RESUMEN
We present the case of an HIV-positive patient who developed polymorphous lesions in which the evidence in the skin biopsy corresponds to the diagnosis of bacillary angiomatosis, and further tests proved the pathological agent involved in this case is not the usual Bartonella species, B. henselae and B. quintana, but B. elizabethae. As far as we know, this is the first case of bacillary angiomatosis secondary to this etiological agent.
Asunto(s)
Angiomatosis Bacilar/inmunología , Angiomatosis Bacilar/microbiología , Infecciones por Bartonella/inmunología , Infecciones por Bartonella/microbiología , Infecciones por VIH , Huésped Inmunocomprometido , Adulto , Bartonella , Humanos , MasculinoRESUMEN
Many mammals are established hosts for the vector borne bacterial genus, Bartonella. Small Indian mongooses (Herpestes auropunctatus) have only been reported as a possible host for Bartonella henselae in southern Japan. Confirming Bartonella presence in mongooses from other regions in the world may support their role as potential reservoirs of this human pathogen. Specifically, documenting Bartonella in Caribbean mongooses would identify a potential source of zoonotic risk with mongoose-human contact in the New World. Using serological and molecular techniques, we investigated B. henselae DNA and specific antibody prevalence in 171 mongooses from all six parishes in Grenada, West Indies. Almost a third (32.3%, 54/167) of the tested mongooses were B. henselae seropositive and extracted DNA from 18/51 (35.3%) blood pellets were PCR positive for the citrate synthase (gltA) and/or the ß subunit of RNA polymerase (rpoB) genes. All sequences were identical to B. henselae genotype I, as previously reported from Japan. This study confirms the role of small Indian mongooses as a natural reservoir of B. henselae in the New World.
Asunto(s)
Angiomatosis Bacilar/epidemiología , Bartonella henselae/aislamiento & purificación , Herpestidae/microbiología , Angiomatosis Bacilar/microbiología , Animales , Bartonella henselae/genética , Bartonella henselae/fisiología , Reservorios de Enfermedades/microbiología , Genotipo , Grenada/epidemiología , Zoonosis/epidemiología , Zoonosis/microbiologíaRESUMEN
Bartonella spp. constitute emerging pathogens of worldwide distribution. Bacillary angiomatosis is the most frequent skin manifestation of bartonelloses; nevertheless, B. henselae infection should always be considered systemic, especially in immunodeficient individuals. The authors report the case of an AIDS patient with bacillary angiomatosis, who had concurrent severe anemia, hepatitis, peritonitis, pleuritis, and pericarditis. Clinical manifestation, electronic microscopic examination of erythrocytes, and histopathology of a papule biopsy suggested a Bartonella sp. infection. Multiple genes were target by PCR and B. henselae DNA was amplified and sequenced (GenBank accession number EF196804) from the angiomatous papule. Treatment with clarithromycin resulted in resolution of the bacillary angiomatosis, fever, anemia, panserosites, and hepatitis.
Asunto(s)
Anemia/microbiología , Angiomatosis Bacilar/microbiología , Bartonella henselae/aislamiento & purificación , Infecciones por VIH/microbiología , Hepatitis/microbiología , Serositis/microbiología , Enfermedades de la Piel/microbiología , Infecciones Oportunistas Relacionadas con el SIDA/tratamiento farmacológico , Infecciones Oportunistas Relacionadas con el SIDA/microbiología , Infecciones Oportunistas Relacionadas con el SIDA/patología , Adulto , Anemia/tratamiento farmacológico , Anemia/patología , Angiomatosis Bacilar/tratamiento farmacológico , Angiomatosis Bacilar/patología , Antibacterianos/uso terapéutico , Bartonella henselae/genética , Secuencia de Bases , Claritromicina/uso terapéutico , ADN Bacteriano/análisis , Eritrocitos/microbiología , Eritrocitos/ultraestructura , Hepatitis/tratamiento farmacológico , Hepatitis/patología , Humanos , Huésped Inmunocomprometido , Masculino , Microscopía Electrónica de Transmisión/métodos , Datos de Secuencia Molecular , Serositis/tratamiento farmacológico , Serositis/patología , Enfermedades de la Piel/tratamiento farmacológico , Enfermedades de la Piel/patología , Resultado del TratamientoRESUMEN
The human bartonelloses are a group of diseases with a rapidly increasing clinical spectrum. Well known manifestations such as Carrion's disease, trench fever, cat-scratch disease, and bacillary angiomatosis are examples of Bartonella sp. infection. Along with these diseases, recurrent bacteremia, endocarditis, septicemia, erythema nodosum, erythema multiforme, trombocytopenic purpura and other syndromes have been reported having been caused by bacteria of this genus. The infectious process and the pathogenesis of these microorganisms are poorly understood. The bartonelloses may have a benign and self-limited evolution in a host, or a potentially fatal one. These bacteria can provoke a granulomatous or an angioproliferative histopathologic response. As these diseases are not yet well defined, we have reviewed the four main human bartonelloses and have examined unclear points about these emergent diseases.
Asunto(s)
Infecciones por Bartonella/microbiología , Bartonella/clasificación , Angiomatosis Bacilar/diagnóstico , Angiomatosis Bacilar/microbiología , Angiomatosis Bacilar/transmisión , Animales , Bartonella/patogenicidad , Infecciones por Bartonella/patología , Infecciones por Bartonella/transmisión , Enfermedad por Rasguño de Gato/diagnóstico , Enfermedad por Rasguño de Gato/microbiología , Enfermedad por Rasguño de Gato/transmisión , Gatos , Humanos , Huésped Inmunocomprometido , Fiebre de las Trincheras/diagnóstico , Fiebre de las Trincheras/microbiología , Fiebre de las Trincheras/transmisiónRESUMEN
The human bartonelloses are a group of diseases with a rapidly increasing clinical spectrum. Well known manifestations such as Carrion's disease, trench fever, cat-scratch disease, and bacillary angiomatosis are examples of Bartonella spp. infection. Along with these diseases, recurrent bacteremia, endocarditis, septicemia, erythema nodosum, erythema multiforme, trombocytopenic purpura and other syndromes have been reported having been caused by bacteria of this genus. The infectious process and the pathogenesis of these microorganisms are poorly understood. The bartonelloses may have a benign and self-limited evolution in a host, or a potentially fatal one. These bacteria can provoke a granulomatous or an angioproliferative histopathologic response. As these diseases are not yet well defined, we have reviewed the four main human bartonelloses and have examined unclear points about these emergent diseases
Asunto(s)
Animales , Gatos , Humanos , Infecciones por Bartonella/microbiología , Bartonella/clasificación , Angiomatosis Bacilar/diagnóstico , Angiomatosis Bacilar/microbiología , Angiomatosis Bacilar/transmisión , Infecciones por Bartonella/patología , Infecciones por Bartonella/transmisión , Bartonella/patogenicidad , Enfermedad por Rasguño de Gato/diagnóstico , Enfermedad por Rasguño de Gato/microbiología , Enfermedad por Rasguño de Gato/transmisión , Huésped Inmunocomprometido , Fiebre de las Trincheras/diagnóstico , Fiebre de las Trincheras/microbiología , Fiebre de las Trincheras/transmisiónAsunto(s)
Infecciones por Bartonella , Enfermedades Cutáneas Bacterianas , Angiomatosis Bacilar/microbiología , Angiomatosis Bacilar/patología , Infecciones por Bartonella/inmunología , Infecciones por Bartonella/microbiología , Infecciones por Bartonella/patología , Enfermedad por Rasguño de Gato/microbiología , Enfermedad por Rasguño de Gato/patología , Humanos , Enfermedades Cutáneas Bacterianas/inmunología , Enfermedades Cutáneas Bacterianas/microbiología , Enfermedades Cutáneas Bacterianas/patología , Fiebre de las Trincheras/microbiología , Fiebre de las Trincheras/patologíaRESUMEN
Human bartonelloses are a group of illnesses of poorly understood pathogenesis. Bartonella henselae is one of the most studied bacterium of its genus. The objective of this study was to observe whether passages of these bacteria, in vivo, would determine ultrastructural changes in them. For this purpose, isogenic mice were inoculated with a standard strain of B. henselae (I). These were initially retrieved from genetically immunodeficient animals (II) and then inoculated in immunocompetent ones. The bacterial colonies obtained (III) were compared, by transmission electron microscopy, with colonies I and II. Loss of fimbriae and an abundant bleb formation were the most common morphological changes found in colony III. Also, on day 6 postinfection, the main histological abnormalities were the endothelial proliferation presented in immunodeficient animals and the incipient granulomata reaction found in one of the immunocompetent inoculated mice, which died spontaneously. These features agree with the Bartonella human disease clinical and histological observations. This study demonstrates that B. henselae in vivo passages induce significant morphological changes in the bacteria and that these abnormalities could explain their seemingly greater virulence. Most of these observations have not been previously described. Thus, further studies on the Bartonella species pathogenesis should consider these data.
Asunto(s)
Angiomatosis Bacilar/inmunología , Angiomatosis Bacilar/microbiología , Bartonella henselae/patogenicidad , Bartonella henselae/ultraestructura , Angiomatosis Bacilar/patología , Animales , Femenino , Huésped Inmunocomprometido , Ratones , Ratones Endogámicos BALB C , Microscopía ElectrónicaRESUMEN
Infections with organisms of the genus Bartonella, for many years important only in South and Central America, have assumed significance in developing countries, especially in conjunction with the advent of the pandemic of the human immunodeficiency virus infection. New molecular and culture techniques have determined that these organisms cause new diseases such as bacillary angiomatosis as well as diseases the etiology of which have been unknown such as cat scratch disease. In this article, the microbiology, pathogenesis, histopathology and clinical manifestations of diseases caused by these organisms are discussed.
Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/microbiología , Angiomatosis Bacilar/microbiología , Infecciones por Bartonella/microbiología , Bartonella/aislamiento & purificación , Enfermedad por Rasguño de Gato/microbiología , Fiebre de las Trincheras/microbiología , Infecciones Oportunistas Relacionadas con el SIDA/epidemiología , Infecciones Oportunistas Relacionadas con el SIDA/patología , Adulto , Angiomatosis Bacilar/epidemiología , Angiomatosis Bacilar/patología , Animales , Infecciones por Bartonella/epidemiología , Infecciones por Bartonella/patología , Enfermedad por Rasguño de Gato/epidemiología , Enfermedad por Rasguño de Gato/patología , Gatos , América Central/epidemiología , Diagnóstico Diferencial , Humanos , Incidencia , Masculino , Factores de Riesgo , América del Sur/epidemiología , Fiebre de las Trincheras/epidemiología , Fiebre de las Trincheras/patologíaRESUMEN
Bacillary angiomatosis is known to be caused by a rickettsial organism; Rochalimaea henselae. This causative agent has been compared with different microorganisms and clinical conditions that appear in similar settings but that have been clearly differentiated from them; e.i. Cat-scratch disease (Afipia felis), Bartonella bacilliformis, other Rochalimaea sp., Kaposi;s sarcoma, Lobular capillary hemangioma, Angiosarcoma, and Epithelioid hemangioma. Clinically the bacillary angiomatosis (BA) skin lesions vary from a single lesion to thousands. The cutaneous lesion appears as a bright-red round papule, subcutaneous nodule, or as a cellulitic plaque. When the lesion is biopsied it tends to blanch-out, bleed, and cause pain. The patient might present with signs and symptoms of chills, headaches, fever, malaise, and anorexia with or without weight loss. The extracutaneous lesions found in BA tend to be from multiple organs affecting from the oral lesions to anal mucosal lesions to widespread visceral lesions. The sites of preferences for BA lesion manifestation tend to be the liver, spleen, lymph nodes, and bone. To diagnose bacillary angiomatosis the physician should prepare a differential diagnosis based primarily on its histopathological and clinical characteristics. To confirm the results from the stain, electron microscopy can identify the bacillus and pin-point the diagnosis of bacillary angiomatosis. The lesions presented by BA respond well to therapy with erythromycin 500mg four times daily for a duration of 2 weeks to 2 months. In case of intolerance to erythromycin the second line of drug that successfully treats the BA bacillus is doxycycline. If relapses of the BA lesion recur, then a prolonged antibiotic therapy is necessary and in AIDS patients the duration may be extended as life-long suppressive therapy
Asunto(s)
Humanos , Angiomatosis Bacilar , Angiomatosis Bacilar/diagnóstico , Angiomatosis Bacilar/microbiología , Angiomatosis Bacilar/terapiaRESUMEN
Bacillary angiomatosis is known to be caused by a rickettsial organism; Rochalimaea henselae. This causative agent has been compared with different microorganisms and clinical conditions that appear in similar settings but that have been clearly differentiated from them; e.i. Cat-scratch disease (Afipia felis), Bartonella bacilliformis, other Rochalimaea sp., Kaposi;s sarcoma, Lobular capillary hemangioma, Angiosarcoma, and Epithelioid hemangioma. Clinically the bacillary angiomatosis (BA) skin lesions vary from a single lesion to thousands. The cutaneous lesion appears as a bright-red round papule, subcutaneous nodule, or as a cellulitic plaque. When the lesion is biopsied it tends to blanch-out, bleed, and cause pain. The patient might present with signs and symptoms of chills, headaches, fever, malaise, and anorexia with or without weight loss. The extracutaneous lesions found in BA tend to be from multiple organs affecting from the oral lesions to anal mucosal lesions to widespread visceral lesions. The sites of preferences for BA lesion manifestation tend to be the liver, spleen, lymph nodes, and bone. To diagnose bacillary angiomatosis the physician should prepare a differential diagnosis based primarily on its histopathological and clinical characteristics. To confirm the results from the stain, electron microscopy can identify the bacillus and pin-point the diagnosis of bacillary angiomatosis. The lesions presented by BA respond well to therapy with erythromycin 500mg four times daily for a duration of 2 weeks to 2 months. In case of intolerance to erythromycin the second line of drug that successfully treats the BA bacillus is doxycycline. If relapses of the BA lesion recur, then a prolonged antibiotic therapy is necessary and in AIDS patients the duration may be extended as life-long suppressive therapy.
Asunto(s)
Angiomatosis Bacilar , Angiomatosis Bacilar/diagnóstico , Angiomatosis Bacilar/microbiología , Angiomatosis Bacilar/terapia , HumanosRESUMEN
Bacillary angiomatosis is a recently recognized bacterial infectious disease that is seen mainly in patients with the acquired immunodeficiency syndrome. Including this publication, 45 patients have been described in the medical literature. In this report we describe examples of the clinical presentations of bacillary angiomatosis and review therapeutic strategies.