Urban trench fever presenting as culture-negative endocarditis

Jenkins, Nick; Ferguson, David J. P.; Alp, N; Harrison, Timothy G.; Bowler, I.C.J.W.

doi:10.1093/qjmed/hcn118

Cited by 6 publications

(3 citation statements)

References 9 publications

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“…We selected four representative species of Bartonella that have been associated with human disease and that are also phylogenetically diverse. B. henselae and B. quintana were extensively studied as pathogens accounting for the majority of Bartonella infections; both have been detected in cases of endocarditis (11,18,30). B. elizabethae was selected as it was originally isolated from a case of human infective endocarditis in North America (12).…”

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Combining Culture Techniques for Bartonella: the Best of Both Worlds

2011

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In this study we compared some common Bartonella culturing methodologies using four diverse species causing human illnesses. Based on a review of the literature, we focused on three major inconsistencies between protocols: base medium, cell coculture, and temperature. Our data showed that Bartonella tamiae demonstrated temperature-dependent growth limitations between common culturing conditions only 2°C apart. Additionally, growth of B. quintana was significantly enhanced by the presence of mammalian cell coculture under mammalian cell culture conditions; however, when the medium was modified to incorporate insect cell culture-based medium, coculturing with mammalian cells was no longer needed. In this study, we were able to overcome these temperature-and cell-dependent limitations and accommodate all of the strains tested by combining mammalian cell culture-based medium with insect cell culture-based medium.Bartonella is a genus of Gram-negative, facultative intracellular bacteria that have been detected in a plethora of insect and mammalian hosts (5,14,19,25). Numerous Bartonella species have been associated with clinical illnesses ranging from mild skin lesions to more severe manifestations, including persistent fevers, neurological symptoms, and endocarditis (6, 10). These bacteria can be fastidious under current laboratory conditions, and attempts to isolate cells from pure culture of biological specimens are often unsuccessful, despite positive molecular detection (1, 7).The majority of culturing methods for Bartonella species found in the literature focus on growth requirements for the two species commonly associated with human infection, Bartonella henselae and B. quintana (3,9,22,27,35). Through a review of the literature on methods for Bartonella isolation from biological samples, we found many differences in the culturing protocols. To summarize, most laboratories use cocultivation with mammalian cells or an axenic, insect cell culture-based medium or plating onto blood-supplemented agar (15,24). The mammalian cell coculture and insect cell culturebased medium are usually used for enrichment before plating of samples on agar. Of particular interest is the variability between the cell culture systems, as this method is traditionally considered to be the most successful for the initial isolation of Bartonella species (22,23,27,31). We focused our comparison on the protocols of three prominent laboratories that commonly culture Bartonella spp. and found the major differences to be localized to three main variables: (i) medium base (RPMI, medium 199 [M199], or Dulbecco modified Eagle medium [DMEM]), (ii) mammalian cell line (bovine endothelial, human endothelial, primate epithelial), and (iii) culturing temperature (35°C, 37°C).In 2005, a cell-free, liquid medium called Bartonella alphaproteobacteria growth medium (BAPGM) was developed to detect Bartonella in veterinary and human blood samples (28). It is a modified formulation of liquid medium designed to support insect cells. This medium required sheep ...

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Combining Culture Techniques for Bartonella: the Best of Both Worlds

2011

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“…The cat-scratch disease, which is mainly caused by B. henselae , has been described as the most common Bartonella infection in humans worldwide (13). B. quintana infection was described during World War I, leading to trench or quintana fever (13), and there have been recent reports of urban trench fever (14,15). The symptoms of Bartonella infection include fever, fatigue, insomnia, joint pain, headache, weight loss, cardiac arrhythmias, and muscle pain (16).…”

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“…Serological tests are still helpful for diagnosis, but serum cross-reactivity between Bartonella , Chlamydia , and Coxiella species may interfere with the diagnosis and choice of treatment (6,20). Thus, molecular techniques such as PCR may be critical in providing a faster and more specific diagnosis of the disease (15,22). More recently, a multiplex PCR assay was developed to detect more than 20 different known and some unknown Bartonella species in both clinical and environmental samples (23).…”

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Association of Bartonella spp bacteremia with Chagas cardiomyopathy, endocarditis and arrythmias in patients from South America

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Verzola

et al. 2012

Braz J Med Biol Res

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Infection with Bartonella spp may cause cardiac arrhythmias, myocarditis and endocarditis in humans. The aim of the present study was to evaluate a possible association between Bartonella spp bacteremia and endocarditis, arrhythmia and Chagas cardiomyopathy in patients from Brazil and Argentina. We screened for the presence of bacterial 16S rRNA in human blood by PCR using oligonucleotides to amplify a 185-bp bacterial DNA fragment. Blood samples were taken from four groups of subjects in Brazil and Argentina: i) control patients without clinical disease, ii) patients with negative blood-culture endocarditis, iii) patients with arrhythmias, and iv) patients with chronic Chagas cardiomyopathy. PCR products were analyzed on 1.5% agarose gel to visualize the 185-bp fragment and then sequenced to confirm the identity of DNA. Sixty of 148 patients (40.5%) with cardiac disease and 1 of 56 subjects (1.8%) from the control group presented positive PCR amplification for Bartonella spp, suggesting a positive association of the bacteria with these diseases. Separate analysis of the four groups showed that the risk of a Brazilian patient with endocarditis being infected with Bartonella was 22 times higher than in the controls. In arrhythmic patients, the prevalence of infection was 45 times higher when compared to the same controls and 40 times higher for patients with Chagas cardiomyopathy. To the best of our knowledge this is the first report of the association between Bartonella spp bacteremia and Chagas disease. The present data may be useful for epidemiological and prevention studies in Brazil and Argentina.

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