RESUMO
BACKGROUND: Bartonellosis is a zoonotic infectious disease of worldwide distribution, caused by an expanding number of recently discovered Bartonella spp. OBJECTIVES: This review serves as an update on comparative medical aspects of this disease, including the epidemiology, pathogenesis, clinical diagnosis, treatment and challenges. RESULTS: Of comparative medical importance, Bartonella spp. are transmitted by several arthropod vectors, including fleas, keds, lice, sand flies, ticks and, potentially, mites and spiders. Prior to 1990, there was only one named Bartonella species (B. bacilliformis), whereas there are now over 36, of which 17 have been associated with an expanding spectrum of animal and human diseases. Recent advances in diagnostic techniques have facilitated documentation of chronic bloodstream and dermatological infections with Bartonella spp. in healthy and sick animals, in human blood donors, and in immunocompetent and immunocompromised human patients. The field of Bartonella research remains in its infancy and is rich in questions, for which patient relevant answers are badly needed. Directed Bartonella research could substantially reduce a spectrum of chronic and debilitating animal and human diseases, and thereby reduce suffering throughout the world. CONCLUSION: A One Health approach to this emerging infectious disease is clearly needed to define disease manifestations, to establish the comparative infectious disease pathogenesis of this stealth pathogen, to validate effective treatment regimens and to prevent zoonotic disease transmission.
Assuntos
Infecções por Bartonella/etiologia , Animais , Bartonella , Infecções por Bartonella/diagnóstico , Infecções por Bartonella/terapia , Infecções por Bartonella/veterinária , Doenças Transmissíveis Emergentes/diagnóstico , Doenças Transmissíveis Emergentes/terapia , Doenças Transmissíveis Emergentes/veterinária , Humanos , Zoonoses/diagnóstico , Zoonoses/microbiologia , Zoonoses/terapia , Zoonoses/transmissãoRESUMO
Errors in urachal obliteration may result in 4 clinical anomalies: patent urachus, urachal cyst, urachal sinus, or vesicourachal diverticulum. Despite the fact that urachal cysts are one of the more common of these anomalies, most go undetected, presenting in the setting of infection. There are reports in the literature of cysts misdiagnosed as other inflammatory processes; however, the converse is reported with less frequency. We present the case of a 3-year-old girl who was admitted to our institution with a suspected urachal cyst. This was subsequently diagnosed as a granulomatous mass caused by the gram negative bacterium Bartonella.
Assuntos
Infecções por Bartonella/diagnóstico , Bartonella/isolamento & purificação , Granuloma/diagnóstico , Cisto do Úraco/diagnóstico , Úraco/anormalidades , Dor Abdominal/diagnóstico , Dor Abdominal/etiologia , Antibacterianos/uso terapêutico , Infecções por Bartonella/terapia , Pré-Escolar , Diagnóstico Diferencial , Feminino , Seguimentos , Granuloma/terapia , Humanos , Laparotomia/métodos , Medição de Risco , Resultado do TratamentoRESUMO
PRACTICAL RELEVANCE: Bartonellae are small, vector-transmitted Gram-negative intracellular bacteria that are well adapted to one or more mammalian reservoir hosts. Cats are the natural reservoir for Bartonella henselae, which is a (re-)emerging bacterial pathogen. It can cause cat scratch disease in humans and, in immunocompromised people, may lead to severe systemic diseases, such as bacillary angiomatosis. Cats bacteraemic with B henselae constitute the main reservoir from which humans become infected. Most cats naturally infected with B henselae show no clinical signs themselves, but other Bartonella species for which cats are accidental hosts appear to have more pathogenicity. GLOBAL IMPORTANCE: Several studies have reported a prevalence of previous or current Bartonella species infection in cats of up to 36%. B henselae is common in cats worldwide, and bacteraemia can be documented by blood culture in about a quarter of healthy cats. The distribution of B henselae to various parts of the world has largely occurred through humans migrating with their pet cats. The pathogen is mainly transmitted from cat to cat by fleas, and the majority of infected cats derive from areas with high flea exposure. No significant difference in B henselae prevalence has been determined between male and female cats. In studies on both naturally and experimentally infected cats, chronic bacteraemia has mainly been found in cats under the age of 2 years, while those over 2 years of age are rarely chronically bacteraemic. EVIDENCE BASE: This article reviews published studies and case reports on bartonellosis to explore the clinical significance of the infection in cats and its impact on humans. The article also discusses possible treatment options for cats and means of minimising the zoonotic potential.
Assuntos
Infecções por Bartonella/veterinária , Doenças do Gato , Zoonoses , Animais , Infecções por Bartonella/diagnóstico , Infecções por Bartonella/microbiologia , Infecções por Bartonella/terapia , Infecções por Bartonella/transmissão , Doenças do Gato/diagnóstico , Doenças do Gato/microbiologia , Doenças do Gato/terapia , Doenças do Gato/transmissão , Gatos , Doença Crônica , Feminino , Humanos , MasculinoRESUMO
Bartonella spp. are a known cause of culture-negative endocarditis. We report a 42-year-old male with underlying surgically corrected congenital heart disease who was diagnosed with Bartonella henselae endocarditis involving the right-ventricle-to-pulmonary-artery conduit.
Assuntos
Infecções por Bartonella/diagnóstico , Bartonella henselae/isolamento & purificação , Endocardite Bacteriana/diagnóstico , Próteses Valvulares Cardíacas/efeitos adversos , Infecções Relacionadas à Prótese/diagnóstico , Adulto , Infecções por Bartonella/terapia , Endocardite Bacteriana/terapia , Próteses Valvulares Cardíacas/microbiologia , Implante de Prótese de Valva Cardíaca , Humanos , Masculino , Infecções Relacionadas à Prótese/terapia , Tetralogia de Fallot/cirurgiaRESUMO
Bartonella spp. are gram-negative bacteria localized in erythrocytes of vertebrate hosts. Genus Bartonella contains numerous recently described species, many of them are new and emerging arthropod-borne human pathogens. In addition to humans, Bartonella spp. have also been isolated from a variety of domesticated (cats, dogs) and wild animals (carnivores, ruminants, rodents), which play a key role as reservoir hosts for these pathogens. The infectious process and the pathogenesis of bartonellosis are still poorly understood. The present paper reviews the factors influencing Bartonella infections including a range of reservoir hosts and vectors, mechanism of phatogenesis, diagnostic methods for indentification Bartonella infections in humans and animals as well as the coinfection with Bartonella and other arthropod-borne pathogens.
Assuntos
Infecções por Bartonella/diagnóstico , Infecções por Bartonella/transmissão , Bartonella/classificação , Reservatórios de Doenças/microbiologia , Vetores de Doenças/classificação , Zoonoses/microbiologia , Animais , Bartonella/isolamento & purificação , Infecções por Bartonella/terapia , Humanos , Especificidade da EspécieRESUMO
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.
Assuntos
Infecções por Bartonella , Doença da Arranhadura de Gato , Infecções por Bartonella/diagnóstico , Infecções por Bartonella/terapia , Doença da Arranhadura de Gato/diagnóstico , Doença da Arranhadura de Gato/terapia , DNA Bacteriano/análise , Diagnóstico Diferencial , Humanos , Reação em Cadeia da Polimerase , Testes SorológicosRESUMO
Objetivos: Describir el tratamiento para infección por Bartonella bacilliformis, en Caraz, Ancash. Diseño: Estudio observacional, transversal y retrospectivo. Lugar: Caraz, Ancash, Perú. Pacientes: Quinientos dieciocho pacientes. Intervenciones: Recolección de datos, entre enero 2004 y marzo 2005, por medio de historias clínicas realizadas en el Hospital de Caraz. Principales medidas de resultados: Esquemas de tratamiento para infección por Bartonella bacilliformis. Resultados: Se registró 248 pacientes en fase aguda. En 215 (86,7 por ciento), se indicó cloramfenicol para su tratamiento y en todos ellos no se registró la dosis de carga de 50 mg/kg, por 3 días; 164 (66,1 por ciento) pacientes necesitaron una dosis de cloramfenicol superior a 25 mg/kg. En fase eruptiva, se registró 270 pacientes; en 260 (96,3 por ciento) se indicó rifampicina y 222 (82,2 por ciento) sobrepasaron los 21 días de duración de tratamiento con dicho antibiótico. Cloramfenicol obtuvoun 89 por ciento de eficacia en curación clínica y rifampicina, 93,1 por ciento. Conclusiones: En la población estudiada, existió una marcada tendencia a aumentar la dosis de cloramfenicol e incrementar el número de días de tratamiento con rifampicina, en fase aguda y eruptiva, respectivamente, de la Enfermedad de Carrión.
Objectives: To describe Bartonella bacilliformis' infection treatment, in Caraz, Ancash. Design: Observational, transverse and retrospective study. Setting: Caraz, Ancash, Peru. Patients: Five hundred and eighteen patients. Interventions: Study of clinical histories data from January 2004 through March 2005 at Caraz Hospital. Main outcome measures: Treatment outlines for Bartonella bacilliformis infection. Results: In the acute phase, 248 patients were registered; in 215 (86,7 per cent) chloramphenicol treatment was indicated but the 50 mg/kg loading dose by 3 days was not prescribed; 164 (66,1 per cent) patients needed a higher chloramphenicol dose of 25 mg/kg. In the eruptive phase, 270 patients were registered; in 260 (96,3 per cent) rifampicin was indicated and 222 (82,2 per cent) for more than the 21 treatment days suggested for this antibiotic. Clinical cure was obtained with chloramphenicol in 89 per cent and 93,1 per cent with rifampicin. Conclusions: In the population studied there was a tendency to increase both chloramphenicol dose and rifampicin number of treatment days respectively in the acute and eruptive phases of Carrion's disease.
Assuntos
Humanos , Masculino , Feminino , Antibacterianos/uso terapêutico , Bartonella bacilliformis , Infecções por Bartonella/terapia , Estudos Retrospectivos , Estudos Transversais , Estudos Observacionais como AssuntoRESUMO
Endocarditis caused by Bartonella species is difficult to diagnose and still remains a rare entity. Therefore, a young male patient undergoing aortic valve replacement for culture-negative endocarditis is reported in whom the diagnosis of a Bartonella quintana infection was made with a great delay postoperatively.
Assuntos
Infecções por Bartonella/diagnóstico , Infecções por Bartonella/etiologia , Endocardite Bacteriana/diagnóstico , Endocardite Bacteriana/etiologia , Próteses Valvulares Cardíacas/efeitos adversos , Infecções Relacionadas à Prótese/diagnóstico , Infecções Relacionadas à Prótese/etiologia , Adulto , Insuficiência da Valva Aórtica/cirurgia , Infecções por Bartonella/terapia , Bartonella quintana/isolamento & purificação , Endocardite Bacteriana/terapia , Humanos , Masculino , Infecções Relacionadas à Prótese/terapia , Doenças Raras/diagnóstico , Doenças Raras/etiologia , Doenças Raras/terapiaRESUMO
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.
Assuntos
Infecções por Bartonella , Animais , Infecções por Bartonella/diagnóstico , Infecções por Bartonella/terapia , Infecções por Bartonella/transmissão , Infecções por Bartonella/veterinária , HumanosRESUMO
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.
Assuntos
Infecções por Bartonella , Doenças Transmissíveis Emergentes , Animais , Infecções por Bartonella/diagnóstico , Infecções por Bartonella/epidemiologia , Infecções por Bartonella/terapia , Infecções por Bartonella/veterinária , Doenças Transmissíveis Emergentes/diagnóstico , Doenças Transmissíveis Emergentes/epidemiologia , Doenças Transmissíveis Emergentes/terapia , Doenças Transmissíveis Emergentes/veterinária , HumanosRESUMO
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.
Assuntos
Infecções por Bartonella/veterinária , Doenças do Gato/diagnóstico , Doenças do Gato/terapia , Doenças do Cão/diagnóstico , Animais , Infecções por Bartonella/diagnóstico , Infecções por Bartonella/terapia , Gatos , Doenças do Cão/terapia , CãesAssuntos
Infecções por Bartonella/diagnóstico , Infecções por Bartonella/microbiologia , Doenças Transmissíveis Emergentes/diagnóstico , Doenças Transmissíveis Emergentes/microbiologia , Antibacterianos/uso terapêutico , Bacteriemia/microbiologia , Infecções por Bartonella/epidemiologia , Infecções por Bartonella/terapia , Infecções por Bartonella/transmissão , Doenças Transmissíveis Emergentes/epidemiologia , Doenças Transmissíveis Emergentes/terapia , Doenças Transmissíveis Emergentes/transmissão , Diagnóstico Diferencial , Endocardite Bacteriana/microbiologia , Ensaio de Imunoadsorção Enzimática , Técnica Indireta de Fluorescência para Anticorpo , HumanosRESUMO
Se describe un brote importante de Carrión en la provincia de Antonio Raymondi, una zona muy alta de de la sierra de Ancash- Perú, en el período de enero a diciembre de 1998. Todos los pacientes fueron evaluados, los casos agudos diagnosticados con frotis sanguíneo y los eruptivos en base a la clínica. Se tuvo 71 casos de fase aguda y 121 casos de la fase eruptiva, siendo la localidad más afectada Chahuarcon (3500 msnm) perteneciente al distrito de Chingas. La mediana de la edad fue 8 años (9 meses a 60 años). En cuanto al sexo predominó el femenino. La mayor cantidad de casos se registró de la semana epidemiológica 21 al 42, siendo la semana 28 la que registró el pico máximo. La tasa de letalidad fue 5,6 por ciento (4/71).
Assuntos
Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Bartonella , Infecções por Bartonella/diagnóstico , Infecções por Bartonella/terapia , Psychodidae/parasitologiaRESUMO
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.
Assuntos
Infecções por Bartonella , Bartonella/classificação , Infecções por Bartonella/diagnóstico , Infecções por Bartonella/epidemiologia , Infecções por Bartonella/microbiologia , Infecções por Bartonella/terapia , HumanosRESUMO
La coloración de Wathin-Starry identifica con facilidad a la bartonella bacilliformis en los nódulos de verruga peruana. Los gérmenes se ven el intersticio, sobre la superficie de las células endoteliales proliferadas y, en casos, aparentemente incorporados en el seno de sus citoplasmas. Los microorganismos son abundantes en las lesiones incipientes y floridas, disminuyen considerablemente en las fases de regresión inicial y desaparecen en la fase de resolución avanzada. La Tinción de Warthin-Starry da resultados similares en los extendidos de bartonelosis en fase hemática.
Assuntos
Infecções por Bartonella/história , Infecções por Bartonella/terapia , Microscopia EletrônicaRESUMO
Se reporta un caso de Bartonelosis humana en fase eruptiva en una paciente de 12 años de edad que fue tratada con sultamicilina 25 mg/k/d. por vía oral más deflazacort 0.7 mg/k/d., ambos hasta completar 10 días, presentando rápida mejoría de los síntomas generales y remisión completa de las lesiones cutáneas a los 21 días. Se revisa además la fisiopatología de la angiogénesis y los posibles mecanismos relacionados a su inhibición por los corticoides.
Assuntos
Infecções por Bartonella/terapia , Neovascularização FisiológicaRESUMO
Por primera vez se presentó una epidemia grave de la fase aguda anemizante de la enfermedad de Carrión en el Valle Sagrado de los Incas. Por ello, entre abril y junio de 1998 se estudió en forma prospectiva un total de 26 pacientes afectados por dicha fase, quienes estuvieron internados en el Hospital Regional del Cuzco. Todos ellos fueron confirmados con frotis positivo para Bartonella bacilliformis; además 6 de ellos tuvieron cultivo positivo para Bartonella bacilliformis. La edad promedio fue de 20 años (rango 21 días a 65 años). De ellos el 54 por ciento (14/26) fueron menores de 14 años. La totalidad de los pacientes procedía del Valle Sagrado de los Incas: 12 de Urubamba, 8 de Calca, 5 de Quispicanchis y uno de Cuzco. El tiempo de enfermedad promedio fue de 8 días (rango 2-22 días). De los síntomas y signos destacan: taquicardia 100 por ciento, taquipnea 97 por ciento, malestar general 85 por ciento, fiebre 81 por ciento, visceromegalia 75 por ciento, cefalea 73 por ciento, anemia severa 71 por ciento, ictericia 62 por ciento, artralgias 46 por ciento, púrpura 40 por ciento, linfoadenomegalia 25 por ciento, compromiso neurológico 31 por ciento, shock al ingreso 15 por ciento, etc. El promedio de hematocrito fue de 18.9 por ciento (rango 9-40). El 77 por ciento (19/26) presentó leucocitosis > 10,000 cel/ml, plaquetopenia el 19 por ciento (5/26), la media del incremento de bilirrubinas fue de 8.7 mg por ciento. El 100 por ciento recibió algún antibiótico solo o combinado, 57 por ciento a base de cloramfenicol (CAF) más penicilina y el 19 por ciento sólo CAF. Además el 85 por ciento (22/26) recibió transfusión sanguínea (rango 1-10 unidades) y el 66 por ciento corticoides endovenosos. Durante la evolución algunos pacientes presentaron complicaciones: 6 convulsiones, 5 anasarca, 5 púrpura (petequias, epístaxis), 4 derrame pericárdico, 4 salmonellosis, 3 neumonía, 2 toxoplasmosis, 2 artritis, 2 meningismo, 1 neumonía por Neumocystis carinii, 1 herpes diseminado. El 77 por ciento (20/26) tuvo una evolución favorable y el 23 por ceinto (6/26) falleció. Se ha encontrado en casas rurales de Pisac, Calca y Ollantaytambo a la Lutzomyia peruensis, probable vector implicado en la transmisión del presente brote.