Abstract
BackgroundBartonella vinsonii subsp. berkhoffii is an important, emerging, intravascular bacterial pathogen that has been recently isolated from immunocompetent patients with endocarditis, arthritis, neurological disease and vasoproliferative neoplasia. Vector transmission is suspected among dogs and wild canines, which are the primary reservoir hosts. This investigation was initiated to determine if pets and family members were infected with one or more Bartonella species.MethodsPCR and enrichment blood culture in Bartonella alpha Proteobacteria growth medium (BAPGM) was used to determine infection status. Antibody titers to B. vinsonii subsp. berkhoffii genotypes I-III and B. henselae were determined using a previously described indirect fluorescent antibody test. Two patients were tested sequentially for over a year to assess the response to antibiotic treatment.ResultsIntravascular infection with B. vinsonii subsp. berkhoffii genotype II and Bartonella henselae (Houston 1 strain) were confirmed in a veterinarian and his daughter by enrichment blood culture, followed by PCR and DNA sequencing. Symptoms included progressive weight loss, muscle weakness, lack of coordination (the father) and headaches, muscle pain and insomnia (the daughter). B. vinsonii subsp. berkhoffii genotype II was also sequenced from a cerebrospinal fluid BAPGM enrichment culture and from a periodontal swab sample. After repeated courses of antibiotics, post-treatment blood cultures were negative, there was a decremental decrease in antibody titers to non-detectable levels and symptoms resolved in both patients.ConclusionsB. vinsonii subsp. berkhoffii and B. henselae are zoonotic pathogens that can be isolated from the blood of immunocompetent family members with arthralgias, fatigue and neurological symptoms. Therapeutic elimination of Bartonella spp. infections can be challenging, and follow-up testing is recommended. An increasing number of arthropod vectors, including biting flies, fleas, keds, lice, sandflies and ticks have been confirmed or are suspected as the primary mode of transmission of Bartonella species among animal populations and may also pose a risk to human beings.
Highlights
Bartonella vinsonii subsp. berkhoffii is an important, emerging, intravascular bacterial pathogen that has been recently isolated from immunocompetent patients with endocarditis, arthritis, neurological disease and vasoproliferative neoplasia
In contrast to the canine reservoir for B. vinsonii subsp. berkhoffii, domestic and wild felids represent the primary reservoir in nature for Bartonella henselae, an organism transmitted among cats by fleas (Ctenocephalides felis); a factor that contributes to a worldwide distribution for this Bartonella sp. [1,2]
He was initially evaluated by a neurologist, and because of his exposure to zoonotic pathogens he was referred for infectious disease evaluation
Summary
Bartonella vinsonii subsp. berkhoffii is an important, emerging, intravascular bacterial pathogen that has been recently isolated from immunocompetent patients with endocarditis, arthritis, neurological disease and vasoproliferative neoplasia. Vector transmission is suspected among dogs and wild canines, which are the primary reservoir hosts. This investigation was initiated to determine if pets and family members were infected with one or more Bartonella species. In contrast to the canine reservoir for B. vinsonii subsp. Berkhoffii, domestic and wild felids represent the primary reservoir in nature for Bartonella henselae, an organism transmitted among cats by fleas (Ctenocephalides felis); a factor that contributes to a worldwide distribution for this Bartonella sp. Berkhoffii in canines and B. henselae in felines, both of these two bacterial species can be pathogenic in both cats and dogs Despite what seems to be exceptional evolutionary adaptation of B. vinsonii subsp. berkhoffii in canines and B. henselae in felines, both of these two bacterial species can be pathogenic in both cats and dogs
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