Infectious endocarditis caused by Bartonella henselae associated with infected pets: two case reports.

BACKGROUND: Blood culture-negative infective endocarditis is a potentially severe disease that can be associated with infectious agents such as Bartonella spp., Coxiella burnetti, Tropheryma whipplei, and some fungi. CASE PRESENTATION: Reported here are two cases of blood culture-negative infective endocarditis in patients with severe aortic and mitral regurgitation in Brazil; the first case is a 47-year-old white man and the second is a 62-year-old white woman. Bartonella henselae deoxyribonucleic acid was detectable in the blood samples and cardiac valve with vegetation paraffin-fixed tissue samples. Additionally, an investigation was carried out on patients' pets, within the context of One Health, and serum samples collected from cats and dogs were reactive by indirect immunofluorescence assay. CONCLUSIONS: Even though the frequency of bartonellosis in Brazil is unknown, physicians should be aware of the possibility of blood culture-negative infective endocarditis caused by Bartonella, particularly in patients with weight loss, kidney changes, and epidemiological history for domestic animals.

Bartonella spp. and hematological changes in privately owned domestic cats from Rio de Janeiro, Brazil.

INTRODUCTION: Bartonella infection in cats can represent a risk to owners, particularly today when considering the increase in cat populations and their role in human bartonellosis epidemiology. In the present study, we aimed to detect Bartonella spp. in blood samples from 163 asymptomatic privately-owned cats from the metropolitan area of Rio de Janeiro State, Brazil by using a conventional PCR test and also to evaluate the association between Bartonella spp. and hematological changes in positive cats. METHODOLOGY: PCR assays were performed targeting the Bartonella spp heat shock protein (htrA) gene and complete blood counts were also performed in all samples. Positive PCR samples were confirmed by the presence of two genes, citrate synthase (gltA) and RNA polymerase beta-subunit-encoding (rpoB). RESULTS: A total of 74.85% (122/163) of the tested cats were positive for Bartonella spp and partial sequencing confirmed to be B. henselae. All hematological findings from the 163 cats tested (PCR-positive and negative), presented normal limits. CONCLUSIONS: This study demonstrates that B. henselae is present in almost 75% asymptomatic privately-owned domestic cats in the metropolitan region of Rio de Janeiro State, Brazil. Our results also show that hematological findings in Bartonella spp. infected cats are uncommon. In this scenario, the use of PCR as a diagnostic tool in feline Bartonella infections should be considered. Finally, these results also demonstrate the potential risk of Bartonella spp. infection in the human population of the metropolitan area of Rio de Janeiro State, Brazil.

Molecular identification of the agent of Q fever - Coxiella burnetii - in domestic animals in State of Rio de Janeiro, Brazil.

INTRODUCTION: Over the last recent years, the number of Q fever cases have has increased throughout the world. An epidemiological investigation was performed in the area in which the first molecular documentation of Q fever in Brazil was previously reported. METHODS: Indirect immunofluorescence assay (IFA) and PCR of Coxiella burnetii targeting the htpAB gene were performed in samples from 14 dogs (blood); 1 cat (blood); 10 goats (blood, milk, vaginal swab and anal swab); 3 sheep (blood); and 2 horses (blood). RESULTS: Two dogs, two sheep and five goats were seroreactive. DNA was amplified from 6 milk and 2 blood samples from goats and from dogs, respectively. The sequence of the amplicons exhibited 99% sequence similarity with the homologous sequence of the htpAB gene of C. burnetii RSA 331 (GenBank - CP000890). CONCLUSIONS: The results confirm C. burnetii infection in animals in Rio de Janeiro and reinforce the need for the surveillance of Q fever in Brazil.

Cytauxzoon felis and 'Candidatus Mycoplasma haemominutum' coinfection in a Brazilian domestic cat (Felis catus).

This article describes the first detection of Cytauxzoon felis, using molecular techniques, in a naturally infected domestic cat from Brazil, South America. Coinfection with 'Candidatus Mycoplasma haemominutum' was also found. The molecular identification of the piroplasmid species was performed by Polymerase Chain Reaction (PCR) and sequencing analysis. A 284 pb fragment of the gene encoding the 18S ribosomal RNA region was amplified and showed 99% identity with other C. felis strains from North America. In addition, PCR-RFLP (restriction fragment length polymorphism) analysis, which amplifies a 595 bp fragment of the gene encoding 16S ribosomal RNA of some bacterial species, identified the co-infecting species as 'Candidatus M. haemominutum'.

Q fever as a cause of fever of unknown origin and thrombocytosis: first molecular evidence of Coxiella burnetii in Brazil.

We report a case of Q fever in a man who presented with fever of 40 days duration associated with thrombocytosis. Serological and molecular analysis (polymerase chain reaction) confirmed infection with Coxiella burnetii. A field study was conducted by collecting blood samples from the patient's family and from the animals in the patient's house. The patient's wife and 2 of 13 dogs showed seroreactivity. Our data indicate that C. burnetii may be an underrecognized cause of fever in Brazil and emphasize the need for clinicians to consider Q fever in patients with a febrile illness, particularly those with a history of animal contact.

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

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.

Cytauxzoon felis and 'Candidatus Mycoplasma haemominutum' coinfection in a brazilian domestic cat (Felis catus) / Co-infecção por Cytauxzoon felis e 'Candidatus Mycoplasma haemominutum' em um gato doméstico (Felis catus) no Brasil

This article describes the first detection of Cytauxzoon felis, using molecular techniques, in a naturally infected domestic cat from Brazil, South America. Coinfection with 'Candidatus Mycoplasma haemominutum' was also found. The molecular identification of the piroplasmid species was performed by Polymerase Chain Reaction (PCR) and sequencing analysis. A 284 pb fragment of the gene encoding the 18S ribosomal RNA region was amplified and showed 99% identity with other C. felis strains from North America. In addition, PCR-RFLP (restriction fragment length polymorphism) analysis, which amplifies a 595 bp fragment of the gene encoding 16S ribosomal RNA of some bacterial species, identified the co-infecting species as 'Candidatus M. haemominutum'.

Este artigo descreve a primeira detecção de Cytauxzoon felis em um gato doméstico naturalmente infectado no Brasil, América do Sul, através de técnicas moleculares. Também foi encontrada co-infecção com 'Candidatus Mycoplasma haemominutum'. A detecção molecular da espécie do piroplasmídeo foi realizada através da reação em cadeia pela polimerase (PCR) e sequenciamento. Um fragmento de 284 pb do gene codificador da região 18S do RNA ribossomal do parasito foi sequenciada e mostrou 99% de identidade com outros isolados de C. felis da América do Norte. Ademais, através da análise por meio de PCR-RFLP (Polimorfismo no comprimento de fragmentos de restrição), que amplifica um fragmento de 595 pb do gene codificador da porção 16 do RNA ribossomal de algumas espécies de bactérias, concluiu-se que a espécie com-infectante era 'Candidatus M. haemominutum'.

Ocorrência de Hepatozoon sp. em caninos naturalmente infectados no município de Piraí, Rio de Janeiro, Brasil

Hepatozoon canis tem sido descrito em cães de várias regiões do Brasil sendo mais relatado em áreas rurais. O objetivodeste trabalho foi determinar a ocorrência de infecção por Hepatozoon spp. através da reação em cadeia da polimerase(PCR), em cães de região periurbana da cidade de Piraí, RJ. Em setembro/2006, foram coletadas amostras de sangue de88 cães da cidade, situada no vale do rio Paraíba do Sul. A PCR foi utilizada para a detecção de Hepatozoon spp. (gene18SRNAr) através de um par de iniciadores gênero-específicos. Duas amostras apresentaram resultado PCR-positivo(2,2%), havendo concordância com a avaliação morfológica em esfregaços sanguíneos. A amostra de Piraí demonstrou altasimilaridade (99%) com Hepatozoon canis. Os cães de Piraí apresentaram baixa frequência de infecção por H. canis,quando comparados a pesquisas anteriores na mesma região.

Bartonelose: análise molecular e sorológica em gatos do Rio de Janeiro Brasil / Bartonellosis: molecular and serological analysis in cats from Rio de Janeiro – Brazil

Bartonella henselae e mais recentemente B. quintana têm sido apontados como agentes causais de diversas moléstias emhumanos, entre as quais a doença da arranhadura do gato, endocardite, meningoencefalite e neuroretinite, podendo levarao óbito, principalmente os imunocomprometidos. O gato doméstico é considerado o principal animal envolvido na transmissãodestes patógenos. Constituiu-se objetivo deste estudo a avaliação da frequência de Bartonella spp. em gatos domésticosdomiciliados do município de Vassouras (RJ) comparando-se os achados na reação em cadeia pela polimerase (PCR) e nasorologia por imunofluorescência indireta (IFA). Amostras sanguíneas de 37 (100%) gatos de um abrigo da cidade deVassouras (RJ) foram analisadas, sendo 36 (97,3%) positivas na PCR para Bartonella spp. Das amostras PCR positivas,nove (25%) e 27 (75%) apresentaram, respectivamente, reatividade e ausência de reatividade ao IFA. Apenas uma (2,7%)amostra de sangue foi concomitantemente negativa na PCR e IFA para Bartonella spp. Este é o primeiro registro de infecçãopor Bartonella spp. em felinos domésticos no estado do Rio de Janeiro (Brasil) identificada por análise molecular e sorológica,o que nos permite concluir que este agente zoonótico está presente em alta frequência em gatos domésticos do municípiode Vassouras (RJ).

Bartonella henselae and B. quintana have been pointed as causal agents of many diseases in humans, and can lead to death, mainly immunodefficient people. Domestic cat is considered the unique animal in transmission of these pathogens. The purpose of this study was to evaluate the frequency of Bartonella spp. in domestic cats from Vassouras city (RJ) by polimerase chain reaction (PCR) and indirect immunofluorescence test assay (IFA) and compare the results. Blood samples from 37 (100%) domestic cats from a shelter of Vassouras city (RJ) were analyzed and 36 (97.3%) were considered positive by polymerase chain reaction (PCR). The indirect immunofluorescence test assay (IFA) revealed 9 (25.0%) and 27 (75.0%) of that PCR positive samples showed, respectively, reaction and absence of reaction to IFA. Only one sample (2.7%) was negative in PCR and IFA. This is the first communication of Bartonella spp. infection in domestic cats in Rio de Janeiro State (Brazil) identified by molecular and serological assays, thus it can be concluded that this zoonotic agent is present in high frequencies in domestic cats from Vassouras city (RJ).