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 Bartonella 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]
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"Bartonella infections can affect virtually any organ system, either singly or multiply (2). Although cutaneous involvement is the most frequently recognized manifestation, there may also be more serious parenchymal involvement.
Concurrent organ involvement must be excluded, as this can impact on morbidity and duration of therapy. Bartonella osteomyelitis presents with painful osteolytic lesions usually in long bones, occasionally with overlying soft tissue masses or erythematous cellulitic dermal plaques. Bone scans with ^99m Technetium methylene diphosphonate are positive (14).
Hepatic involvement results in a condition termed peliosis hepatis. This consists of unique vascular lesions associated with the BA bacillus that can be seen on ultrasound or computerized tomographic (CT) scan. Hepatic transaminases can be normal or only mildly elevated, but alkaline phosphatase is often markedly elevated, up to five times normal (15).
Bacteremia can occur in the absence of localized tissue infection (16) and presents with fever, chills and weight loss. Blood cultures are positive only if strict guidelines for culture are followed (17). Rarely, there can also be involvement of the gastrointestinal tract, respiratory system, lymphatic system, central nervous system, bone marrow, Peyronie's Disease, endocardium and venous systems (with thrombosis) (2)."
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"Bartonella species are intra- and extracellular, pleomorphic, gram-negative alpha proteobacteria that are the causative agents of Orroya fever, Trench fever, and Cat Scratch disease. Currently, the family contains at least 19 members; many of which are emerging human and canine pathogens.3,4,7,8
Several members of the Bartonella family have become important causes of blood culture-negative infective endocarditis ("sterile") in humans.13,16 There was no disease associated with Bartonella infection in dogs until 1995, when the first case of canine heart valve infection was associated with the novel species B. vinsonii berkhoffi.2 Subsequently, in a study of 12 dogs seroreactive to B. vinsonii berkhoffi, valvular endocarditis was found in eight dogs and the 16S ribosomal subunit of B. vinsonii berkhoffi was amplified from blood or valvular tissue in three dogs.1 B. clarridgeiae and B. washoensis have also been associated with cases of endocarditis in dogs.3,4 Bartonella organisms in dogs have subsequently been associated with granulomatous lymphadenitis, rhinitis, and hepatitis.8,15 Despite the widespread recognition that these bacteria can cause disease in animals, associated lesions are poorly characterized. This study is a retrospective report of the gross, histologic, and ultrastructural features of a series of valvular endocarditis cases associated with Bartonella."
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I once read a blurb that bartonellosis is significantly represented in the homeless population.
-------------------- pingpong Posts: 361 | From At the Pingpong Tournament | Registered: Oct 2007
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adamm
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HOly moly--henselae is hat I have.
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English Title: Aortic valvular endocarditis caused by Bartonella vinsonii subsp. berkhoffii in 2 dogs presenting for fulminant pulmonary edema. Personal Authors: Smarick, S. D., Jandrey, K. E., Chomel, B. B., Thomas, W. P., Aldrich, J. Author Affiliation: Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California Davis, One Shields Avenue, Davis, CA 95616, USA. Editors: No editors Document Title: Journal of Veterinary Emergency and Critical Care, 2004 (Vol. 14) (No. 1) 42-51
Abstract: Objective: To describe the clinical course of 2 dogs that presented with fulminant cardiogenic pulmonary oedema due to aortic valvular endocarditis caused by Bartonella vinsonii subsp. berkhoffii. Case series summary: Two dogs that were presented for respiratory distress had severe pulmonary infiltrates. Mechanical ventilation was required to support the dogs while the cause of the infiltrates was determined. The diagnosis of cardiogenic oedema was made based on echocardiographic findings of aortic valve vegetation and severe aortic valvular regurgitation. Values obtained from pulmonary artery catheterization supported this diagnosis. Both dogs were euthanized, one within 24 hours of admission due to severe aortic regurgitation thought to be untreatable, and the other 9 days after admission due to the development of acute renal failure. Histological evaluation of the aortic valves, serology, and polymerase chain reaction confirmed Bartonella vinsonii subsp. berkhoffii as the cause of the aortic endocarditis. New or unique information provided: In medium-to-large breed dogs presenting with fulminant pulmonary oedema, aortic valvular endocarditis due to Bartonella spp. should be considered as a causal agent.
Publisher: Blackwell Publishing
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I still haven't found anyone describing pleopmorphic bartonella yet - at least not specifically. Numerous article have stated the pleomorphic forms of bart., but no detailed description of these forms. It's getting quite frustrating.
Anyone out there come across anything?
I've also read that there are various forms of bart. that utilize flagella for motility, specifically Bartonella bacilliformis. I'm wondering if this could explain the 41-band on some of those with negative borrelia western blots??? [Not all of them, of course]
Lou- did you ever get the powerpoint presentation? I can print it off and send it to you if you like.
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