Abstract
BackgroundBartonella species comprise a group of zoonotic pathogens that are usually acquired by vector transmission or by animal bites or scratches.MethodsPCR targeting the Bartonella 16S-23S intergenic spacer (ITS) region was used in conjunction with BAPGM (Bartonella alpha Proteobacteria growth medium) enrichment blood culture to determine the infection status of the family members and to amplify DNA from spiders and woodlice. Antibody titers to B. vinsonii subsp. berkhoffii (Bvb) genotypes I-III, B. henselae (Bh) and B. koehlerae (Bk) were determined using an IFA test. Management of the medical problems reported by these patients was provided by their respective physicians.ResultsIn this investigation, immediately prior to the onset of symptoms two children in a family experienced puncture-like skin lesions after exposure to and presumptive bites from woodlouse hunter spiders. Shortly thereafter, the mother and both children developed hive-like lesions. Over the ensuing months, the youngest son was diagnosed with Guillain-Barre (GBS) syndrome followed by Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP). The older son developed intermittent disorientation and irritability, and the mother experienced fatigue, headaches, joint pain and memory loss. When tested approximately three years after the woodlouse hunter spider infestation, all three family members were Bartonella henselae seroreactive and B. henselae DNA was amplified and sequenced from blood, serum or Bartonella alpha-proteobacteria (BAPGM) enrichment blood cultures from the mother and oldest son. Also, B. henselae DNA was PCR amplified and sequenced from a woodlouse and from woodlouse hunter spiders collected adjacent to the family’s home.ConclusionsAlthough it was not possible to determine whether the family’s B. henselae infections were acquired by spider bites or whether the spiders and woodlice were merely accidental hosts, physicians should consider the possibility that B. henselae represents an antecedent infection for GBS, CIDP, and non-specific neurocognitive abnormalities.
Highlights
Bartonella species comprise a group of zoonotic pathogens that are usually acquired by vector transmission or by animal bites or scratches
In May 2010, as detailed in the case report below, the youngest son was diagnosed with Guillain-Barre syndrome (GBS), and subsequently with Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)
B. henselae DNA was amplified from two spiders collected 13 months apart, a woodlouse, and from serum, blood and Bartonella alpha proteobacteria growth medium (BAPGM) enrichment culture samples from two family members, these results should be interpreted with caution, as it is not clear whether Bartonella was acquired at the time of the infestation and spider bites or whether the spiders and woodlice are accidental hosts for Bartonella spp
Summary
Bartonella species comprise a group of zoonotic pathogens that are usually acquired by vector transmission or by animal bites or scratches. Bartonella species (spp.) are hemotropic, arthropod-borne bacteria that cause longterm bacteremia in mammalian reservoir hosts [1,2]. Since 1990, over thirty Bartonella species and subspecies have been characterized and named, with many other putative species yet to be described These bacteria reside in diverse ecological niches; many cause persistent intravascular infection in reservoir hosts and 17 Bartonella spp. have been associated with an expanding spectrum of human and animal diseases, ranging from acute febrile illnesses to more severe disease manifestations, including encephalopathy, endocarditis, myocarditis, sensory and motor neuropathies, pleural and pericardial effusion, pneumonia, granulomatous hepatitis and hemolytic anemia [3,4,5,6,7]. The natural history for seemingly all Bartonella spp. consists of one or more reservoir hosts and one or more transmission competent arthropod vectors. Genetic diversity and bacterial strain variability appear to enhance the ability of Bartonella spp. to infect specific reservoir hosts, and accidental hosts, as has been shown for B. henselae [11]
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