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Expert Bartonella Author and Doctor

Advanced Diagnosis and Treatments

Bartonella Bacilliformis — A Unique Species of Bartonella

Dr. Schaller has written four Bartonella books and as a physician has been researching vast ways to diagnosis Bartonella and what actually works. Everything does not work. And it is very hard to diagnosis Bartonella with antibodies or DNA [PCR]. It does not mean this is a waste of time but Dr. Schaller's approaches are vastly most advanced, complex, and have been going on longer with full-time study. No one on earth has over one book on Bartonella, and he has many texts of the highest advanced science in Bartonella care, and thirteen books on tick infection medicine.

  1. Int J Antimicrob Agents. 2014 Jul;44(1):16-25. doi: 10.1016/j.ijantimicag.2014.04.006. Epub 2014 May 9.

    Pathogenicity and treatment of Bartonella infections.

    Angelakis E(1), Raoult D(2).

    Author information: (1)URMITE UMR 6236, CNRS-IRD, Faculté de Médecine Aix Marseille Universite, 27 Bd. Jean Moulin, 13385 Marseille cedex 05, France. (2)URMITE UMR 6236, CNRS-IRD, Faculté de Médecine Aix Marseille Universite, 27 Bd. Jean Moulin, 13385 Marseille cedex 05, France. Electronic address:

    Bartonella spp. are responsible for emerging and re-emerging diseases around the world. The majority of human infections are caused by Bartonella henselae, Bartonella quintana and Bartonella bacilliformis, although other Bartonella spp. have also been associated with clinical manifestations in humans. The severity of Bartonella infection correlates with the patient's immune status. Clinical manifestations can range from benign and self-limited to severe and life-threatening disease. Clinical conditions associated with Bartonella spp. include local lymphadenopathy, bacteraemia, endocarditis, and tissue colonisation resulting in bacillary angiomatosis and peliosis hepatis. Without treatment, Bartonella infection can cause high mortality. To date, no single treatment is effective for all Bartonella-associated diseases. In the absence of systematic reviews, treatment decisions for Bartonella infections are based on case reports that test a limited number of patients. Antibiotics do not significantly affect the cure rate in patients with Bartonella lymphadenopathy. Patients with Bartonella spp. bacteraemia should be treated with gentamicin and doxycycline, but chloramphenicol has been proposed for the treatment of B. bacilliformis bacteraemia. Gentamicin in combination with doxycycline is considered the best treatment regimen for endocarditis, and erythromycin is the first-line antibiotic therapy for the treatment of angioproliferative lesions. Rifampicin or streptomycin can be used to treat verruga peruana. In this review, we present recent data and recommendations related to the treatment of Bartonella infections based on the pathogenicity of Bartonella spp.

    Copyright © 2014 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

    PMID: 24933445 [PubMed - indexed for MEDLINE]

  2. PLoS One. 2014 Mar 20;9(3):e92283. doi: 10.1371/journal.pone.0092283. eCollection 2014.

    Diagnosis of Carrion's disease by direct blood PCR in thin blood smear negative samples.

    del Valle Mendoza J(1), Silva Caso W(2), Tinco Valdez C(3), Pons MJ(4), del Valle LJ(5), Oré VC(1), Michelena DC(2), Mayra JB(6), Gavidea VZ(6), Vargas M(7), Ruiz J(4).

    Author information: (1)Facultad de Ciencias de la Salud. Universidad Peruana de Ciencias Aplicadas - UPC, Lima, Peru; Instituto de Investigación Nutricional, Lima, Peru. (2)Facultad de Ciencias de la Salud. Universidad Peruana de Ciencias Aplicadas - UPC, Lima, Peru. (3)Instituto de Investigación Nutricional, Lima, Peru. (4)Barcelona Centre for International Health Research (CRESIB, Hospital Clínic - Universitat de Barcelona), Barcelona, Spain. (5)Universidad Politécnica de Catalunya (UPC), Barcelona, Spain. (6)Dirección Regional de Salud de Cajamarca (DIRESA-Cajamarca), Cajamarca, Peru. (7)Fundación Clinic, IDIBAPS, Hospital Clinic i Provincial de Barcelona, Barcelona, Spain.

    Bartonella bacilliformis is the etiologic agent of Carrion's disease. This disease has two well established phases, the most relevant being the so called Oroya Fever, in which B. bacilliformis infect the erythrocytes resulting in severe anemia and transient immunosuppression, with a high lethality in the absence of adequate antibiotic treatment. The presence of B. bacilliformis was studied in 113 blood samples suspected of Carrion's disease based on clinical criteria, despite the absence of a positive thin blood smear, by two different PCR techniques (using Bartonella-specific and universal 16S rRNA gene primers), and by bacterial culture. The specific 16S rRNA gene primers revealed the presence of 21 B. bacilliformis and 1 Bartonella elizabethae, while universal primers showed both the presence of 3 coinfections in which a concomitant pathogen was detected plus Bartonella, in addition to the presence of infections by other microorganisms such as Agrobacterium or Bacillus firmus. These data support the need to implement molecular tools to diagnose Carrion's disease.

    PMCID: PMC3961319 PMID: 24651298 [PubMed - indexed for MEDLINE]

  3. Int J Infect Dis. 2013 Oct;17(10):e811-9. doi: 10.1016/j.ijid.2013.02.016. Epub 2013 Apr 18.

    Treatment outcomes of human bartonellosis: a systematic review and meta-analysis.

    Prutsky G(1), Domecq JP, Mori L, Bebko S, Matzumura M, Sabouni A, Shahrour A, Erwin PJ, Boyce TG, Montori VM, Malaga G, Murad MH.

    Author information: (1)Knowledge and Evaluation Research Unit (KER), Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; Unidad de Conocimiento y Evidencia (CONEVID), Universidad Peruana Cayetano Heredia, Lima, Peru. Electronic address:

    BACKGROUND: Bartonella henselae, Bartonella quintana, and Bartonella bacilliformis are responsible for the majority of cases of bartonellosis in humans. These species have various unique epidemiologic characteristics, clinical manifestations, and treatment approaches. The objective of this study was to summarize the evidence on the treatment for the three most common species of Bartonella in humans. METHODS: We searched electronic databases through August 2011 for randomized controlled trials and observational studies designed to evaluate the efficacy and safety of the regimens used to treat diseases produced by B. henselae, B. quintana, and B. bacilliformis. Study selection and appraisal were done in duplicate. RESULTS: We found two randomized and seven non-randomized studies at high risk of bias. For cat scratch disease, antibiotics did not significantly affect the cure rate or time to achieve cure. In chronic bacteremia, gentamicin and doxycycline significantly increased the resolution rate. The recommended treatment was not better than other regimens for infectious endocarditis and bacillary angiomatosis. CONCLUSIONS: Current clinical practice for the treatment of bartonellosis relies mostly on expert opinion and antimicrobial susceptibility data. Randomized controlled trials are needed in the field to compare different treatment options.

    Copyright © 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

    PMID: 23602630 [PubMed - indexed for MEDLINE]

  4. PLoS Negl Trop Dis. 2012;6(10):e1819. doi: 10.1371/journal.pntd.0001819. Epub 2012 Oct 25.

    Bartonella bacilliformis: a systematic review of the literature to guide the research agenda for elimination.

    Sanchez Clemente N(1), Ugarte-Gil CA, Solórzano N, Maguiña C, Pachas P, Blazes D, Bailey R, Mabey D, Moore D.

    Author information: (1)London School of Hygiene and Tropical Medicine, London, United Kingdom.

    BACKGROUND: Carrion's disease affects small Andean communities in Peru, Colombia and Ecuador and is characterized by two distinct disease manifestations: an abrupt acute bacteraemic illness (Oroya fever) and an indolent cutaneous eruptive condition (verruga Peruana). Case fatality rates of untreated acute disease can exceed 80% during outbreaks. Despite being an ancient disease that has affected populations since pre-Inca times, research in this area has been limited and diagnostic and treatment guidelines are based on very low evidence reports. The apparently limited geographical distribution and ecology of Bartonella bacilliformis may present an opportunity for disease elimination if a clear understanding of the epidemiology and optimal case and outbreak management can be gained. METHODS: All available databases were searched for English and Spanish language articles on Carrion's disease. In addition, experts in the field were consulted for recent un-published work and conference papers. The highest level evidence studies in the fields of diagnostics, treatment, vector control and epidemiology were critically reviewed and allocated a level of evidence, using the Oxford Centre for Evidence-Based Medicine (CEBM) guidelines. RESULTS: A total of 44 studies were considered to be of sufficient quality to be included in the analysis. The majority of these were level 4 or 5 (low quality) evidence and based on small sample sizes. Few studies had been carried out in endemic areas. CONCLUSIONS: Current approaches to the diagnosis and management of Carrion's disease are based on small retrospective or observational studies and expert opinion. Few studies take a public health perspective or examine vector control and prevention. High quality studies performed in endemic areas are required to define optimal diagnostic and treatment strategies.

    PMCID: PMC3493376 PMID: 23145188 [PubMed - indexed for MEDLINE]

  5. Blood Transfus. 2012 Oct;10(4):563-4. doi: 10.2450/2012.0152-11. Epub 2012 Mar 29.

    Long time survival of Bartonella bacilliformis in blood stored at 4 °C. A risk for blood transfusions.

    Ruiz J, Silva W, Pons MJ, Del Valle LJ, Tinco CR, Casabona VD, Gomes C, Bazan J, Zavaleta V, Cornejo H, Champin D, del Valle J.

    PMCID: PMC3496215 PMID: 22507863 [PubMed - indexed for MEDLINE]

  6. Am J Trop Med Hyg. 2012 Mar;86(3):381. doi: 10.4269/ajtmh.2012.11-0540.

    A 60-year-old man from the highlands of Peru with fever and hemolysis.

    Seas C(1), Villaverde H, Maguiña C.

    Author information: (1)Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.

    PMCID: PMC3284348 PMID: 22403303 [PubMed - indexed for MEDLINE]

  7. Rev Inst Med Trop Sao Paulo. 2011 May-Jun;53(3):149-54.

    Cytokines and T-Lymphocute count in patients in the acute and chronic phases of Bartonella bacilliformis infection in an endemic area in peru: a pilot study.

    Huarcaya E(1), Best I, Rodriguez-Tafur J, Maguiña C, Solórzano N, Menacho J, Lopez De Guimaraes D, Chauca J, Ventosilla P.

    Author information: (1)Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.

    Human Bartonellosis has an acute phase characterized by fever and hemolytic anemia, and a chronic phase with bacillary angiomatosis-like lesions. This cross-sectional pilot study evaluated the immunology patterns using pre- and post-treatment samples in patients with Human Bartonellosis. Patients between five and 60 years of age, from endemic areas in Peru, in the acute or chronic phases were included. In patients in the acute phase of Bartonellosis a state of immune peripheral tolerance should be established for persistence of the infection. Our findings were that elevation of the anti-inflammatory cytokine IL-10 and numeric abnormalities of CD4(+) and CD8(+) T-Lymphocyte counts correlated significantly with an unfavorable immune state. During the chronic phase, the elevated levels of IFN-γ and IL-4 observed in our series correlated with previous findings of endothelial invasion of B. henselae in animal models.

    PMID: 21755237 [PubMed - indexed for MEDLINE]

  8. J Vet Emerg Crit Care (San Antonio). 2010 Feb;20(1):62-9. doi: 10.1111/j.1476-4431.2009.00491.x.

    Feline hemotropic mycoplasmas.

    Sykes JE(1).

    Author information: (1)Department of Medicine & Epidemiology, University of California - Davis, Davis, CA 95618, USA.

    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]

  9. Med Hypotheses. 2010 Jan;74(1):45-9. doi: 10.1016/j.mehy.2009.06.054. Epub 2009 Aug 7.

    The pathophysiology of the acute phase of human bartonellosis resembles AIDS.

    Ticona E(1), Huaroto L, Garcia Y, Vargas L, Madariaga MG.

    Author information: (1)Servicio de Enfermedades Infecciosas, Hospital Nacional Dos de Mayo, Parque Historia de la Medicina Peruana s/n, Lima 01, Peru.

    Human bartonellosis is a South American anthroponosis caused by Bartonella bacilliformis. The disease has an acute phase characterized by invasion of red blood cells by parasites, and consequent severe anemia; and a chronic phase presenting with benign vascular tumors. During the acute phase, affected individuals are prone to developing opportunistic infections with a variety of organisms similar to the ones seen in AIDS. After antibiotic treatment is instituted, a subgroup of patients may develop atypical symptoms which potentially represent clinical manifestations of the restoration of macrophage function. We speculate that the pathophysiology of the acute phase of human bartonellosis resembles AIDS, with a period of immunosuppression following the infection and later, clinical manifestations of immune reconstitution subsequent to treatment.

    PMID: 19665314 [PubMed - indexed for MEDLINE]

  10. Mikrobiyol Bul. 2008 Jan;42(1):163-75.

    [Bartonella henselae and its infections].

    [Article in Turkish]

    Celebi B(1).

    Author information: (1)Refik Saydam Hifzissihha Merkezi Başkanliği, Salgin Hastaliklar Araştirma Müdürlüğü, Bakteriyel Zoonozlar Araştirma Laboratuvari, Ankara.

    In recent years the number of identified Bartonella species has increased rapidly and several species in Bartonella genus isolated from various mammalian reservoirs were recognized as zoonotic agents in humans. Three Bartonella species are considered to be pathogenic for humans; B. henselae, B. quintana and B. bacilliformis. B. henselae causes asymptomatic intraerythrocytic bacteraemia in the feline reservoir host and is the most important zoonotic species as the cause of human diseases including cat scratch disease, bacillary angiomatosis, bacillary peliosis, bacteraemia, endocarditis and neurological disorders. In this review article general characteristics of B. henselae, infection types and clinical features, laboratory diagnosis, treatment and preventive measures have been discussed.

    PMID: 18444576 [PubMed - indexed for MEDLINE]

  11. J Antimicrob Chemother. 2007 Jun;59(6):1065-70. Epub 2007 Apr 21.

    Molecular mechanisms of resistance to antibiotics in Bartonella bacilliformis.

    Biswas S(1), Raoult D, Rolain JM.

    Author information: (1)Unité des Rickettsies, CNRS UMR 6020, IFR 48, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, 27 Bd Jean Moulin, 13385 Marseille Cedex 05, France.

    OBJECTIVES: Bartonella bacilliformis is the aetiological agent of Carrion's disease. Although ciprofloxacin, rifampicin and erythromycin have been successfully used in the treatment of the disease, failures and relapses have been reported. The objective of our study was to select in vitro mutants resistant to antibiotics in order to determine the frequency of mutations and to characterize the mechanism of resistance at the molecular level. METHODS: Antibiotic-resistant mutants were selected by serial passages of bacteria on blood agar plates containing antibiotics. Candidate genes involved in resistance were amplified and sequenced and compared in order to look at mutations associated with antibiotic resistance. RESULTS: Ciprofloxacin-, rifampicin- and erythromycin-resistant mutants were obtained after five, three and four passages, respectively. Conversely, no mutant was obtained with either gentamicin or doxycycline even after 16 passages. The ciprofloxacin mutant contained an amino acid change at position 87 (Asp --> Asn) in its quinolone resistance-determining region of the DNA gyrase protein, whereas the rifampicin-resistant strain had an amino acid change at position 531 (Ser --> Phe) in the rifampicin resistance-determining region of the rpoB gene. Similarly, the erythromycin-resistant mutant showed an A2058G mutation in the 23S rRNA gene. CONCLUSIONS: According with the current knowledge on the treatment of human bartonellosis, we believe that doxycycline in association with gentamicin may be the preferred regimen for the treatment of the acute and eruptive stages of Carrion's disease, but clinical trials are warranted to support our findings.

    PMID: 17449882 [PubMed - indexed for MEDLINE]

  12. Vaccine. 2007 Jan 2;25(1):43-54. Epub 2006 Aug 4.

    The identification of two protective DNA vaccines from a panel of five plasmid constructs encoding Brucella melitensis 16M genes.

    Commander NJ(1), Spencer SA, Wren BW, MacMillan AP.

    Author information: (1)Department of Statutory and Exotic Bacterial Diseases, Veterinary Laboratories Agency, Woodham Lane, New Haw, Addlestone, Surrey KT15 3NB, UK.

    Five candidate genes from the Brucella melitensis 16M genome were selected. Eukaryotic expression plasmids encoding these antigens were constructed and expression was verified in vitro from transfected Cos7 cells. Each vaccine was assessed for protective efficacy in a BALB/c mouse brucellosis infection model. >From these experiments two protective DNA vaccines were identified: p-omp25 and p-ialB. The Omp25 antigen (BMEI1249) has previously been studied in terms of Brucella virulence, serodiagnosis and as a protective antigen. However, this study represents the first report of a significant protective effect achieved against B. melitensis 16M challenge using the Omp25 antigen in a DNA vaccine approach. The other protective vaccine identified in this study was p-ialB. The ialB candidate (BMEI1584) was selected based upon its' putative function as an invasion protein which was assigned due to shared identity with the invasion protein B (ialB) of Bartonella bacilliformis. This candidate has not previously been investigated with regard to Brucella virulence or pathogenesis. This study is the first report to identify the Brucella invasion protein B (BMEI1584) as a novel protective antigen for brucellosis.

    PMID: 17049676 [PubMed - indexed for MEDLINE]

  13. Rev Inst Med Trop Sao Paulo. 2004 May-Jun;46(3):171-4. Epub 2004 Jul 20.

    Carrion's disease (Bartonellosis bacilliformis) confirmed by histopathology in the High Forest of Peru.

    Maco V(1), Maguiña C, Tirado A, Maco V, Vidal JE.

    Author information: (1)Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.

    Bartonellosis or Carrion's disease is endemic in some regions of Peru, classically found in the inter-Andean valleys located between 500 and 3200 meters above sea level. We report the case of a 43 year-old male patient, farmer, who was born in the Pichanaki district (Chanchamayo, Junin), located in the High Forest of Peru. He presented with disseminated, raised, erythematous cutaneous lesions, some of which bled. The distribution of these lesions included the nasal mucosa and penile region. Additionally subcutaneous nodules were distributed over the trunk and extremities. Hematologic exams showed a moderate anemia. Serologic studies for HIV and Treponema pallidum were negative. The histopathologic results of two biopsies were compatible with Peruvian wart. Oral treatment with ciprofloxacin (500 mg BID) was begun. Over 10 days, the patient showed clinical improvement. This is the first report of a confirmed case of bartonellosis in the eruptive phase originating from the Peruvian High Forest, showing the geographical expansion of the Carrion's disease.

    PMID: 15286824 [PubMed - indexed for MEDLINE]

  14. Am J Trop Med Hyg. 2004 Jul;71(1):53-5.

    Report of an unusual case of persistent bacteremia by Bartonella bacilliformis in a splenectomized patient.

    Henríquez C(1), Hinojosa JC, Ventosilla P, Infante B, Merello J, Mallqui V, Verastegui M, Maguiña C.

    Author information: (1)Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, AP 4314, Lima 100, Peru.

    We report a case of a 56-year-old man with a history of splenectomy for idiopathic thrombocytopenic purpura who developed persistent bacteremia in the acute phase of human bartonellosis. This patient did not develop hemolytic anemia. Only after several courses of antibiotic treatment was the infection eradicated. This is an unusual case of overwhelming post-splenectomy infection by Bartonella bacilliformis, which provides clinical evidence that the spleen is a critical effector organ of clearance of this infection as well as the effector organ of bartonellosis-associated hemolytic anemia.

    PMID: 15238689 [PubMed - indexed for MEDLINE]

  15. Recenti Prog Med. 2003 Apr;94(4):177-85.


    [Article in Italian]

    Mansueto P(1), Di Lorenzo G, Rizzo M, Mazzola G, Affronti M, Battista Rini G, Mansueto S.

    Author information: (1)Dipartimento di Medicina Clinica e delle Patologie Emergenti, Università degli Studi di Palermo.

    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]

  16. FEMS Microbiol Lett. 2000 Jan 1;182(1):119-24.

    Contact-dependent hemolytic activity distinct from deforming activity of Bartonella bacilliformis.

    Hendrix LR(1).

    Author information: (1)Department of Medical Microbiology and Immunology, Texas A&M University System Health Science Center, College Station, TX 77843-1114, USA.

    Although Bartonella bacilliformis causes a severe anemia in humans, this study presents the first report of hemolytic activity by B. bacilliformis. The activity was not apparent in culture supernatants but was reliably detected when B. bacilliformis cells were centrifuged onto erythrocytes prior to incubation. Abrogation of hemolytic activity by proteinase K treatment suggested the hemolysin was a Bartonella protein. Even though hemolysis required relatively long incubation times, de novo protein synthesis was not required to produce the protein. A preparation containing factors released by B. bacilliformis, including deformin, a B. bacilliformis protein able to induce pits and invaginations in erythrocyte membranes, had some ability to lyse erythrocytes. However, pre-deformed erythrocytes did not lyse faster or to a greater extent than control erythrocytes after the addition of B. bacilliformis cells. Inhibition of deformation caused by B. bacilliformis cells with the erythrocyte ATPase inhibitor, vanadate, did not affect hemolytic activity. This study suggests hemolytic activity and deforming activity are attributable to different B. bacilliformis proteins.

    PMID: 10612742 [PubMed - indexed for MEDLINE]

  17. Ann Biol Clin (Paris). 1999 Jan-Feb;57(1):29-36.

    [Bartonellosis. II. Other Bartonella responsible for human diseases].

    [Article in French]

    Piémont Y(1), Heller R.

    Author information: (1)Institut de bactériologie, Faculté de Médecine et Hôpitaux universitaires de Strasbourg, 3, rue Koeberlé, 67000 Strasbourg.

    In addition to Bartonella henselae, five other Bartonella species were involved in human pathology. As for B. henselae, ectoparasites seem to be responsible for the transmission of most or all these bacterial species. B. bacilliformis is responsible for Carrion's disease that occurs in some valleys of Colombia, Ecuador and Peru. This disease is transmitted by biting of infected sandflies. The bacterial reservoir is constituted by humans only. That disease occurs either as an acute form with severe infectious hemolytic anemia (or Oroya fever), or as benign cutaneous tumors, also called verruga peruana. Healthy blood carriers of the bacterium exist. Trench fever was described during the First World War. This non-lethal disease is constituted of recurrent febrile attacks associated particularly with osseous pains. The causative agent of the disease is B. quintana, transmitted by the body louse. Humans seem to be the reservoir of that bacterium. In some patients, B. quintana can be responsible for endocarditis, bacillary angiomatosis and chronic or recurrent bacteremia. Other human infections due to Bartonella sp. have been described: B. vinsonii, isolated from blood of small rodents, and B. elizabethae, the reservoir of which is currently unknown, can be responsible for endocardites. B. clarridgeiae (isolated from blood of 5% of pet cats and 17% of stray cats) may be responsible for human cat scratch disease. All these bartonelloses are diagnosed by non-standard blood culture or by in vitro DNA amplification or by serological testing. Their treatment requires tetracyclines or chloramphenicol or macrolides.

    PMID: 9920964 [PubMed - indexed for MEDLINE]

  18. Trans R Soc Trop Med Hyg. 1997 Sep-Oct;91(5):544-6.

    An outbreak of bartonellosis in Zamora Chinchipe Province in Ecuador.

    Cooper P(1), Guderian R, Orellana P, Sandoval C, Olalla H, Valdez M, Calvopiña M, Guevara A, Griffin G.

    Author information: (1)Department of Clinical Investigations, Hospital Vozandes, Quito, Ecuador.

    We report an outbreak of human bartonellosis in Zamora Chinchipe Province in Ecuador, which occurred in 1995-1996. Nineteen cases were seen, of which 18 presented with classical oroya fever (fever and profound anaemia) and one with verruga peruana; 11 of the cases (58%) had positive blood films containing Bartonella bacilliformis. The houses of cases and neighbouring controls were visited; blood samples for thin films and cultures were collected from members of each house and a questionnaire was administered to investigate possible risk factors for disease transmission. In none of those sampled was B. bacilliformis bacteriologically demonstrable. All case houses were located in isolated areas at the margin of forest and the presence of dead rodents was reported only in case houses (P < 0.05). We suggest that human bartonellosis is a zoonosis with a natural rodent reservoir and that migrant humans infected in this way may become a temporary reservoir host in populated areas.

    PMID: 9463663 [PubMed - indexed for MEDLINE]

    19. Med Hypotheses. 1997 Jun;48(6):511-5.

    Bartonellosis and human immunodeficiency disease (AIDS): L-forms as persisters, activating factors, and mechanism of disease.

    Sood FH, Phatak VD, Chaudhari MS.

    Bartonella, genus Proteus, can cause immunodepressive disease. The organisms, in parasitized red blood cells, may invade the brain and every other system and space in the human body. Bartonella henselae is proposed to have a role in the pathogenesis of acquired immunodeficiency syndrome (AIDS) encephalopathy. Bartonella bacilliformis produces two known toxins that can induce spasm and angiomatosis, respectively, and manifest as diseases associated with symptomatic AIDS. The skin lesions of bartonellosis may be mistaken clinically and histologically for Kaposi's sarcoma. Bacteria of the genus Proteus produce L-forms: their elementary bodies may be mistaken for what are called the 'human immunodeficiency viruses' (HIV). Antibiotics, especially penicillin, induce bacteria to produce L-forms. Air pollution and high sugar, salt and fat diets are factors that may increase the lipid content of microbes that produce toxins and L-forms that may persist or revert to bacterial form.

    PMID: 9247895 [PubMed - indexed for MEDLINE]

  19. Pediatr Infect Dis J. 1997 Feb;16(2):163-79.

    The expanding spectrum of Bartonella infections: II. Cat-scratch disease.

    Bass JW(1), Vincent JM, Person DA.

    Author information: (1)Department of Pediatrics, Tripler Army Medical Center, Honolulu, HI 96859-5000, USA.

    Recent advancements and developments in molecular biotechnology have allowed more precise reclassification of many microorganisms. With the use of these new taxonomy tools, several organisms previously thought to belong to other genera have been recently described as bartonellae. Of the 11 organisms now described as Bartonella spp., only four have been shown to be pathogenic for humans. Table 1 lists the four Bartonella human pathogens along with the their known epidemiology and the scope and range of disease associated with each. All are now considered to be bacteria and can be grown on blood-enriched agar although primary isolation in some may best be achieved in cell tissue culture. B. bacilliformis infection is limited to certain geographic regions in South America where the only human reservoir and the sandfly vector(s) that spreads the disease reside together. Specific antibiotic treatment is dramatically effective in treating the highly fatal, acute intraerythrocytic hemolytic form of the disease, but their effectiveness in treating the vascular proliferative forms (verruga peruana) or the chronic asymptomatic, bacteremic, carrier state of the disease has not been effective. This disease should remain confined to its present endemic geographic areas in South American unless asymptomatic bacteremic persons from these areas migrate to areas where sandflies and humans exist that are capable of establishing this infection in new endemic areas. B. quintana and B. henselae cause a wide range of clinical diseases in humans, the type and extent of which varies significantly with the immune status of the host. In immunocompetent hosts the pathologic response is granulomatous, suppurative, extracellular and intracellular, generally self-limited and usually unresponsive to antibiotic treatment, even to those drugs to which the organism is shown to be sensitive in vitro. In contrast, in immunocompromised hosts the pathologic response is vasculoproliferative, organisms may be seen intracellularly but they are often seen in abundance in extracellular clumps and infection is usually progressive and fatal unless treated. In these patients clinical response to treatment with drugs that are effective in vitro against these organisms has usually been dramatic. Of these agents those that penetrate cells and are found in high concentrations intracellularly, such as erythromycin, clarithromycin, azithromycin, rifampin, doxycycline and gentamicin, appear to be most effective. These agents not only appear to provide the most dramatic treatment response in patients with BA, BP and PRFB and other manifestations of B. henselae (and B. quintana as well) in immunocompromised persons, they appear to be the most promising agents for treatment of persons with both typical and atypical CSD. Further studies will be necessary to more clearly elucidated the mechanisms responsible for the diverse clinical presentations of infection with these organisms in human hosts relative to their immune status. In addition clarification of the epidemiology of B. elizabethae infections in humans may be helpful in understanding the nature of infection with Bartonella organisms.

    PMID: 9041596 [PubMed - indexed for MEDLINE]

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