Co-infection with Anaplasma platys, Bartonella henselae and Candidatus Mycoplasma haematoparvum in a veterinarian

Abstract

BackgroundDuring a two year period, a 27-year-old female veterinarian experienced migraine headaches, seizures, including status epilepticus, and other neurological and neurocognitive abnormalities. Prior to and during her illness, she had been actively involved in hospital-based work treating domestic animals, primarily cats and dogs, in Grenada and Ireland and anatomical research requiring the dissection of wild animals (including lions, giraffe, rabbits, mongoose, and other animals), mostly in South Africa. The woman reported contact with fleas, ticks, lice, biting flies, mosquitoes, spiders and mites and had also been scratched or bitten by dogs, cats, birds, horses, reptiles, rabbits and rodents. Prior diagnostic testing resulted in findings that were inconclusive or within normal reference ranges and no etiological diagnosis had been obtained to explain the patient’s symptoms.MethodsPCR assays targeting Anaplasma spp. Bartonella spp. and hemotopic Mycoplasma spp. were used to test patient blood samples. PCR positive amplicons were sequenced directly and compared to GenBank sequences. In addition, Bartonella alpha Proteobacteria growth medium (BAPGM) enrichment blood culture was used to facilitate bacterial growth and Bartonella spp. serology was performed by indirect fluorescent antibody testing.ResultsAnaplasma platys, Bartonella henselae and Candidatus Mycoplasma haematoparvum DNA was amplified and sequenced from the woman’s blood, serum or blood culture samples. Her serum was variably seroreactive to several Bartonella sp. antigens. Despite symptomatic improvement, six months of doxycycline most likely failed to eliminate the B. henselae infection, whereas A. platys and Candidatus M. haematoparvum DNA was no longer amplified from post-treatment samples.ConclusionsAs is typical of many veterinary professionals, this individual had frequent exposure to arthropod vectors and near daily contact with persistently bacteremic reservoir hosts, including cats, the primary reservoir host for B. henselae, and dogs, the presumed primary reservoir host for A. platys and Candidatus Mycoplasma haematoparvum. Physicians caring for veterinarians should be aware of the occupational zoonotic risks associated with the daily activities of these animal health professionals.

Occurrence of Mycoplasma haemocanis in dogs infested by ticks in Campo Grande, Mato Grosso do Sul, Brazil

“…Although contact with saliva was not confirmed as a risk factor for infection, a study by Sazaki et al (2008) showed that dogs of the Tosa breed, which are usually known as fighting dogs, are more prone to infection in Japan. Maggi et al (2013) Immunosuppression and weakness caused by other concomitant diseases have been identified as important factors that favor infection by these agents (PRYOR & BRADBURY, 1975;KRAKOWKA, 1977;GRETILLAT, 1981;NOVACCO et al, 2010;ROURA et al, 2010). In Brazil, coinfections by M. haemocanis and other tick-borne pathogens in dogs have also been reported (TRAPP et al, 2006;RAMOS et al, 2010).…”

“…ticks, fleas, lice, mites, flies and mosquitoes) have been identified as vectors of numerous species of hemoplasmas in different vertebrate hosts (Table 1). Most of them are known to infest different species and represent a possible interspecific transmission vector, as probably occurred in animal-origin human mycoplasmosis (SANTOS et al, 2008;MAGGI et al, 2013). Therefore, it is mandatory to investigate the vector competence of other arthropods in relation to hemotropic mycoplasmas transmission to dogs, since the importance of the R. sanguineus tick remains unclear.…”

Detección molecular de Rickettsia massiliae y Anaplasma platys en garrapatas Rhipicephalus sanguineus y caninos domésticos del municipio de Bahía Blanca (Argentina)

“…En el caso de A. platys, en Venezuela se ha identificado la presencia de mórulas compatibles en el citoplasma de plaquetas de pacientes con seropositividad al virus de la inmunodeficiencia humana 38 y también se detectó mediante RPC en un veterinario con síndrome febril y co-morbilidades 39 . Sin embargo, se necesitan estudios complementarios para confirmar su rol como agente zoonótico.…”

It shouldn’t happen to a dog … or a veterinarian: clinical paradigms for canine vector-borne diseases

“…For example, co-infection of a female veterinarian by Bartonella henselae, Anaplasma platys, and Candidatus Mycoplasma haematoparvum was reported recently and, importantly in this context, the latter two organisms were known previously to only infect dogs [62]. The emergence of infectious viral hepatitis and HIV resulted in the universal adoption of comprehensive protective practices within the human medical community [63]; maybe this case should serve as a reminder that there is much to understand about risks to veterinarians, and this paradigm calls for a cultural change in work practices and attitudes in regard to vector-borne infections [61].…”