Bartonella species, disease expression and host immunity

Instructor

Edward Breitschwerdt, DVM
Melanie S. Steele Professor of Medicine and Infectious Diseases
Comparative Medicine Institute
NCSU College of Veterinary Medicine

Description

This module provides an overview of the major factors that influence disease expression resulting from Bartonella spp infection with particular attention to bacterial infection strategies and the histopathological progression of lesions observed in both immunocompetent and severely immunodeficient patients.

Learning objectives

1. List the major factors that influence disease expression after infection with a Bartonella species
2. List the strategies of frontal versus stealth pathogens
3. Describe the histopathological progression of lesions in individuals ranging from immunocompetence to severe immunodeficiency

This session, Bartonella species, disease expression and host immunity, is approved for 1.0 enduring AAFP Prescribed credit.

AAFP Prescribed credit is accepted by the American Medical Association as equivalent to AMA PRA Category 1 credit(s)™ toward the AMA Physician’s Recognition Award. When applying for the AMA PRA, Prescribed credit earned must be reported as Prescribed, not as Category 1.

The AAFP has reviewed One Health Medical Education for a Changing Climate and deemed it acceptable for AAFP credit. Term of approval is from 01/02/2024 to 01/01/2025. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Evidence-based bibliography for further study

Arvand, M. and Schäd, S.G., 2006. Isolation of Bartonella henselae DNA from the peripheral blood of a patient with cat scratch disease up to 4 months after the cat scratch injury. Journal of clinical microbiology, 44(6), pp.2288-2290. 

Breitschwerdt, E.B., Maggi, R.G., Duncan, A.W., Nicholson, W.L., Hegarty, B.C. and Woods, C.W., 2007. Bartonella species in blood of immunocompetent persons with animal and arthropod contact. Emerging infectious diseases, 13(6), p.938. 

Breitschwerdt, E.B., Maggi, R.G., Lantos, P.M., Woods, C.W., Hegarty, B.C. and Bradley, J.M., 2010. Bartonella vinsonii subsp. berkhoffii and Bartonella henselae bacteremia in a father and daughter with neurological disease. Parasites & vectors, 3(1), pp.1-9. 

Breitschwerdt, E.B., Mascarelli, P.E., Schweickert, L.A., Maggi, R.G., Hegarty, B.C., Bradley, J.M. and Woods, C.W., 2011. Hallucinations, sensory neuropathy, and peripheral visual deficits in a young woman infected with Bartonella koehlerae. Journal of clinical microbiology, 49(9), pp.3415-3417. 

Caniza, M.A., Granger, D.L., Wilson, K.H., Washington, M.K., Kordick, D.L., Frush, D.P. and Blitchington, R.B., 1995. Bartonella henselae: etiology of pulmonary nodules in a patient with depressed cell-mediated immunity. Clinical infectious diseases, 20(6), pp.1505-1511. 

Ericson, M., Balakrishnan, N., Mozayeni, B.R., Woods, C.W., Dencklau, J., Kelly, S. and Breitschwerdt, E.B., 2017. Culture, PCR, DNA sequencing, and second harmonic generation (SHG) visualization of Bartonella henselae from a surgically excised human femoral head. Clinical rheumatology, 36(7), pp.1669-1675. 

Giladi, M., Maman, E., Paran, D., Bickels, J., Comaneshter, D., Avidor, B., Varon‐Graidy, M., Ephros, M. and Wientroub, S., 2005. Cat‐scratch disease–associated arthropathy. Arthritis & Rheumatism, 52(11), pp.3611-3617. 

Kordick, D.L., Brown, T.T., Shin, K. and Breitschwerdt, E.B., 1999. Clinical and Pathologic Evaluation of ChronicBartonella henselae or Bartonella clarridgeiaeInfection in Cats. Journal of clinical microbiology, 37(5), pp.1536-1547. 

Maggi, R.G., Mozayeni, B.R., Pultorak, E.L., Hegarty, B.C., Bradley, J.M., Correa, M. and Breitschwerdt, E.B., 2012. Bartonella spp. bacteremia and rheumatic symptoms in patients from Lyme disease–endemic region. Emerging infectious diseases, 18(5), p.783.

Maggi, R.G., Ericson, M., Mascarelli, P.E., Bradley, J.M. and Breitschwerdt, E.B., 2013. Bartonella henselae bacteremia in a mother and son potentially associated with tick exposure. Parasites & vectors, 6(1), pp.1-9. 

Merrell, D.S. and Falkow, S., 2004. Frontal and stealth attack strategies in microbial pathogenesis. Nature, 430(6996), pp.250-256.

Païssé, S., Valle, C., Servant, F., Courtney, M., Burcelin, R., Amar, J. and Lelouvier, B., 2016. Comprehensive description of blood microbiome from healthy donors assessed by 16 S targeted metagenomic sequencing. Transfusion, 56(5), pp.1138-1147. 

Pitassi, L.H.U., de Paiva Diniz, P.P.V., Scorpio, D.G., Drummond, M.R., Lania, B.G., Barjas-Castro, M.L., Gilioli, R., Colombo, S., Sowy, S., Breitschwerdt, E.B. and Nicholson, W.L., 2015. Bartonella spp. bacteremia in blood donors from Campinas, Brazil. PLoS neglected tropical diseases, 9(1). 

Relman, D.A., Loutit, J.S., Schmidt, T.M., Falkow, S. and Tompkins, L.S., 1990. The agent of bacillary angiomatosis: an approach to the identification of uncultured pathogens. New England Journal of Medicine, 323(23), pp.1573-1580.