positive results 24 hr after infection. However, culture analysis of blood taken between 6 hr and 7 days after infection from groups receiving live B. henselae were negative. Following intraperitoneal infection, B. henselae was detected by polymerase chain reaction in liver and mesenteric lymph nodes by 6 hr and up to 7 days after infection in liver, kidney and spleen tissue. Enzyme-linked immunosorbent assay (ELISA) of serum samples collected as early as 13 days after infection indicated humoral immune responses to B. henselae. Specific humoral responses remained through week 6. Analysis of faecal samples revealed induction of B. henselae-specific immunoglobulin A by day 28 after infection. In addition, B. henselae-specific cellular responses were indicated by a positive delayed-type hypersensitivity and a T helper 1 (Th1) (CD4+ T cell)-type cytokine response following in vitro stimulation of splenocytes. The significance and implications of these data in relation to B. henselae infections are discussed.

PMCID: PMC2326841 PMID: 10447753 [PubMed - indexed for MEDLINE]

720. Trends Microbiol. 1999 Jun;7(6):226-8.

Bartonella as emerging pathogens.

Dehio C, Sander A.

Dept of Infection Biology, Max-Planck-Institute for Biology, Tübingen, Germany. christoph.dehio@tuebingen.mpg.de

PMID: 10447359 [PubMed - indexed for MEDLINE]

721. Ophthalmology. 1999 Aug;106(8):1546-53.

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.

Department of Ophthalmology, Emory University, Atlanta, Georgia, USA.

Comment in Ophthalmology. 2000 May;107(5):817-8.

OBJECTIVE: To evaluate the posterior segment findings seen in ocular cat scratch disease. DESIGN: Retrospective case series. PARTICIPANTS: There were 24 patients (35 eyes) with choroidal, retinal, or optic disc manifestations of Bartonella infection evaluated at the authors' institutions over a 6-year period. MAIN OUTCOME MEASURES: Clinical and photographic records were reviewed for evidence of disc edema, macular star, foci of retinitis or choroiditis, choroidal masses, optic nerve masses, vascular-occlusive events, or other findings. RESULTS: Discrete white retinal or choroidal lesions, 50 to 3000 microm in diameter, were the most common posterior segment findings in this series of patients (83% of eyes, 83% of patients). Optic disc swelling was the second most common finding (46% of eyes, 63% of patients) followed by a macular star (43% of eyes, 63% of patients). Vascular-occlusive events were also seen (14% of eyes, 21% of patients), and the site of occlusion was found to be intimately associated with the aforementioned retinal lesions. Final visual acuity was 20/25 or better in 26 (74%) of 35 eyes and was similar in both treated and untreated patients. CONCLUSION: Isolated foci of retinitis or choroiditis were the most common ocular manifestation of cat scratch disease in the authors' patient population, but an array of posterior segment findings may occur.

PMID: 10442903 [PubMed - indexed for MEDLINE]

722. Clin Infect Dis. 1999 Jul;29(1):221-3.

Atypical mass lesion associated with cat-scratch disease.

Kerrison JB, Bennett MD, Newman NJ, Phillips PH, Aaberg TM Sr.

Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA.

PMID: 10433602 [PubMed - indexed for MEDLINE]

723. Arch Pediatr Adolesc Med. 1999 Jul;153(7):761-2.

Radiological case of the month. Atypical cat-scratch disease.

Kurbasic M, Jones VF, Maxfield CM.

University of Louisville School of Medicine, Department of Pediatrics, KY 40292, USA.

PMID: 10401812 [PubMed - indexed for MEDLINE]

724. J Pediatr Gastroenterol Nutr. 1999 Jul;29(1):52-6.

Systemic Bartonella henselae infection with hepatosplenic involvement.

Ventura A, Massei F, Not T, Massimetti M, Bussani R, Maggiore G.

Istituto di Clinica Pediatrica, Università di Trieste, Italy.

BACKGROUND: Systemic manifestations of Bartonella henselae infection are rare in the immunocompetent host. The infection generally has initial symptoms of prolonged fever and multiple granulomatous lesions in liver and spleen. METHODS: Retrospective analysis of the records of all patients with hypoechogenic lesions in the liver and/or spleen diagnosed from 1990 through 1996 in three pediatric clinics in northern Italy. RESULTS: Among the 13 patients reviewed, 9 had evidence of B. henselae infection and hepatosplenic involvement: five had prolonged and unexplained fever lasting from 3 to 16 weeks, and four had typical cat-scratch disease and peripheral lymphadenitis. All patients had increased sedimentation rate and normal aminotransferase serum activity. Five children had a liver biopsy, by laparotomy in three and by needle in two. In all, the predominant liver lesion was a necrotizing granuloma. All patients were treated with broad-spectrum antibiotics. Fever lasted from 3 to 16 weeks, and hepatic and splenic lesions resolved in all with residual splenic calcification in one. CONCLUSIONS: Systemic B. henselae infection represents an important cause of inflammatory hypoechogenic hepatosplenic lesions in children. Serology provides rapid diagnosis, avoiding multiple and invasive investigations. Hepatosplenic involvement can be found even in children with typical cat-scratch disease without apparent systemic manifestations. The frequency of liver and/or splenic involvement in cat-scratch disease is probably underestimated.

PMID: 10400104 [PubMed - indexed for MEDLINE]

725. J Mal Vasc. 1999 May;24(2):135-8.

[Infection and angiomatous cutaneous lesions].

[Article in French]

Janier M.

Service de Dermatologie, Hôpital Saint-Joseph, Paris.

The occurrence of angiomatous cutaneous lesions in the presence of an infective process is not a frequent phenomenon. Most infectious diseases are associated with an exanthematous reaction. The combination of an infective illness and angiomatous lesions is seen essentially in the bartonelloses and in Kaposi's disease. Bartonelloses: group of infections due to alpha-proteobacteria such as Bartonella. Bartonella bacilliformis (BB), is the causal agent of Carrion's disease, the chronic cutaneous form of which (verruga peruana), in which the vector is an arthropod of the Lutzomyia species found in South America, presents superficial and deep angiomatous cutaneous nodules. Spontaneous regression occurs in a few months or years. Bartonella henselae (BH) and Bartonella quintana (BQ), are the causal agents of bacillary angiomatosis (BA), described in 1983, in which angiomatous papules or nodules with an appearance like botryomycomas, are associated with visceral lesions. The characteristic histological features (with the demonstration or the bacilli by Warthin-Starry stain) together with culture of the bacterium in various tissues (including the blood) are diagnostic. BA occurs most commonly, but not exclusively, in patients with HIV infection. Furthermore, BH is responsible for cat scratch disease while BQ causes trench fever. The reservoir of BH is the cat. The bartonella produce angiogenic factors responsible for the neovascularisation seen in angiomatous lesions. The differential diagnosis is between botryomycomas and Kaposi's disease. Numerous antibiotics are effective against botryomycomas, particularly chloramphenicol and penicillin for BB and macrolides, cyclins and fluoroquinolones for BH and BQ. Kaposi's disease (KD): whether classical, endemic or epidemic (due to HIV infection) is characterised by cutaneous and visceral angiomatous lesions: these are associated with multifocal tumorous proliferations (of endothelial and fusiform cells) affected by angiogenic growth factors (PDGF, FGF, IL6, alphaTGF, HIVtat, androgens) and strongly linked to the lymphocytic and endothelial tropism of a gamma herpes virus (HHV8, Chang and Moore 1994). HHV8 infection, probably sexually transmitted, is also the cause of lymphomas occurring in cavities and of Castleman's disease. The course of KD is very variable: from the indolent form in elderly HIV-ve patients, to the explosive forms in the immunodepressed (particularly in HIV+ve patients.

PMID: 10399647 [PubMed - indexed for MEDLINE]

726. Clin Diagn Lab Immunol. 1999 Jul;6(4):558-66.

Identification of Bartonella-specific immunodominant antigens recognized by the feline humoral immune system.

Freeland RL, Scholl DT, Rohde KR, Shelton LJ, O'Reilly KL.

Department of Veterinary Microbiology and Parasitology, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana 70803, USA.

The seroreactivities of both naturally and experimentally infected cats to Bartonella henselae was examined. Serum samples collected weekly from nine cats experimentally infected with B. henselae LSU16 were tested by enzyme-linked immunosorbent assay (ELISA) and Western blot analysis. The magnitude and isotype of the antibody response were investigated by ELISA. Western blot analysis allowed the identification of at least 24 Bartonella-specific antigens recognized by the cats during infection. Antibody titers to specific antigens, as determined by Western blot analysis, ranged from 10 to 640 and varied among the different antibody-antigen interactions. Absorption of sera from an experimentally infected cat, using whole cells and cell lysates of various Bartonella species and other bacteria that commonly colonize cats, supported the identification of those Bartonella-specific antigens recognized by the experimentally infected cats. Furthermore, a number of possible species- and type-specific antigens were identified. Finally, sera obtained from cats at local animal shelters were screened for the presence of antibodies directed against the Bartonella-specific bands identified in the experimentally infected cats. A number of Bartonella-specific antigens have been identified to which strong antibody responses are generated in both experimentally and naturally infected cats, some of which may be useful in diagnosing species- and/or type-specific infections. In addition, the results from these experiments will lead to the development of monoclonal antibodies targeted against those genus-, species-, and type-specific antigens.

PMCID: PMC95728 PMID: 10391863 [PubMed - indexed for MEDLINE]

727. Pediatr Infect Dis J. 1999 Jun;18(6):567-8.

Recurrent encephalopathy in cat-scratch disease.

Noyola DE, Holder DL, Fishman MA, Edwards MS.

Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston 77030, USA. dnoyola@bcm.tmc.edu

PMID: 10391197 [PubMed - indexed for MEDLINE]

728. Aust N Z J Ophthalmol. 1999 Apr;27(2):153-6.

Conservative management of documented neuroretinitis in cat scratch disease associated with Bartonella henselae infection.

Rosen BS, Barry CJ, Nicoll AM, Constable IJ.

Centre for Ophthalmology and Visual Science, Lions Eye Institute, Nedlands, Western Australia, Australia. bradrosen@hotmail.com

BACKGROUND: Bartonella henselae has been identified as the causative agent of the neuroretinitis associated with cat scratch disease (CSD). Immunofluorescent antibody tests with good sensitivity and specificity are available to aid in diagnosis. Despite diagnostic advances, optimal management remains controversial. We present a case of documented B. henselae macular neuroretinitis managed without antibiotics and discuss antibiotic use in this condition. METHODS: We examined a young woman with macular neuroretinitis and established a diagnosis of CSD. Management consisted of a review of the literature, followed by educating her about the condition and close observation. We documented the course of her disease. RESULTS: We diagnosed neuroretinitis associated with B. henselae infection based on immunofluorescent antibody titres and clinical presentation. Our patient's neuroretinitis resolved promptly without antibiotic therapy. CONCLUSIONS: Macular neuroretinitis in CSD can be satisfactorily diagnosed with the use of fluorescent antibodies in the appropriate clinical setting. Optimal treatment for the disease has not been established and observation combined with patient education remains an appropriate option. The self-limited nature of the disease implies that treatment studies not using controls must be interpreted with great caution. Adverse drug reactions and other iatrogenic complications can be reduced by limiting antibiotic use in settings where a meaningful treatment benefit has not been established.

PMID: 10379716 [PubMed - indexed for MEDLINE]

729. N Engl J Med. 1999 Jun 10;340(23):1842.

Infected dog and cat bites.

Numazaki K, Chiba S, Ueno H.

PMID: 10366326 [PubMed - indexed for MEDLINE]

730. Br J Ophthalmol. 1999 Mar;83(3):270-5.

Presumed ocular bartonellosis.

Kerkhoff FT, Ossewaarde JM, de Loos WS, Rothova A.

Department of Ophthalmology, FC Donders Institute, University Hospital Utrecht, Netherlands.

BACKGROUND: The spectrum of diseases caused by Bartonella henselae continues to expand and ocular involvement during this infection is being diagnosed with increasing frequency. METHODS: The clinical features and visual prognosis for 13 patients with intraocular inflammatory disease and laboratory evidence of bartonellosis were investigated. There were nine patients with neuroretinitis and four with panuveitis with positive antibody titres against B henselae determined by an enzyme immunoassay (IgG exceeding 1:900 and/or IgM exceeding 1:250). RESULTS: Positive IgG levels were found for eight patients and positive IgM levels for five. Despite animal exposure of 10 patients, only two (IgG positive) cases had systemic symptoms consistent with the diagnosis of cat scratch disease. Pathological fluorescein leakage of the optic disc was observed in all affected eyes. At 6 months' follow up, 3/18 (17%) affected eyes had a visual acuity of less than 20/100, owing to optic disc atrophy and cystoid macular oedema. 12 patients (17 eyes) were treated with antibiotics; visual acuity improved two or more Snellen lines for 9/17 (53%) eyes. CONCLUSIONS: The possibility of B henselae infection should be considered in patients with neuroretinitis and panuveitis (especially in cases with associated optic nerve involvement) even in the absence of systemic symptoms typical for cat scratch disease.

PMCID: PMC1722950 PMID: 10365031 [PubMed - indexed for MEDLINE]

731. Int J STD AIDS. 1999 May;10(5):334-5.

A case of cat scratch disease masquerading as lymphogranuloma venereum.

Hagley M, Carne CA, Gorgees N.

Clinic 1A, Addenbrooke's Hospital, Cambridge, UK.

Comment in Int J STD AIDS. 1999 Oct;10(10):694.

PMID: 10361925 [PubMed - indexed for MEDLINE]

732. Am J Trop Med Hyg. 1999 Apr;60(4):593-7.

Bartonella henselae and Bartonella clarridgeiae infection in domestic cats from The Philippines.

Chomel BB, Carlos ET, Kasten RW, Yamamoto K, Chang CC, Carlos RS, Abenes MV, Pajares CM.

Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis 95616, USA.

One hundred seven domestic cats from The Philippines were serologically tested to establish the prevalence of Bartonella infection. A subset of 31 of these cats also had whole blood collected to tentatively isolate Bartonella strains. Bartonella henselae and B. clarridgeiae were isolated from 19 (61%) of these cats. Bartonella henselae type I was isolated from 17 (89%) of the 19 culture-positive cats. Six cats (31%) were infected with B. clarridgeiae, of which four were coinfected with B. henselae. Sixty-eight percent (73 of 107) and 65% (70 of 107) of the cats had antibodies to B. henselae and B. clarridgeiae, respectively, detected by an immunofluorescence antibody (IFA) test at a titer > or = 1:64. When tested by enzyme immunoassay (EIA), 67 cats (62.6%) had antibodies to B. henselae and 71 cats (66.4%) had antibodies to B. clarridgeiae. Compared with the IFA test, the B. henselae EIA had a sensitivity of 90.4% and a specificity of 97%, with positive and negative predictive values of 98.5% and 82.5%, respectively. Similarly, the B. clarridgeiae EIA had a sensitivity of 97% and a specificity of 92% specificity, with positive and negative predictive values of 95.8% and 94.4%, respectively. The presence of antibodies to Bartonella was strongly associated with flea infestation. Domestic cats represent a large reservoir of Bartonella infection in the Philippines.

PMID: 10348234 [PubMed - indexed for MEDLINE]

733. Infect Immun. 1999 Jun;67(6):3066-72.

Acute clinical disease in cats following infection with a pathogenic strain of Bartonella henselae (LSU16).

O'Reilly KL, Bauer RW, Freeland RL, Foil LD, Hughes KJ, Rohde KR, Roy AF, Stout RW, Triche PC.

Department of Veterinary Microbiology and Parasitology, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana 70803, USA. oreilly@mail.vetmed.lsu.edu

Bartonella henselae is the causative agent of human cat scratch disease as well as several serious sequelae of infections, including bacillary angiomatosis and bacillary peliosis. Conflicting reports describe the pathogenesis of B. henselae in the cat. In this study, we characterized a strain of B. henselae termed LSU16. This strain was isolated on rabbit blood agar from a naturally infected 10-month-old female cat during a recurrent episode of bacteremia. The bacterial species was confirmed by PCR-restriction fragment length polymorphism analysis. Nine cats were infected intradermally with 5 x 10(7) CFU of LSU16, and clinical signs, antibody responses, and bacteremia were monitored. All nine cats developed raised, erythematous areas at the site of inoculation within 72 h postinoculation; the swelling peaked at 14 days postinfection and was not palpable by 28 days postinfection. Fever developed in all nine cats between 6 and 16 days postinfection and lasted for 1 to 8 days. Between 6 and 16 days postinfection, all nine cats experienced lethargy which persisted 5 to 18 days. Seven of nine cats were bacteremic by day 7, and all nine cats had become bacteremic by 14 days postinfection. Bacteremia peaked at 14 to 28 days postinfection in all cats. In six of the nine infected cats, bacterial numbers reached nondetectable levels during the 7th week postinfection; however, a single animal maintained bacteremia to 18 weeks postinfection. All nine cats developed strong antibody responses to B. henselae, as determined by Western blot analysis and enzyme-linked immunosorbent assay. Subsequently, three naive cats were injected intradermally with blood from cats infected with LSU16 from a pure culture, and five naive cats were injected with feces from fleas which had been feeding on cats infected with a pure culture of LSU16. These cats developed signs similar to those described in the previous experiment and were euthanized at 5 weeks postinfection. We conclude that B. henselae LSU16 is a virulent strain of B. henselae in cats and propose that the virulence of B. henselae in cats is strain dependent.

PMCID: PMC96623 PMID: 10338522 [PubMed - indexed for MEDLINE]

734. Eur J Pediatr. 1999 May;158(5):403-5.

Cat-scratch disease simulating a malignant process of the chest wall.

Millot F, Tailboux L, Paccalin M, Barret D, Zelinsky A, Thomas E, Levillain P, Guilhot F.

Service d'Hématologie et Oncologie Médicale, CHU Jean Bernard, La Milétrie, Poitiers, France. hemato@chu.univ-poitiers.fr

Cat-scratch disease is a well-known cause of regional adenopathy in immunocompetent children. Rarely, patients may present with symptoms simulating a neoplastic disease. The case of a 12-year-old boy with fever, swelling of the chest wall and hepatosplenic nodules is reported. Histological analysis of biopsy specimen obtained from the chest wall lesion and the liver revealed granulomatous reaction without malignant cells. Serological investigations were positive for Bartonella species. The symptoms and the lesions disappeared after oral antibiotic therapy (ciprofloxacin) was started. The patient remained symptom-free 12 months later. CONCLUSION: The present case emphasizes the wide spectrum of clinical manifestations associated with cat-scratch disease which should be investigated as differential diagnosis of manifestations suggesting a neoplastic disease in children.

PMID: 10333124 [PubMed - indexed for MEDLINE]

735. J Clin Microbiol. 1999 Jun;37(6):1899-905.

Culture of Bartonella quintana and Bartonella henselae from human samples: a 5-year experience (1993 to 1998).

La Scola B, Raoult D.

Unité des Rickettsies, CNRS UPRESA 6020, Faculté de Médecine, 13385 Marseille Cedex 05, France.

Bartonella quintana and Bartonella henselae are fastidious gram-negative bacteria responsible for bacillary angiomatosis, trench fever, cat scratch disease, and endocarditis. During a 5-year period, we received 2,043 samples for culture of Bartonella sp. We found Bartonella sp. to be the etiologic agent in 38 cases of endocarditis, 78 cases of cat scratch disease, 16 cases of bacteremia in homeless people, and 7 cases of bacillary angiomatosis. We correlated the results of positive cultures with the clinical form of the disease, type of sample, culture procedure, PCR-based genomic detection, and antibody determination. Seventy-two isolates of B. quintana and nine isolates of B. henselae from 43 patients were obtained. Sixty-three of the B. quintana isolates and two of the B. henselae isolates, obtained from patients with no prior antibiotic therapy, were stably subcultured. The sensitivity of culture was low when compared with that of PCR-based detection methods in valves of patients with endocarditis (44 and 81%, respectively), skin biopsy samples of patients with bacillary angiomatosis (43 and 100%, respectively), and lymph nodes of cat scratch disease (13 and 30%, respectively). Serological diagnosis was also more sensitive in cases of endocarditis (97%) and cat scratch disease (90%). Among endocarditis patients, the sensitivity of the shell vial culture assay was 28% when inoculated with blood samples and 44% when inoculated with valvular biopsy samples, and the sensitivity of both was significantly higher than that of culture on agar (5% for blood [P = 0.045] and 4% for valve biopsy samples [P < 0.0005]). The most efficient culture procedure was the subculture of blood culture broth into shell vials (sensitivity, 71%). For patients with endocarditis, previous antibiotic therapy significantly affected results of blood culture; no patient who had been administered antibiotics yielded a positive blood culture, whereas 80% of patients with no previous antibiotic therapy yielded positive blood cultures (P = 0.0006). Previous antibiotic therapy did not, however, prevent isolation of Bartonella sp. from cardiac valves but did prevent the establishment of strains, as none of the 15 isolates from treated patients could be successfully subcultured. For the diagnosis of B. quintana bacteremia in homeless people, the efficiency of systematic subculture of blood culture broth onto agar was higher than that of direct blood plating (respective sensitivities, 98 and 10% [P < 10(-7)]). Nevertheless, both procedures are complementary, since when used together their sensitivity reached 100%. All homeless people with positive blood cultures had negative serology. The isolation rate of B. henselae from PCR-positive lymph nodes, in patients with cat scratch disease, was significantly lower than that from valves of endocarditis patients and skin biopsy samples from bacillary angiomatosis patients (13 and 33%, respectively [P = 0.084]). In cases of bacillary angiomatosis for which an agent was identified to species level, the isolation rate of B. henselae was lower than the isolation rate of B. quintana (28 and 64%, respectively [P = 0.003]). If culture is to be considered an efficient tool for the diagnosis of several Bartonella-related diseases, methodologies need to be improved, notably for the recovery of B. henselae from lymph nodes of patients with cat scratch disease.

PMCID: PMC84980 PMID: 10325344 [PubMed - indexed for MEDLINE]

736. Acta Paediatr. 1999 Mar;88(3):284-9.

Serologic response to Bartonella henselae in patients with cat scratch disease and in sick and healthy children.

Not T, Canciani M, Buratti E, Dal Molin G, Tommasini A, Trevisiol C, Ventura A.

Clinica Pediatrica and Istituto d'Igiene, Trieste, Italy. not@burlo.trieste.it

Indirect fluorescent antibody assay (IFA) is the most reliable test for detecting antibody to Bartonella henselae in the diagnosis of cat scratch disease (CSD). Recently, an ELISA test has been proposed, but conflicting results are reported. We compared IgG-IFA and IgG-IgM ELISA methods in CSD patients and in healthy children. We also tested ELISA specificity in a large group of healthy controls and in children with lymphoma-associated lymphadenopathy and with pyogenic lymphadenitis. The ELISA procedure was positive in 69/78 patients with CSD (sensitivity 89.6%), in 5/100 healthy children (specificity 95%), in 2/51 patients with non-Hodgkin's lymphoma or pyogenic lymphadenitis (specificity 96%) and in 27/296 blood donors (specificity 91.6%). In 34 patients with CSD, ELISA IgM and IgG responses decreased significantly between time of diagnosis of the disease and recovery. We found significantly higher IgG-ELISA titres in cat-owners, whether blood donors or healthy children, than in non-cat-owners. The IgG-IFA test gave positive results in 69/78 patients with CSD (sensitivity 89.6%) and in 5/62 healthy controls (specificity 92.5%). The ELISA method is a cheap, sensitive method for determining antibody response to Bartonella henselae infection and is also important for evaluating the clinical course of the disease and the efficacy of antibiotic therapy. The high specificity of ELISA in patients with non-Hodgkin's lymphoma will help the clinician to exclude a potentially life-threatening disease associated with lymphadenopathy.

PMID: 10229038 [PubMed - indexed for MEDLINE]

737. J Pediatr. 1999 May;134(5):635-8.

Cat-scratch disease encephalopathy: a cause of status epilepticus in school-aged children.

Armengol CE, Hendley JO.

University of Virginia, Department of Pediatrics, Charlottesville, Virginia, USA.

We describe 6 school-aged patients who presented with status epilepticus (SE) secondary to cat-scratch disease (CSD) encephalopathy to alert clinicians to this distinctive clinical entity. The hospital database for admissions during 1 year was reviewed for patients presenting with SE; 4 of 5 previously healthy school-aged children with SE had CSD encephalopathy based on elevated indirect fluorescent antibody titers to Bartonella henselae. CSD encephalopathy should be included in the differential diagnosis of school-aged children presenting with SE.

PMID: 10228301 [PubMed - indexed for MEDLINE]

738. Kansenshogaku Zasshi. 1999 Mar;73(3):248-52.

[Three children with systemic cat scratch disease].

[Article in Japanese]

Murano I, Yoshii H, Kurashige H, Sugio Y, Uchida M, Shinohara T, Tsuneoka H, Yamamoto K, Iino H, Fujii R, Fujisawa K, Tsukahara M.

Department of Pediatrics, Yamaguchi Prefecture Central Hospital.

Three girls with systemic cat scratch disease, aged 10, 13 and 9 years, were reported. They presented a prolonged fever and back pain in the early stage of the disease, and had no regional lymphadenopathy. Two of them had hepatosplenic granulomas, one with multiple 5 mm hypoechoic lesions in the liver and spleen, and the other with a single 2.5 cm hypodense lesion in the left hepatic lobe. The latter patient underwent a partial left hepatic lobectomy. All patients had elevated titers of antibodies to Bartonella henselae. Polymerase chain reaction detected B. henselae DNA in tissue specimens of the patient who underwent a hepatic lobectomy. Cat scratch disease should be recognized as a cause of fever of unknown origin because the prevalence of B henselae infection might be higher in Japan.

PMID: 10222672 [PubMed - indexed for MEDLINE]

739. J Am Vet Med Assoc. 1999 Apr 15;214(8):1205-7, 1200.

Bartonella spp infection as a possible cause of uveitis in a cat.

Lappin MR, Black JC.

Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins 80523, USA.

A 6-year-old castrated mixed-breed cat was evaluated because of unilateral anterior uveitis. The cat was seronegative for antibodies to Toxoplasma gondii, coronaviruses, and feline immunodeficiency virus, and antigens for FeLV p27 and Cryptococcus neoformans. Antibodies to Bartonella spp were detected in serum and aqueous humor. The antibody coefficient (C value) for IgG antibodies to Bartonella spp in the aqueous humor was 4.42; values > 1 suggest ocular production of antibodies and supports a diagnosis of ocular infection. Topical administration of prednisolone and oral administration of prednisone failed to induce a response; however, the uveitis resolved rapidly after the cat was given doxycycline orally. Clinical or laboratory evidence of immunodeficiency in this cat was not detected. Detection of a serum IgG antibody titer to Bartonella spp and ocular production of IgG antibodies to Bartonella spp, exclusion of other causes of uveitis, and response to doxycycline suggests that the cat may have had bartonellosis resulting in uveal tract inflammation.

PMID: 10212684 [PubMed - indexed for MEDLINE]

740. J Clin Microbiol. 1999 May;37(5):1536-47.

Clinical and pathologic evaluation of chronic Bartonella henselae or Bartonella clarridgeiae infection in cats.

Kordick DL, Brown TT, Shin K, Breitschwerdt EB.

Department of Companion Animal and Special Species Medicine, Pathology, and Parasitology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina 27606, USA.

Human Bartonella infections result in diverse medical presentations, whereas many cats appear to tolerate chronic bacteremia without obvious clinical abnormalities. Eighteen specific-pathogen-free cats were inoculated with Bartonella henselae- and/or Bartonella clarridgeiae-infected cat blood and monitored for 454 days. Relapsing bacteremia did not correlate with changes in protein profiles or differences in antigenic protein recognition. Intradermal skin testing did not induce a delayed type hypersensitivity reaction to cat scratch disease skin test antigen. Thirteen cats were euthanatized at the end of the study. Despite persistent infection, clinical signs were minimal and gross necropsy results were unremarkable. Histopathology revealed peripheral lymph node hyperplasia (in all of the 13 cats), splenic follicular hyperplasia (in 9 cats), lymphocytic cholangitis/pericholangitis (in 9 cats), lymphocytic hepatitis (in 6 cats), lymphoplasmacytic myocarditis (in 8 cats), and interstitial lymphocytic nephritis (in 4 cats). Structures suggestive of Bartonella were visualized in some Warthin-Starry stained sections, and Bartonella DNA was amplified from the lymph node (from 6 of the 13 cats), liver (from 11 cats) heart (from 8 cats), kidney (from 9 cats), lung (from 2 cats), and brain (from 9 cats). This study indicates that B. henselae or B. clarridgeiae can induce chronic infection following blood transfusion in specific-pathogen-free cats and that Bartonella DNA can be detected in blood, brain, lymph node, myocardium, liver, and kidney tissues of both blood culture-positive cats and blood culture-negative cats. Detection of histologic changes in these cats supports a potential etiologic role for Bartonella species in several idiopathic disease processes in cats.

PMCID: PMC84823 PMID: 10203518 [PubMed - indexed for MEDLINE]

741. Pediatr Infect Dis J. 1999 Mar;18(3):276-8.

Prevalence of Bartonella henselae immunoglobulin G antibodies in Singaporean cats.

Nasirudeen AM, Thong ML.

Department of Microbiology, Faculty of Medicine, National University of Singapore, Republic of Singapore.

BACKGROUND: Bartonella henselae causes several clinical diseases in humans. The most common infection is the classical cat-scratch disease (CSD) occurring in immunocompetent and immunocompromised children exposed to newly acquired kittens. This is the first study of B. henselae infection in Singaporean cat population. METHODS: Indirect fluorescent antibody tests were carried out on cat sera obtained from 80 cat blood samples. RESULTS: Of the cats studied in this project 47.5% tested seropositive, with high IgG titers (> or =1024) in 31 of 38 seropositive cats, 60.5% of which were males. CONCLUSIONS: Males cats had higher rates of infection than female cats. Serologic studies of cats in different parts of the United States have indicated that the prevalence of IgG antibody to B. henselae in cats is highest in regions with warm, humid climates and lowest in areas with cool, dry climates. The indirect fluorescent antibody test data for B. henselae infection in Singapore cats support this contention.

PMID: 10093952 [PubMed - indexed for MEDLINE]

742. Presse Med. 1999 Feb 27;28(8):429-34, 438.

[Bartonella infection in humans].

[Article in French]

Raoult D.

Unité des Rickettsies, Université de la Méditerranée, Faculté de Médecine, Marseille.

BARTONELLA BACILLIFORMIS: Among the 3 species of Bartonella known to be human pathogens, B. bacilliformis causes Carriun's disease, which manifests an acute phase (Oroya fever) and a chronic phase marked by benign skin eruption with wart like macules of vascular origin. Until 1993, B. bacilliformis was considered to be the only species in Bartonella genus. In 1993, species formally in the Rochalimaea genus were designated as Bartonella species. BARTONELLA QUINTANA: This species causes trench fever. It is also the causal agent in cases of bacillary angiomatosis, septicemia, endocarditis with negative blood cultures, and chronic nodal infections, particularly in immunosuppressed patients. Trench fever is transmitted by body lice and is becoming more prevalent, particularly in the homeless. BARTONELLA HENSELAE: This agent causes bacillary angiomatosis, visceral peliosis, septicemia, endocarditis and cat-scratch disease. Transmitted by cats, and perhaps by lice, cat-scratch disease is one of the most frequent zoonoses. OTHER SPECIES: The spectrum of Bartonella infections has continued to widen these last 5 years. The role of B. elizabethae and C. clarridgeiae as human pathogens remains to be defined [abstract corrected]

PMID: 10093604 [PubMed - indexed for MEDLINE]

743. Ryoikibetsu Shokogun Shirizu. 1999;(23 Pt 1):107-9.

[Cat scratch disease].

[Article in Japanese]

Sakata Y.

St. Joseph's Institution & Hospital for Severely Handicapped Children.

PMID: 10088350 [PubMed - indexed for MEDLINE]

744. Med J Aust. 1999 Feb 15;170(4):168-70.

Cat scratch disease diagnosed by polymerase chain reaction in a patient with suspected tuberculous lymphadenitis.

Gottlieb T, Atkins BL, Robson JM.

Department of Infectious Diseases and Microbiology, Concord Hospital, Sydney, NSW. Tom@micr.crg.cs.nsw.gov.au

We present a patient diagnosed as having tuberculous lymphadenitis after lymph node biopsy and referred for tuberculous therapy. On review, because of recent cat exposure, she was tested for cat scratch disease (CSD), but serological tests for Bartonella henselae were negative. However, the diagnosis of CSD was confirmed, and tuberculosis excluded, by polymerase chain reaction techniques. This case serves as a reminder that CSD may mimic tuberculosis histologically and that sensitive molecular diagnostic tests are available.

PMID: 10078182 [PubMed - indexed for MEDLINE]

745. J Clin Microbiol. 1999 Apr;37(4):1117-22.

Bartonella koehlerae sp. nov., isolated from cats.

Droz S, Chi B, Horn E, Steigerwalt AG, Whitney AM, Brenner DJ.

Institute for Medical Microbiology, University of Berne, CH-3010 Berne, Switzerland. sara.droz@imm.unibe.ch

Two of the 25 Bartonella isolates recovered during a prevalence study of Bartonella henselae bacteremia in domestic cats from the greater San Francisco Bay region were found to differ phenotypically and genotypically from all prior B. henselae isolates. These isolates, C-29 and C-30, which were recovered from the blood of two pet cats belonging to the same household, grew on chocolate agar as pinpoint colonies following 14 days of incubation at 35 degrees C in a candle jar but failed to grow on heart infusion agar supplemented with 5% rabbit blood. Additional phenotypic characteristics distinguished the isolates C-29 and C-30 from other feline B. henselae isolates. The restriction patterns obtained for C-29 and C-30 by citrate synthase PCR-restriction fragment length polymorphism (RFLP) analysis as well as by genomic RFLP could not be distinguished from each other but were distinctly different from that of the B. henselae type strain. In reciprocal reactions, DNAs from strains C-29 and C-30 were 97 to 100% related under optimal and stringent DNA reassociation conditions, with 0 to 0.5% divergence within related sequences. Labeled DNA from the type strain of B. henselae was 61 to 65% related to unlabeled DNAs from strains C-29 and C-30 in 55 degrees C reactions, with 5.0 to 5.5% divergence within the related sequences, and 31 to 41% related in stringent, 70 degrees C reactions. In reciprocal reactions, labeled DNAs from strains C-29 and C-30 were 68 to 92% related to those of the B. henselae type strain and other B. henselae strains, with 5 to 7% divergence. The 16S rRNA gene sequence of strain C-29 was 99.54% homologous to that of the type strain of B. henselae. On the basis of these findings, the two isolates C-29 and C-30 are designated a new species of Bartonella, for which we propose the name Bartonella koehlerae. The type strain of Bartonella koehlerae is strain C-29 (ATCC 700693).

PMCID: PMC88658 PMID: 10074535 [PubMed - indexed for MEDLINE]

746. J Clin Microbiol. 1999 Apr;37(4):993-7.

Detection of Bartonella henselae DNA by two different PCR assays and determination of the genotypes of strains involved in histologically defined cat scratch disease.

Sander A, Posselt M, Böhm N, Ruess M, Altwegg M.

Abteilung Mikrobiologie und Hygiene, Institut für Medizinische Mikrobiologie und Hygiene, Freiburg Germany. sander@ukl.uni-freiburg.de

Cat scratch disease (CSD) is a common cause of subacute regional lymphadenopathy, not only in children but also in adults. Serological and molecular studies demonstrated that Bartonella henselae is the etiologic agent in most cases of CSD. Amplification of B. henselae DNA in affected tissue and detection of antibodies to B. henselae are the two mainstays in the laboratory diagnosis of CSD. We designed a retrospective study and investigated formalin-fixed, paraffin-embedded lymph nodes from 60 patients (25 female, 35 male) with histologically suspected CSD by PCR amplification. The sensitivities of two different PCR assays were compared. The first primer pair amplified a 296-bp fragment of the 16S rRNA gene in 36 of the 60 samples, corresponding to a sensitivity of 60%. The second primer pair amplified a 414-bp fragment of the htrA gene in 26 of the 60 lymph nodes, corresponding to a sensitivity of 43.3%. Bartonella DNA could be detected in a total of 39 (65%) of the 60 lymph nodes investigated. However, histopathologic findings are typical but not specific for CSD and cannot be considered as a "gold standard" for diagnosis of CSD. The sensitivity of the PCR assays increased from 65 to 87% if two criteria (histology and serology) were used in combination for diagnosis of CSD. Two genotypes (I and II) of B. henselae are described as being involved in CSD. Genotype I was found in 23 (59%) and genotype II was found in 9 (23%) of the 39 PCR-positive lymph nodes. Seven (18%) lymph nodes were negative in both type-specific PCR assays. Thirty (50%) of our 60 patients were younger than 20 years old (15 were younger than 10 years), 20 (33%) were between 21 and 40 years old, and 10 (17%) patients were between 41 and 84 years old. Our data suggest that detection of Bartonella DNA in patients' samples might confirm the histologically suspected diagnosis of CSD.

PMCID: PMC88638 PMID: 10074515 [PubMed - indexed for MEDLINE]

747. Enferm Infecc Microbiol Clin. 1999 Jan;17(1):15-8.

[Cat-scratch disease: series of 14 cases. The diagnostic usefulness of serology].

[Article in Spanish]

Aguirrebengoa K, Benito JR, Montejo M, Bereciartua E, Pérez-Irezabal J, González-Zárate P.

Unidad de Enfermedades Infecciosas-Servicio de Medicina Interna, Hospital de Cruces, Baracaldo, Vizcaya.

BACKGROUND: Disease by cat scratch (CSD) is a syndrome characterized by regional adenopathies following cat scratch or bite. Despite knowing the etiologic agent of the same, there is still controversy in the diagnosis of the syndrome in daily clinical practice. MATERIALS AND METHODS: The cases of CSD diagnosed from 1990 to 1997 with positive serology for Bartonella henselae performed by indirect immunofluorescence were reviewed. RESULTS: In 13 out of the 14 patients studied direct contact with cats was reported. Lymph node involvement corresponded to the following regions: axillary (57%), inguinal (28%), epitroclear (21%), cervical (14%), and periauricular (7%). In 35% of the cases, several territories were involved. In 3 patients the adenopathies were fluctuating. Eleven anatomopathologic studies were performed with 6 diagnoses of granulomatous adenitis, 3 reactive adenitis and 2 purulent adenitis. The serology for Bartonella henselae was positive in all the patients with a range of 1/64-1/256. The evolution was favorable in all the patients. DISCUSSION: Interpretation of the results of serology should be cautions and always related to the clinical and epidemiological picture of the patient. This technique should be considered as another criteria in the diagnosis of cat scratch disease to the detriment of the cutaneous test.

PMID: 10069107 [PubMed - indexed for MEDLINE]

748. Clin Infect Dis. 1999 Feb;28(2):274-8.

Cat-scratch disease with paravertebral mass and osteomyelitis.

Robson JM, Harte GJ, Osborne DR, McCormack JG.

Sullivan Nicolaides Pathology, Taringa, Australia.

The case of a 9-year-old girl with cat-scratch disease (CSD) complicated by development of a paravertebral mass and osteomyelitis is presented. Following multiple scratches and inguinal lymphadenopathy, she developed back pain, and imaging demonstrated a paravertebral mass with evidence of osteomyelitis involving vertebra T9. The diagnosis was made on the basis of detection of Bartonella henselae by use of molecular techniques on an aspirate from the vertebral column and supportive serology for infection with B. henselae. Eleven other cases of this unusual manifestation associated with CSD have been reported in the literature and are reviewed. The patient was treated with gentamicin, followed by rifampicin and trimethoprim-sulfamethoxazole, orally and made a favorable recovery over 7 months. This is comparable with other case reports, regardless of the choice of antibiotic therapy. CSD in immunocompetent hosts is not always self-limiting, and tissues beyond the lymph nodes can be involved.

PMID: 10064243 [PubMed - indexed for MEDLINE]

749. Eur J Pediatr. 1999 Feb;158(2):165-6.

Bone pain after lymphadenitis. Bartonella henselae granulomatous osteitis.

Maggiore G, Massei F, Bussani R, Ventura A.

Dipartimento di Medicina della Procreazione e della Età Evolutiva, Spedali Riuniti di S. Chiara, Pisa, Italy.

PMID: 10048617 [PubMed - indexed for MEDLINE]

750. Am J Ophthalmol. 1999 Feb;127(2):223-4.

Bartonella henselae infection associated with peripapillary angioma, branch retinal artery occlusion, and severe vision loss.

Gray AV, Reed JB, Wendel RT, Morse LS.

Department of Ophthalmology, University of California, Davis, Sacramento 95817, USA.

PURPOSE: To report atypical clinical features of Bartonella henselae neuroretinitis treated with combination antibiotics. METHOD: Case report. RESULTS: A 20-year-old man with a positive B. henselae titer developed a unilateral neuroretinitis, a large peripapillary angiomatous lesion, branch artery occlusion with ischemic maculopathy, and vision loss that failed to improve with clindamycin. Treatment with doxycycline and rifampin led to rapid clinical improvement. The severe vision loss in this case is atypical. CONCLUSIONS: Ocular findings associated with B. henselae infection may include retinal angiomatous lesion and branch retinal artery occlusion. Doxycycline and rifampin were successful in treating the infection.

PMID: 10030575 [PubMed - indexed for MEDLINE]

751. South Med J. 1999 Jan;92(1):73-6.

Cat-scratch disease causing status epilepticus in children.

Easley RB, Cooperstock MS, Tobias JD.

Department of Child Health, University of Missouri, Columbia 65212, USA.

Status epilepticus from cat-scratch encephalopathy is often recalcitrant to usual therapies, causing treatment to focus on critical care management of the patient that may require aggressive interventions, such as continuous pentobarbital administration. We describe two children whose initial clinical presentation of cat-scratch disease was status epilepticus with normal cerebrospinal fluid studies. A history of cat exposure (specifically, kitten and/or fleas), regional lymphadenopathy, and a papule or inoculation site should be sought, but are not essential for diagnosis. The presumptive diagnosis of cat-scratch disease can be made by serology alone even in the absence of classic diagnostic criteria. Our two cases and other reports in the literature show a favorable prognosis in most cases, despite the occurrence of status epilepticus. The diagnosis of cat-scratch disease should be strongly considered in all children with unexplained status epilepticus or encephalopathy and serologic testing for Bartonella henselae should be done.

PMID: 9932833 [PubMed - indexed for MEDLINE]

752. Rev Clin Esp. 1998 Dec;198(12):805-9.

[Seroepidemiology of Bartonella henselae infection in a risk group].

[Article in Spanish]

Blanco Ramos JR, Oteo Revuelta JA, Martínez de Artola V, Ramalle Gómara E, García Pineda A, Ibarra Cucalón V.

Servicio de Medicina Interna y Enfermedades Infecciosas, Hospital de La Rioja, Logroño.

BACKGROUND: Bartonella henselae infections are closely related to a number of clinical conditions of growing interest in our environment. As cats are the reservoir, and their bites and scratches are the main transmission mechanism, we attempted to study the seroepidemiology of the infection caused by this microorganism in a risk group of patients (cat owners) and a control group (blood donors). PATIENTS AND METHODS: October 1977. Measurement of antibody titres to B. henselae at different dilutions (breakpoint > or = 1:64) by indirect immunofluorescence (IFI) in 83 cat owners and 85 blood donors. Also, an epidemiologic investigation was carried out (age, sex, alcohol, intake, common cat exposure, cat bite or cat scratch, number and age of cats, bite or presence of fleas, use of repellents, clinical picture consistent with cat scratch disease [CSD]). RESULTS: Twenty-four cat owners (28.9%) and five blood donors (5.9%) had titres > or = 1:64 (OR: 6.51; 95% CI: 2.32 to 22.9). Also, the logistic regression analysis showed an association with daily alcohol intake and the previous antecedent of lymph node enlargement of unknown origin among cat owners. CONCLUSIONS: A high prevalence of antibodies to B. henselae was demonstrate among cat owners.

PMID: 9930000 [PubMed - indexed for MEDLINE]

753. Ann Dermatol Venereol. 1998 Dec;125(12):894-6.

[Cutaneous vasculitis disclosing cat-scratch disease].

[Article in French]

Schmoor P, Darie H, Maccari F, Gros P, Millet P.

Service de Dermatologie, Hôpital d'Instruction des Armées Bégin, Saint-Mandé.

BACKGROUND: We describe a case of cat-scratch disease ingnaugurated by vascular purpura and discuss the role of the causal agent, Bartonella henselae. CASE REPORT: A 49-year-old woman presented vascular purpura without fever. Skin biopsy demonstrated leukocytoclasic vasculitis. She owned a cat and a had a scratch scar on the back of her left hand. A few days later, two inflammatory epitrochlear lymph nodes suppurated. Catscratch disease was confirmed by serology and PRC analysis of pus aspirated from the nodes. The purpura resolved spontaneously in three weeks. Left axillary adenopathy developed and suppurated. In spite of four antibiotics, the nodes subsided only ten months later, leaving scars. DISCUSSION: Two arguments favor Bartonella henselae as the causal agent in this cutaneous vasculitis. The simultaneous onset of the two diseases and the absence of another cause of vasculitis. This patient did not have Bartonella henselae endocarditis which could have explained this vasculitis. Only one case of hypersensitivity vasculitis has been described during cat-scratch disease. The exceptional feature of this association is perhaps the result of the unawareness of moderate or asymptomatic cat-scratch disease. Bartonella henselae was possibility caused hypersensitivity vasculitis.

PMID: 9922863 [PubMed - indexed for MEDLINE]

754. Ann Biol Clin (Paris). 1999 Jan-Feb;57(1):29-36.

[Bartonellosis. II. Other Bartonella responsible for human diseases].

[Article in French]

Piémont Y, Heller R.

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]

755. Ophthalmology. 1999 Jan;106(1):1-2.

Management of B. henselae neuroretinitis in cat-scratch disease.

Rosen B.

Comment on Ophthalmology. 1998 Mar;105(3):459-66.

PMID: 9917766 [PubMed - indexed for MEDLINE]

756. Ophthalmology. 1999 Jan;106(1):1.

Cat-scratch disease.

Lee AG.

Comment on Ophthalmology. 1998 Jun;105(6):1024-31.

PMID: 9917765 [PubMed - indexed for MEDLINE]

757. Adv Vet Med. 1999;41:333-46.

Vaccination of cats against emerging and reemerging zoonotic pathogens.

Olsen CW.

Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison 53706, USA.

Many of the emerging infectious agents that threaten the human population are either directly zoonotic or involve animals, rather than humans, as their primary reservoir in nature. Vaccination of animals may be an important consideration for control of some of these diseases, and this review has specifically focused on the concept of vaccinating cats in the prevention of infection with T. gondii, B. henselae, and H. pylori. If we return to the considerations that were presented in Table III, T. gondii is really the only one of these three agents for which each of these "criteria" for vaccination is fulfilled at the present time. However, cats clearly play an important role in the epidemiology of infection with B. henselae and this is an organism for which we probably will and should see a vaccine for widespread and routine use in cats.

PMID: 9890026 [PubMed - indexed for MEDLINE]

758. Rev Med Liege. 1998 Nov;53(11):680-4.

[Cat-scratch disease].

[Article in French]

Rigo F, Senterre J.

Faculté de Médecine, Université de Liège, CHR Citadelle.

Cat-scratch disease is a subacute, regional lymphadenitis syndrome that occurs mainly in children. The causative agent is Bartonella henselae. After an incubation period ranging usually between 1 and 2 weeks, red papules develop at the site of cutaneous inoculation and persist until the development of lymphadenopathy with some malaise. Cases with complications have been observed including Parinaud oculoglandular syndrome, encephalopathy, a variety of exanthems and granumatous hepatitis. Diagnosis is based on serologic tests and, when necessary, antimicrobial treatment can be considered. Incision and drainage should not be done.

PMID: 9887661 [PubMed - indexed for MEDLINE]

759. N Engl J Med. 1999 Jan 14;340(2):108.

Images in clinical medicine. Cat scratch disease.

Giladi M, Avidor B.

Tel Aviv Medical Center, Israel.

Comment in N Engl J Med. 1999 Jun 10;340(23):1842; author reply 1843.

PMID: 9887162 [PubMed - indexed for MEDLINE]

760. Clin Diagn Lab Immunol. 1999 Jan;6(1):41-4.

Prevalence of Bartonella henselae and Bartonella clarridgeiae in an urban Indonesian cat population.

Marston EL, Finkel B, Regnery RL, Winoto IL, Graham RR, Wignal S, Simanjuntak G, Olson JG.

Centers for Disease Control and Prevention, Public Health Service, U. S. Department of Health and Human Services, Atlanta, Georgia 30333, USA.

We studied evidence of Bartonella henselae and Bartonella clarridgeiae infection in 54 cats living in Jakarta, Indonesia. By using an indirect immunofluorescence assay, we found immunoglobulin G antibody to B. henselae in 40 of 74 cats (54%). The blood of 14 feral cats was cultured on rabbit blood agar plates for 28 days. Bartonella-like colonies were identified as B. henselae or B. clarridgeiae by using restriction fragment length polymorphism analysis and direct sequencing of the PCR amplicons. Of the cats sampled in the study, 6 of 14 (43%; all feral) were culture positive for B. henselae; 3 of 14 (21%; 2 feral and 1 pet) culture positive for B. clarridgeiae. This is the first report that documents B. henselae and B. clarridgeiae infections in Indonesian cats.

PMCID: PMC95657 PMID: 9874661 [PubMed - indexed for MEDLINE]

761. Clin Infect Dis. 1998 Dec;27(6):1533-4.

Detection of specific cellular immune response to Bartonella henselae in a patient with cat scratch disease.

Arvand M, Mielke ME, Sterry K, Hahn H.

Institut für Infektionsmedizin, Universitätsklinikum Benjamin Franklin, Freie Universität Berlin, Germany.

PMID: 9868676 [PubMed - indexed for MEDLINE]

762. J Clin Microbiol. 1998 Dec;36(12):3741-2.

Bartonella henselae-based indirect fluorescence assays are useful for diagnosis of cat scratch disease.

Zbinden R.

Comment on J Clin Microbiol. 1997 Aug;35(8):1931-7.

PMCID: PMC105282 PMID: 9867494 [PubMed - indexed for MEDLINE]

763. Hosp Pract (Minneap). 1998 Dec 15;33(12):37-8, 41-4, 49.

Bartonella infections: diverse and elusive.

Loutit JS.

Department of Medicine, Stanford University School of Medicine, Calif., USA.

Children with young cats, HIV-infected patients with low CD4 counts, and lice-infested homeless people are among those with an increased risk. Clinical presentation varies with the infecting Bartonella species and the host. Treatment for cat-scratch disease is supportive; macrolide therapy is an appropriate choice for other Bartonella infections.

PMID: 9866646 [PubMed - indexed for MEDLINE]

764. Surv Ophthalmol. 1998 Nov-Dec;43(3):270-4.

Optic disk edema with a macular star.

Ghauri RR, Lee AG.

Texas A&M University Health Sciences Center, College Station, USA.

A 13-year-old boy presented with acute loss of vision in his right eye of 2 weeks' duration. He had a high fever and was ill for several days, then improved but suffered recurrent episodes of sweating and a high fever. Ophthalmoscopy of the right eye showed optic disk edema, mild vitreous cells, and minimal exudates in the macula. Bartonella henselae titers were positive. A diagnosis of optic disk edema with a macular star secondary to cat-scratch disease was made. The patient was treated with doxycycline and made a dramatic improvement to visual acuity of 20/30 with a minimal residual relative central scotoma. The optic disk edema and macular star resolved, and the patient was left with mild optic atrophy in the right eye.

PMID: 9862313 [PubMed - indexed for MEDLINE]

765. Lancet. 1998 Nov 21;352(9141):1682.

Bartonella henselae infection from a dog.

Tsukahara M, Tsuneoka H, Iino H, Ohno K, Murano I.

PMID: 9853451 [PubMed - indexed for MEDLINE]

766. Ann Biol Clin (Paris). 1998 Nov-Dec;56(6):681-92.

[Bartonellosis: I. Bartonella henselae].

[Article in French]

Piémont Y, Heller R.

Institut de bactériologie, Faculté de médecine, Strasbourg.

The recent discovery of the bacterium Bartonella henselae was mainly due to the development of molecular biology techniques adapted to microbial diagnosis and to the description of new human diseases linked to Aids. About 10% of pet cats and 33% of stray cats harbour that bacterium in their blood. In immunocompetent patients, that bacterium is responsible for human cat scratch disease, characterized essentially by a localized lymph nodes enlargement in the vicinity of the entry site of the bacteria. This disease occurs more likely in pet cats less than 1-year-old and infested with fleas. The bacterium is transmitted to humans by scratches or bites; the role of fleas is possible, but is not yet documented. In 5 to 13% of cases, the cat scratch disease appears as more severe, including health impairment, hepatitis, Parinaud's oculo-glandular syndrome, neurological complications or stellate retinitis. In immunocompromised patients, B. henselae is responsible for various clinical presentations: bacillary angiomatosis, bacillary peliosis, recurrent or persistent bacteremia or endocarditis. Diagnosis of infections due to B. henselae can be performed by serological specific testing with sensitivity and specificity values ranging from 75 to 100%. Cultivation of the bacterium is fastidious, particularly in cases of cat scratch disease. The most efficient diagnostic test is the in vitro DNA amplification which has the drawback to require a lymph node sample. Antibiotics are usually inefficient for the treatment of cat scratch disease. By contrast, in immunocompromised patients, these infections are successfully treated for a more or less long time by macrolides or tetracyclines or rifampin.

PMID: 9853027 [PubMed - indexed for MEDLINE]

767. Pediatr Infect Dis J. 1998 Nov;17(11):1059-61.

Therapeutic options for cat-scratch disease.

Zangwill K.

Comment on Pediatr Infect Dis J. 1998 Jun;17(6):447-52.

PMID: 9850000 [PubMed - indexed for MEDLINE]

768. Med Clin (Barc). 1998 Oct 17;111(12):478.

[Serologic diagnosis of cat-scratch disease].

[Article in Spanish]

Bosch X, Segura-Corrales J, Solé M, Martínez-Orozco F.

PMID: 9842534 [PubMed - indexed for MEDLINE]

769. Vet Immunol Immunopathol. 1998 Oct 23;65(2-4):191-204.

Homologous protection but lack of heterologous-protection by various species and types of Bartonella in specific pathogen-free cats.

Yamamoto K, Chomel BB, Kasten RW, Chang CC, Tseggai T, Decker PR, Mackowiak M, Floyd-Hawkins KA, Pedersen NC.

Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis 95616, USA.

Cat-scratch disease (CSD) is caused by Bartonella henselae, and possibly by B. clarridgeiae. In immuno-compromised persons, B. henselae is one of the agents causing bacillary angiomatosis. Domestic cats are the main reservoir of these bacteria, which are transmitted primarily from cat to cat by fleas. Possible strategies to prevent the spread of infection among cats are to eliminate flea infestation or to prophylactically immunize cats. In order to develop an appropriate vaccine, it is important to determine if cats become resistant to re-infection by the same strain or various types or species of Bartonella. In a series of experiments, 21 SPF cats were experimentally infected by the intradermal route with 10(5)-10(10) colony-forming units/ml of either B. henselae type II (17 cats), or a new strain 'Humboldt' isolated from a mountain lion (4 cats). The cats were bled weekly to every other week for determination of bacteremia and specific antibody production. After they cleared their infection, they were challenged by a homologous or heterologous strain of Bartonella: 10 cats were challenged with B. henselae type II, three cats with B. henselae type I, four cats with B. clarridgeiae and four cats with the 'Humboldt' strain. Seven of these cats received a third inoculum dose resulting in three cats sequentially infected with sequence B. henselae type II/B. henselae type II/'Humboldt', two cats with sequence B. henselae type II/'Humboldt'/B. clarridgeiae, and two cats with the sequence 'Humboldt'/B. henselae type II/'Humboldt'. All cats challenged with a homologous strain remained abacteremic after challenge and had an increased IgG antibody titer. All cats challenged with either a different Bartonella species or type became bacteremic. The few cats receiving a third inoculum with a strain homologous to the initial strain remained abacteremicafter that challenge. All cats infected with B. clarridgeiae suffered relapsing bacteremia compared to only 36% of the B. henselae infected cats and 22% of the 'Humboldt'-infected cats (p=0.008). The duration of bacteremia was significantly longer in B. henselae primary-infected cats (mean: 34 weeks) than B. henselae heterologously challenged cats (mean: 9 weeks) (p=0.014). These data clearly indicate the lack of cross-protection between B. henselae and B. clarridgeiae and furthermore, indicate the lack of protection between B. henselae types I and II, and a wildlife isolate. A vaccine strategy for CSD prevention in domestic cats will require a multivalent vaccine approach.

PMID: 9839874 [PubMed - indexed for MEDLINE]

770. Vet Immunol Immunopathol. 1998 Oct 23;65(2-4):177-89.

Evidence of reproductive failure and lack of perinatal transmission of Bartonella henselae in experimentally infected cats.

Guptill L, Slater LN, Wu CC, Lin TL, Glickman LT, Welch DF, Tobolski J, HogenEsch H.

Department of Veterinary Pathobiology, Purdue University, W. Lafayette, IN 47907, USA. yoran@vet.purdue.edu

Five female specific pathogen-free (SPF) cats inoculated intradermally with B. henselae and bacteremic for 4 weeks, and one cat inoculated with 0.9% NaCl, were bred with uninfected SPF male cats. The uninfected female became pregnant with one breeding, while three infected cats became pregnant 1-12 weeks later, after repeated breedings. Two infected females either did not become pregnant or maintain pregnancies despite repeated breedings. Infected cats produced anti-B. henselae IgM and IgG antibodies. Fetuses and kittens of infected cats were not infected and did not produce anti-B. henselae antibodies. Male cats bred with infected females did not become infected or seroconvert. Maternal anti-B. henselae IgG antibodies detected in sera of kittens 2 weeks post-partum were no longer detectable 10 weeks post-partum. These findings suggest that B. henselae causes reproductive failure in female cats, but is not transmitted transplacentally, in colostrum or milk, or venereally. Infected cats immunosuppressed with methylprednisolone acetate after their kittens were weaned had no detectable bacteria in tissues, suggesting that they were no longer infected.

PMID: 9839873 [PubMed - indexed for MEDLINE]

771. Acta Derm Venereol. 1998 Nov;78(6):477.

A case of cat scratch disease diagnosed by serologic tests specific for Bartonella henselae.

Koga T, Kubota Y, Toshitani S.

PMID: 9833058 [PubMed - indexed for MEDLINE]

772. Hosp Pract (Minneap). 1998 Nov 15;33(11):25-8.

A man with fever and lymphadenopathy.

Koche LS, Cutolo E, Greene GS, Adelman HM.

University of South Florida, USA.

A 40-year-old man presented with a three-week history of malaise, nausea, night sweats, decreased appetite, and a 15-lb weight loss. He reported having had diarrhea, occasionally with bright red blood, for the first two weeks and a temperature as high as 39.4 degrees C for the last two weeks. He had not had cough, shortness of breath, wheezing, chest pain, arthralgias, rash, or conjunctivitis. He had not eaten raw oysters or raspberries.

PMID: 9826954 [PubMed - indexed for MEDLINE]

773. Infect Immun. 1998 Dec;66(12):5915-20.

Characterization of human immunoglobulin (Ig) isotype and IgG subclass response to Bartonella henselae infection.

McGill SL, Regnery RL, Karem KL.

Viral and Rickettsial Zoonoses Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Serologic parameters of cat scratch disease (CSD) were evaluated by Western blot analysis. Sera from patients with serologically confirmed CSD antigen were screened for immunoglobulin (Ig) isotype-specific as well as IgG subclass-specific reactivity against Bartonella henselae whole-cell antigen. Bartonella-negative control sera were used to determine baseline antibody activity. Heterogeneous B. henselae-specific IgG reactivity with numerous protein bands, ranging from >150 to <17 kDa, was observed. Though individual banding patterns were variable, one approximately 83-kDa B. henselae protein (Bh83) was immunoreactive with all CSD sera tested, suggesting it is a conserved antigen during infection. Bh83 was not recognized by reference human antisera against Rickettsia rickettsii, Chlamydia group positive, Treponema pallidum, Orientia tsutsugamushi, Fransciscella tularensis, Ehrlichia chaffeensis, Mycoplasma pneumoniae, and Escherichia coli, although other cross-reactive proteins were evident. Significantly, CSD sera failed to recognize the 83-kDa protein when tested against Bartonella quintana antigen, though sera from B. quintana-infected patients did react to Bh83. This cross-reactivity suggests epitope conservation during infection with B. henselae or B. quintana. Western blot analysis further revealed similar banding patterns when B. henselae was reacted against the Ig isotypes IgG and IgG1 and both secretory and alpha chains of IgA. Neither IgM nor IgE reacted significantly to Bartonella antigen by our Western blot analysis. Dissection of the antibody response at the IgG subclass level indicated that prominent antigen recognition was limited to IgG1. These observations provide insight into induced immunity during CSD and provide evidence for conserved epitope expression during infection with B. henselae or B. quintana.

PMCID: PMC108749 PMID: 9826373 [PubMed - indexed for MEDLINE]

774. Scand J Infect Dis. 1998;30(4):387-91.

Two different genotypes of Bartonella henselae in children with cat-scratch disease and their pet cats.

Sander A, Ruess M, Deichmann K, Böhm N, Bredt W.

Abteilung Mikrobiologie und Hygiene, Institut für Med. Mikrobiologie und Hygiene, Klinikum der Universität Freiburg, Germany.

Two genotypes (I and II) of Bartonella henselae are involved in cat-scratch disease (CSD). Lymph node biopsies were taken from 3 children suffering from CSD, and blood cultures were obtained from their pet cats. Cat-scratch disease was confirmed serologically, histologically and by detection of B. henselae DNA in all 3 lymph nodes by PCR. Bartonella henselae grew in all cats' blood cultures. The first 2 children were siblings. Both children and their pet cats were infected with B. henselae genotype II, and the third patient and her cat were infected with B. henselae genotype I. In all cases, there were no essential differences in the clinical manifestations of the infection caused by these 2 genotypes of B. henselae.

PMID: 9817520 [PubMed - indexed for MEDLINE]

775. Clin Diagn Lab Immunol. 1998 Nov;5(6):766-72.

Use of the cell division protein FtsZ as a means of differentiating among Bartonella species.

Kelly TM, Padmalayam I, Baumstark BR.

Department of Biology, Georgia State University, Atlanta, Georgia 30302, USA.

Genes coding for homologs of the highly conserved cell division protein FtsZ were isolated from Bartonella henselae and Bartonella quintana, the causative agents of cat scratch disease and trench fever, respectively. DNA fragments coding for the ftsZ open reading frames (ORFs) were cloned into Escherichia coli following PCR amplification with primers based on the ftsZ sequence of the closely related species Bartonella bacilliformis. The amino acid sequences predicted from the cloned B. henselae and B. quintana ftsZ ORFs are 81 to 83% identical to the corresponding protein in B. bacilliformis. Like the FtsZ protein of B. bacilliformis, the B. henselae and B. quintana homologs are about twice as large as the FtsZ proteins reported in most other organisms. Localized sequence differences within the C-terminal coding regions of the Bartonella ftsZ genes were used as the basis for species-specific identification of these organisms at both the DNA and protein levels. Oligonucleotide primers which permit the amplification of an ftsZ fragment from each of the Bartonella species without amplifying DNA from the other two species were designed. Anti-FtsZ antisera raised in rabbits against synthetic peptides corresponding to the relatively divergent C-terminal regions were shown via Western blot analysis to react only with the FtsZ protein from the cognate Bartonella species. These observations raise the possibility that the differences in ftsZ sequences can be used as the basis for diagnostic tests to differentiate among these closely related pathogens.

PMCID: PMC96199 PMID: 9801332 [PubMed - indexed for MEDLINE]

776. J Vet Med Sci. 1998 Sep;60(9):997-1000.

Seroprevalence of Bartonella henselae and Toxoplasma gondii infections among pet cats in Kanagawa and Saitama Prefectures.

Maruyama S, Hiraga S, Yokoyama E, Naoi M, Tsuruoka Y, Ogura Y, Tamura K, Namba S, Kameyama Y, Nakamura S, Katsube Y.

Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Kanagawa, Japan.

Seroprevalence of Bartonella henselae and Toxoplasma gondii was investigated among 471 pet cats obtained from seven private animal hospitals in Kanagawa and Saitama Prefectures during the period from May 1994 to June 1995. 'Furthermore, 67 randomly selected from the 471 serum samples were examined for the feline immunodeficiency virus (FIV) antibody and feline leukemia virus (FeLV) antigen. The antibody to B. henselae was examined by an indirect immunofluorescent antibody test. T. gondii, FIV and FeLV infections in cats were detected with respective commercial kits. Of the cat serum samples tested, 43 (9.1%) were found to be seropositive for B. henselae and 41 (8.7%) for T. gondii. The B. henselae-positive rate (12.9%) of male cats was significantly higher than that (5.2%) of female cats. On the other hand, T. gondii-positive rate was 9.1% in male and 8.7% in female cats and there was no significant difference in the positivity between sexes. The positive rate in each hospital varied from 0 to 19.5% for B. henselae and 4.9 to 18.8% for T. gondii. The ages of B. henselae- and T. gondii-positive cats were distributed from < 1-year-old to 14-year-old and the seropositivity increased with age of cats. Of the 67 cat serum samples, 16 and 6 cases were positive for FIV and FeLV, respectively. There was no relationship between these viral and B. henselae infections in cats.

PMID: 9795899 [PubMed - indexed for MEDLINE]

777. Infect Immun. 1998 Nov;66(11):5534-6.

Murine model of Bartonella henselae infection in the immunocompetent host.

Regnath T, Mielke ME, Arvand M, Hahn H.

Institute of Infectious Diseases, University Hospital Benjamin Franklin, Free University of Berlin, 12203 Berlin, Germany. regnath@zedat.fu-berlin.de

Bartonella henselae is an emerging pathogen causing cat scratch disease, bacillary angiomatosis, and peliosis hepatis. Progress in understanding the pathogenesis of and the immune response to these infections has been limited by the lack of an animal model. Following intraperitoneal infection of C57BL/6 mice with B. henselae, organs were cleared of cultivatable bacteria within 6 days. In contrast, B. henselae DNA could be detected in liver tissue for at least 3 months. Liver tissue showed granulomatous inflammation reaching its highest degree of intensity during the fourth week of infection and resolving within 12 weeks postinfection. This mouse model is applicable to the study of the pathogenesis of B. henselae and the immune response to this pathogen in the immunocompetent host.

PMCID: PMC108694 PMID: 9784568 [PubMed - indexed for MEDLINE]

778. Neurology. 1998 Oct;51(4):1239.

Cat-scratch encephalopathy.

McGrath N, Wallis W.

Comment on Neurology. 1997 Sep;49(3):876-8.

PMID: 9781592 [PubMed - indexed for MEDLINE]

779. Kansenshogaku Zasshi. 1998 Aug;72(8):801-7.

[Determination of anti-Bartonella henselae antibody by indirect fluorescence antibody test--comparison of two types of antigen: non-cocultivated B. henselae and cocultivated B. henselae with Vero cells].

[Article in Japanese]

Tsuneoka H, Fujii R, Yamamoto K, Fujisawa K, Iino H, Matsuda M, Tsukahara M.

Department of Clinical Laboratory, Yamaguchi-ken Kouseiren Nagato General Hospital.

Serum anti-Bartonella henselae IgG and IgM antibody titers for the diagnosis of cat scratch disease (CSD) were determined by indirect fluorescence antibody (IFA) tests. B. henselae as antigen were harvested either by cocultivating with Vero cells (cocultivated B. henselae) or by cultivating without them (non-cocultivated B. henselae). Based on the results on 110 healthy adults, cut off values were set at 1:32 for IgG, and < 1:20 for IgM antibodies. According to these criteria, IgG antibody was positive in 2.7% of the 110 adults, while nobody was positive for IgM antibody. The titers did not change depending on the types of antigen used. On the other hand, IgG antibody titers against cocultivated B. henselae tended to be higher than those against non-cocultivated B. henselae in 33 CSD suspected patients; 75.8% of the patients were anti-B. henselae IgG positive when tested with cocultivated B. henselae as antigen, while only 48.5% of the same patients gave positive results with non-cocultivated B. henselae. Anti-B. henselae IgM antibody was positive in 24.2% of the 33 CSD suspected patients against both types antigen. Vero cells themselves seemed to nonspecifically bind some IgM (but not IgG). We recommended cocultivated B. henselae as antigen for IgG IFA, and non-cocultivated B. henselae for IgM IFA in the serological tests of CSD.

PMID: 9780582 [PubMed - indexed for MEDLINE]

780. Pediatr Infect Dis J. 1998 Sep;17(9):844-6.

Subacute orbital abscess in a four-year-old girl with a new kitten.

Gaebler JW, Burgett RA, Caldemeyer KS.

Department of Pediatrics, Indiana University School of Medicine, Indianapolis, USA.

PMID: 9779778 [PubMed - indexed for MEDLINE]

781. J Med Entomol. 1998 Sep;35(5):625-8.

Experimental infection of domestic cats with Bartonella henselae by inoculation of Ctenocephalides felis (Siphonaptera: Pulicidae) feces.

Foil L, Andress E, Freeland RL, Roy AF, Rutledge R, Triche PC, O'Reilly KL.

Department of Entomology, Louisiana State University Agricultural Center, Baton Rouge 70803, USA.

Caged cat fleas, Ctenocephalides felis (Bouché), were fed on 6 cats; 3 cats were injected with 5 x 10(7) colony forming units of Bartonella henselae intradermally and 3 cats were injected with an equal volume of saline. After the fleas fed for 4 d, 5 groups of 50 B. henselae-exposed fleas were caged and allowed to feed on 5 cats for 6 d. Five cats each were injected intradermally with 1 ml of saline containing 45 mg of feces from B. henselae-exposed fleas. Five cats were fed 50 B. henselae-exposed fleas and 45 mg of fresh feces from B. henselae-exposed fleas. Five cats received all 3 treatments by using fleas and feces collected from cats inoculated with saline (controls). Cats were bled weekly and tested by culture and serology. The cats that were injected with feces from infected fleas were positive by culture for B. henselae at 1 or 2 wk after exposure and were the only cats to become bacteremic or seropositive by week 20.

PMID: 9775583 [PubMed - indexed for MEDLINE]

782. Rev Med Interne. 1998;19 Suppl 2:280s-282s.

[Down the claws!].

[Article in French]

Paccalin M, Roblot P, Millot F, Roblot F, Marchand E, Levillain P, Guilhot F, Becq-Giraudon B.

Service de médecine interne et maladies infectieuses, CHU La Milétrie, Poitiers.

PMID: 9775093 [PubMed - indexed for MEDLINE]

783. An Esp Pediatr. 1998 Aug;49(2):191-2.

[Fever of unknown origin].

[Article in Spanish]

Fortuño Cebamanos B, de Juan Martín F, Omeñaca Teres M.

Servicio de Microbiología, Hospital Infantil, Hospital Miguel Servet, Zaragoza.

PMID: 9773562 [PubMed - indexed for MEDLINE]

784. J Bone Joint Surg Br. 1998 Sep;80(5):766-7.

Cat-scratch disease osteomyelitis from a dog scratch.

Keret D, Giladi M, Kletter Y, Wientroub S.

Department of Pediatric Orthopaedics, Dana Children's Hospital, Tel-Aviv, Israel.

Osteomyelitis is a rare manifestation of cat-scratch disease in patients who do not have AIDS. The clinical presentation and non-specific subacute course of the disease make diagnosis difficult. We present a child with osteomyelitis of a metacarpal following a dog scratch. Bartonella henselae was found to be the aetiological agent. The bone healed after treatment with antibiotics. Increased awareness and a comprehensive medical history are needed to identify patients with suspected Bartonella henselae osteomyelitis.

PMID: 9768882 [PubMed - indexed for MEDLINE]

785. Enferm Infecc Microbiol Clin. 1998 Jun-Jul;16(6):291-2.

[Cat scratch disease: description of a new case].

[Article in Spanish]

Simó J, Riquelme D, Anda P.

PMID: 9763751 [PubMed - indexed for MEDLINE]

786. AJR Am J Roentgenol. 1998 Oct;171(4):1164-5.

Disseminated Bartonella henselae (cat-scratch disease): appearance of multifocal osteomyelitis with MR imaging.

Ratner LM, Kesack A, McCauley TR, Disler DG.

Albany Medical College, NY 12208, USA.

PMID: 9763023 [PubMed - indexed for MEDLINE]

787. Arch Ophthalmol. 1998 Sep;116(9):1249-51.

Cat-scratch disease manifesting as unifocal helioid choroiditis.

Pollock SC, Kristinsson J.

PMID: 9747695 [PubMed - indexed for MEDLINE]

788. J Formos Med Assoc. 1998 Aug;97(8):569-72.

Cat-scratch disease caused by Bartonella henselae: the first case report in Taiwan.

Lee SC, Fung CP, Lee N, Shieh WB.

Department of Pathology, Chang Gung Memorial Hospital, Keelung, Taiwan.

We report a typical case of cat-scratch disease caused by Bartonella henselae, in Taiwan. A 20-year-old man developed right axillary lymphadenopathy 2 weeks after being scratched on his right hand by a kitten. The axillary lymphadenopathy resolved gradually and spontaneously after 10 weeks without specific treatment. Serologic tests were not done during the acute stage of the event. However, an immunofluorescent antibody test performed during the convalescent stage was positive for B. henselae antibodies, and the concentration dropped by fourfold 2 months later. Histopathologic examination of a biopsy specimen from the right axillary lymph node revealed findings characteristic of cat-scratch disease including multiple foci of microabscesses surrounded by histiocytes and infiltration by plasma cells and lymphocytes. This is the first reported case of cat-scratch disease in Taiwan, with a history of contact with a cat, a positive serologic test for B. henselae infection and characteristic histopathologic findings of cat-scratch disease which met the criteria for diagnosis.

PMID: 9747069 [PubMed - indexed for MEDLINE]

789. J Clin Microbiol. 1998 Sep;36(9):2800.

Cat scratch disease due to Bartonella henselae serotype Marseille (Swiss cat) in a seronegative patient.

Mainardi JL, Figliolini C, Goldstein FW, Blanche P, Baret-Rigoulet M, Galezowski N, Fournier PE, Raoult D.

PMCID: PMC105217 PMID: 9742017 [PubMed - indexed for MEDLINE]

790. J Clin Microbiol. 1998 Oct;36(10):2973-81.

Comparison of different DNA fingerprinting techniques for molecular typing of Bartonella henselae isolates.

Sander A, Ruess M, Bereswill S, Schuppler M, Steinbrueckner B.

Abteilung Mikrobiologie und Hygiene, Institut für Medizinische Mikrobiologie und Hygiene, Klinikum der Universität Freiburg, Freiburg, Germany. Sander@ukl.uni-freiburg.de

Seventeen isolates of Bartonella henselae from the region of Freiburg, Germany, obtained from blood cultures of domestic cats, were examined for their genetic heterogeneity. On the basis of different DNA fingerprinting methods, including pulsed-field gel electrophoresis (PFGE), enterobacterial repetitive intergenic consensus (ERIC)-PCR, repetitive extragenic palindromic (REP) PCR, and arbitrarily primed (AP)-PCR, three different variants were identified among the isolates (variants I to III). Variant I included 6 strains, variant II included 10 strains, and variant III included only one strain. By all methods used, the isolates could be clearly distinguished from the type strain, Houston-1, which was designated variant IV. A previously published type-specific amplification of 16S rDNA differentiated two types of the B. henselae isolates (16S rRNA types 1 and 2). The majority of the isolates (16 of 17), including all variants I and II, were 16S rRNA type 2. Only one isolate (variant III) and the Houston-1 strain (variant IV) comprised the 16S rRNA type 1. Comparison of the 16S rDNA sequences from one representative strain from each of the three variants (I to III) confirmed the results obtained by 16S rRNA type-specific PCR. The sequences from variant I and variant II were identical, whereas the sequence of variant III differed in three positions. All methods applied in this study allowed subtyping of the isolates. PFGE and ERIC-PCR provided the highest discriminatory potential for subtyping B. henselae strains, whereas AP-PCR with the M13 primer showed a very clear differentiation between the four variants. Our results suggest that the genetic heterogeneity of B. henselae strains is high. The methods applied were found useful for typing B. henselae isolates, providing tools for epidemiological and clinical follow-up studies.

PMCID: PMC105097 PMID: 9738053 [PubMed - indexed for MEDLINE]

791. Lancet. 1998 Mar 28;351(9107):954.

A farmer with a lump in his throat.

Ridder GJ, Richter B, Laszig R, Sander A.

Department of Otorhinolaryngology, University of Freiburg, Germany.

PMID: 9734943 [PubMed - indexed for MEDLINE]

792. Retina. 1998;18(4):348-55.

Bartonella serology for patients with intraocular inflammatory disease.

Rothova A, Kerkhoff F, Hooft HJ, Ossewaarde JM.

Department of Ophthalmology, F.C. Donders Institute, Academic Hospital Utrecht, The Netherlands.

Erratum in Retina 1999;19(3):260.

PURPOSE: To determine the role of Bartonella henselae in intraocular inflammatory disease and identify its clinical features. METHODS: We retrospectively determined the serum immunoglobulin (Ig)G and IgM antibodies against B. henselae and Bartonella quintana by enzyme immunoassays in stored sera of 138 consecutive newly referred patients with uveitis who, during the acute stage of their ocular disease, underwent a standardized screening protocol to determine the cause of uveitis. RESULTS: For the entire series, the frequency of high positive levels of IgG (above 1:900) or IgM (above 1:300) antibody against B. henselae was 6% (8/138) and 3% (4/138), respectively. Except for cross-reactions between B. henselae and B. quintana, we did not find additional evidence for cross-reactions among the various bacteria tested (Coxiella burnetii and Chlamydia pneumoniae). All patients with proven infectious uveitis (n = 21) and those with established uveitic entities (n = 37) had negative B. henselae serology. High positive IgG levels were observed in 9% of patients (5/54) with unknown cause of uveitis, in two subjects with human leukocyte antigen (HLA)-B27 positive uveitis, and in one with sarcoidosis. Five patients with uveitis of unknown origin and highly elevated IgG levels against B. henselae exhibited clinical features characterized by papillitis with surrounding retinal focal lesions or edema. CONCLUSIONS: The serologic and clinical data indicate that uveitis in seropositive cases may be caused by B. henselae. We do not recommend including testing for B. henselae in initial screening of patients with uveitis, but consider it worthwhile for those with papillitis and screening results within normal limits.

PMID: 9730179 [PubMed - indexed for MEDLINE]

793. AJNR Am J Neuroradiol. 1998 Aug;19(7):1294-5.

Cat-scratch disease with an extraaxial mass.

Roebuck DJ.

Department of Radiology, Royal Alexandra Hospital for Children, Sydney, Australia.

CT and MR imaging of the brain and gallium-67 scintigraphy showed an enhancing, gallium-avid mass in the left middle cranial fossa of a 10-year-old girl. Craniotomy revealed an inflammatory mass related to the left trigeminal nerve. The lesion contained rodlike bacteria, and serologic tests were positive for cat-scratch disease. Neurologic involvement in cat-scratch disease is uncommon, and the presence of organisms in neural tissue has not been reported.

PMID: 9726471 [PubMed - indexed for MEDLINE]

794. Br J Ophthalmol. 1998 May;82(5):587-8.

Anterior uveitis associated with cat scratch disease.

ur Rehman S, Metcalfe TW, Barnham M.

PMCID: PMC1722597 PMID: 9713073 [PubMed - indexed for MEDLINE]

795. Clin Infect Dis. 1998 Aug;27(2):353-7.

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.

Margileth AM, Baehren DF.

Department of Pediatrics, Mercer University School of Medicine, Macon, Georgia, USA.

We describe a patient who presented with a massive chest-wall abscess after a severe debilitating illness that lasted 3 months. Steroid therapy, administered for 4 weeks, masked the slow development of an extensive axillary and chest-wall abscess. After multiple negative tests, the patient's prolonged illness was diagnosed as cat-scratch disease (CSD). An indirect fluorescent antibody test revealed that two convalescent serum samples were positive for IgG to Bartonella clarridgeiae, but no other Bartonella species. We also review 12 cases of severe chest and pulmonary disease due to CSD that were reported in the English-language literature. Thoracopulmonary findings associated with CSD, pathogenic mechanisms of bartonella infections, diagnostic criteria, and management of CSD are presented.

PMID: 9709886 [PubMed - indexed for MEDLINE]

796. J Clin Microbiol. 1998 Sep;36(9):2499-502.

Cat scratch disease: the rare role of Afipia felis.

Giladi M, Avidor B, Kletter Y, Abulafia S, Slater LN, Welch DF, Brenner DJ, Steigerwalt AG, Whitney AM, Ephros M.

The Bernard Pridan Laboratory for Molecular Biology of Infectious Diseases, Ichilov Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. giladi@tasmc.health.gov.il

Since its isolation in 1988, Afipia felis has been associated with cat scratch disease (CSD) in only one report and its role in CSD has been questioned. We have cultured A. felis from a lymph node of a patient with CSD. 16S rRNA gene sequencing, DNA relatedness studies, fatty acid analysis, and PCR of the A. felis ferredoxin gene showed that the isolate is identical to the previously reported A. felis isolate. To determine the role of A. felis in CSD, PCR of the 16S rRNA gene followed by hybridizations with specific probes were performed with lymph node specimens from CSD patients. All 32 specimens tested positive for Bartonella henselae and negative for A. felis. We conclude that A. felis is a rare cause of CSD. Diagnostic tests not conducive to the identification of A. felis might cause the diagnosis of CSD due to A. felis to be missed.

PMCID: PMC105152 PMID: 9705382 [PubMed - indexed for MEDLINE]

797. Z Rheumatol. 1998 Jun;57(3):159-63.

[Reactive arthritis after cat bit: a rare manifestation of cat scratch disease--case report and overview].

[Article in German]

Jendro MC, Weber G, Brabant T, Zeidler H, Wollenhaupt J.

Abteilung Rheumatologie, Medizinischen Hochschule Hannover.

Cat scratch disease (CSD) is a rarely recognized infectious disease in Germany. Only a few years ago the causative agent, Bartonella henselae, could be isolated. The typical clinical manifestations of CSD consist of skin changes at the inoculation site and a benign lymphadenopathy; other manifestations are rare. We report the case of a 47 year old woman, who developed a reactive spondylarthropathy with synovitis of finger joints, polyarthralgias of large- and medium-sized joints, and inflammatory spinal pain after a cat bite. The rheumatic manifestations resolved after 10 months by treatment with non-steroidal antirheumatic drugs. Only a few cases of rheumatic manifestations associated with CSD have been described in the literature. Because the prevalence of Bartonella henselae infection of cats is high in Europe, rheumatic manifestations might be more frequent. Diagnosis of CSD is now improved by the development of serological tests. We provide an overview of the clinical manifestations and the diagnostic criteria.

PMID: 9702836 [PubMed - indexed for MEDLINE]

798. Arch Pediatr Adolesc Med. 1998 Aug;152(8):823-4.

Radiological case of the month. Cat-scratch disease with hepatic and splenic involvement.

Stuart SM, Nowicki MJ.

Department of Pediatrics, Naval Medical Center, Portsmouth, VA 23708, USA.

PMID: 9701150 [PubMed - indexed for MEDLINE]

799. Rev Clin Esp. 1998 Jun;198(6):360-3.

[Cat-scratch disease. Presentation of 2 cases in a family with serologic follow-up and discussion of diagnostic methods].

[Article in Spanish]

Segura-Corrales J, Bosch-Aparici X, Bosch-Mestres J, Solé-Arqués M, Martínez-Orozco F.

Unidades de Medicina Interna, Hospital Clínic i Provincial, Barcelona.

Two cases are reported of cat scratch disease which we consider worth describing both because of their familial presentation (the involved patients were brothers) and the serologic follow-up performed after diagnosis, which showed significant increases in IgG antibody titers to Bartonella henselae in both patients, one on day 35 and the other on day 45 after diagnosis. Cat scratch disease is a rarely diagnosed condition in our environment and it is easily misdiagnosed with other regional lymphadenitis; hence, a serologic test revealing a seroconversion or a significant increase in serologic titers will be very useful, as well as the epidemiologic antecedent of cat exposure.

PMID: 9691742 [PubMed - indexed for MEDLINE]

800. Clin Diagn Lab Immunol. 1998 Jul;5(4):486-90.

Seroprevalence of antibodies to Bartonella henselae in patients with cat scratch disease and in healthy controls: evaluation and comparison of two commercial serological tests.

Sander A, Posselt M, Oberle K, Bredt W.

Abteilung Mikrobiologie und Hygiene, Institut für Medizinische Mikrobiologie und Hygiene, Klinikum der Universität Freiburg, Germany. sander@ukl.uni-freiburg.de

Serologic testing for the presence of antibodies to Bartonella henselae is a widely accepted diagnostic procedure for laboratory confirmation of the diagnosis of cat scratch disease (CSD). In this study a commercially available indirect immunofluorescence assay (IFA) based on B. henselae-infected human larynx carcinoma cells (test A) was evaluated. Sera from 42 patients with CSD (20 confirmed by PCR) and 270 sera from healthy controls (consisting of 63 cat owners, 65 individuals whose last close contact with cats was >6 months previously, and 142 persons who had never been exposed to cats) were investigated for antibodies to B. henselae. All patients with CSD had titers of immunoglobulin G (IgG) to B. henselae of 128 or higher (test A; sensitivity, 100%). Of the 270 controls 189 (70%) were seronegative (titer, <64), 38 (14.1%) had titers of 64, 30 (11.1%) had titers of 128, 9 (3.3%) had titers of 256, and 4 (1.5%) had high titers, 512 (test A; specificity, 70%). Of the cat owners and individuals who had never had close contact with cats, 71.4 and 71.12%, respectively, were seronegative, and titers of 64, 128, 256, and 512 were found in 14.3 and 16.2%, 1.6 and 10.5%, 9.5 and 0.7%, and 3.2 and 1.4%, respectively. The sera from the patients and from the first 100 healthy adults without a history of close contact with cats were additionally tested with a second commercially available IFA, based on Vero cells infected with B. henselae and Bartonella quintana (test B). The sensitivity and specificity of test B were 93 and 73%, respectively. For patients with CSD the cross-reactivity between B. henselae and B. quintana in this test was 95%. Both systems are highly sensitive but less specific for detection of IgG antibodies to B. henselae in samples from patients with clinically apparent CSD. For detection of IgM antibodies, test A seems to be more sensitive (88%) and more specific (95%) than test B (sensitivity and specificity of 64 and 86%, respectively). The data show that the seroprevalence of antibodies to B. henselae in German individuals is high (30%). Low antibody levels are not sufficient evidence of active or prior infection.

PMCID: PMC95604 PMID: 9665953 [PubMed - indexed for MEDLINE]