Bartonella henselae bacteremia in a mother and son potentially associated with tick exposure

Particle and Fibre Toxicology

Edward B Breitschwerdt³  Julie M Bradley³  Patricia E Mascarelli³  Marna Ericson²  Ricardo G Maggi¹ 

[1] Galaxy Diagnostics Inc., Research Triangle Park, Durham, USA;Cutaneous Imaging Center, Department of Dermatology and Center for Drug Design, University of Minnesota, Minnesota, USA;Intracellular Pathogens Research Laboratory, Center for Comparative Medicine and Translational Research, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA

关键词: Neurological disorder;    Neuropathy;    Striae;    Bacteremia;    BAPGM;    Bartonella;   

Others  :  1228001
DOI  :  10.1186/1756-3305-6-101

 received in 2013-03-14, accepted in 2013-03-21,  发布年份 2013

【 摘 要 】

Background

Bartonella henselae is a zoonotic, alpha Proteobacterium, historically associated with cat scratch disease (CSD), but more recently associated with persistent bacteremia, fever of unknown origin, arthritic and neurological disorders, and bacillary angiomatosis, and peliosis hepatis in immunocompromised patients. A family from the Netherlands contacted our laboratory requesting to be included in a research study (NCSU-IRB#1960), designed to characterize Bartonella spp. bacteremia in people with extensive arthropod or animal exposure. All four family members had been exposed to tick bites in Zeeland, southwestern Netherlands. The mother and son were exhibiting symptoms including fatigue, headaches, memory loss, disorientation, peripheral neuropathic pain, striae (son only), and loss of coordination, whereas the father and daughter were healthy.

Methods

Each family member was tested for serological evidence of Bartonella exposure using B. vinsonii subsp. berkhoffii genotypes I-III, B. henselae and B. koehlerae indirect fluorescent antibody assays and for bacteremia using the BAPGM enrichment blood culture platform.

Results

The mother was seroreactive to multiple Bartonella spp. antigens and bacteremia was confirmed by PCR amplification of B. henselae DNA from blood, and from a BAPGM blood agar plate subculture isolate. The son was not seroreactive to any Bartonella sp. antigen, but B. henselae DNA was amplified from several blood and serum samples, from BAPGM enrichment blood culture, and from a cutaneous striae biopsy. The father and daughter were seronegative to all Bartonella spp. antigens, and negative for Bartonella DNA amplification.

Conclusions

Historically, persistent B. henselae bacteremia was not thought to occur in immunocompetent humans. To our knowledge, this study provides preliminary evidence supporting the possibility of persistent B. henselae bacteremia in immunocompetent persons from Europe. Cat or flea contact was considered an unlikely source of transmission and the mother, a physician, reported that clinical symptoms developed following tick exposure. To our knowledge, this is the first time that a B. henselae organism has been visualized in and amplified from a striae lesion. As the tick bites occurred three years prior to documentation of B. henselae bacteremia, the mode of transmission could not be determined.

【 授权许可】

   
2013 Maggi et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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