Bartonella is a genus of gram-negative bacteria Bacteria Bacteria are prokaryotic single-celled microorganisms that are metabolically active and divide by binary fission. Some of these organisms play a significant role in the pathogenesis of diseases. Bacteriology in the family Bartonellaceae. As a facultative intracellular Facultative intracellular Yersinia spp./Yersiniosis parasite, Bartonella can infect healthy people as well as act as an opportunistic pathogen Opportunistic pathogen Moraxella. Bartonella species are transmitted by vectors such as ticks Ticks Blood-sucking acarid parasites of the order ixodida comprising two families: the softbacked ticks (argasidae) and hardbacked ticks (ixodidae). Ticks are larger than their relatives, the mites. They penetrate the skin of their host by means of highly specialized, hooked mouth parts and feed on its blood. Ticks attack all groups of terrestrial vertebrates. In humans they are responsible for many tick-borne diseases, including the transmission of rocky mountain spotted fever; tularemia; babesiosis; african swine fever; and relapsing fever. Coxiella/Q Fever, fleas, sandflies, and mosquitoes. B. henselae is the most common of the 3 species known to cause human disease; it is a zoonosis that causes cat-scratch disease and bacillary angiomatosis Bacillary Angiomatosis A reactive vascular proliferation that is characterized by the multiple tumor-like lesions in skin, bone, brain, and other organs. Bacillary angiomatosis is caused by infection with gram-negative Bartonella bacilli (such as Bartonella henselae), and is often seen in AIDS patients and other immunocompromised hosts. AIDS-defining Conditions (BA). The other 2 species are human-specific: B. bacilliformis causes trench fever Fever Fever is defined as a measured body temperature of at least 38°C (100.4°F). Fever is caused by circulating endogenous and/or exogenous pyrogens that increase levels of prostaglandin E2 in the hypothalamus. Fever is commonly associated with chills, rigors, sweating, and flushing of the skin. Fever and BA, and B. quintana causes Oroya fever Fever Fever is defined as a measured body temperature of at least 38°C (100.4°F). Fever is caused by circulating endogenous and/or exogenous pyrogens that increase levels of prostaglandin E2 in the hypothalamus. Fever is commonly associated with chills, rigors, sweating, and flushing of the skin. Fever, verruga peruana, and Carrion’s disease.
Last updated: 10 Jun, 2021
Transmission electron micrographs showing morphology of Bartonella bacilliformis:
Scale
Scale
Dermatologic Examination bars represent 100 nm in panel A and 500 nm in panel B.
Pathogenesis of Bartonella:
Following transmission by an arthropod vector (a), the Bartonella
bacteria
Bacteria
Bacteria are prokaryotic single-celled microorganisms that are metabolically active and divide by binary fission. Some of these organisms play a significant role in the pathogenesis of diseases.
Bacteriology colonize the
skin
Skin
The skin, also referred to as the integumentary system, is the largest organ of the body. The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue.
Skin: Structure and Functions (b). The
bacteria
Bacteria
Bacteria are prokaryotic single-celled microorganisms that are metabolically active and divide by binary fission. Some of these organisms play a significant role in the pathogenesis of diseases.
Bacteriology are then transported to the vascular
endothelium
Endothelium
A layer of epithelium that lines the heart, blood vessels (vascular endothelium), lymph vessels (lymphatic endothelium), and the serous cavities of the body.
Arteries: Histology (c) and are seeded into the bloodstream to invade
erythrocytes
Erythrocytes
Erythrocytes, or red blood cells (RBCs), are the most abundant cells in the blood. While erythrocytes in the fetus are initially produced in the yolk sac then the liver, the bone marrow eventually becomes the main site of production.
Erythrocytes: Histology (d). After replication inside the RBC (e), the
bacteria
Bacteria
Bacteria are prokaryotic single-celled microorganisms that are metabolically active and divide by binary fission. Some of these organisms play a significant role in the pathogenesis of diseases.
Bacteriology persist in the intraerythrocytic niche (f), making them competent for transmission by another bloodsucking arthropod (g).
Bartonellosis in humans is caused by 3 main species of Bartonella bacteria Bacteria Bacteria are prokaryotic single-celled microorganisms that are metabolically active and divide by binary fission. Some of these organisms play a significant role in the pathogenesis of diseases. Bacteriology and produces a wide range of symptoms and diseases depending on the species and the immune state of the infected individual.
Species | Disease |
---|---|
B. bacilliformis |
Carrion’s disease, also known as:
|
B. quintana |
|
B. henselae |
|
Transmission:
Clinical presentation Presentation The position or orientation of the fetus at near term or during obstetric labor, determined by its relation to the spine of the mother and the birth canal. The normal position is a vertical, cephalic presentation with the fetal vertex flexed on the neck. Normal and Abnormal Labor:
Transmission:
Clinical presentation Presentation The position or orientation of the fetus at near term or during obstetric labor, determined by its relation to the spine of the mother and the birth canal. The normal position is a vertical, cephalic presentation with the fetal vertex flexed on the neck. Normal and Abnormal Labor:
Transmission:
Clinical presentation Presentation The position or orientation of the fetus at near term or during obstetric labor, determined by its relation to the spine of the mother and the birth canal. The normal position is a vertical, cephalic presentation with the fetal vertex flexed on the neck. Normal and Abnormal Labor:
Clinical
presentation
Presentation
The position or orientation of the fetus at near term or during obstetric labor, determined by its relation to the spine of the mother and the birth canal. The normal position is a vertical, cephalic presentation with the fetal vertex flexed on the neck.
Normal and Abnormal Labor of a patient with
bacillary angiomatosis
Bacillary Angiomatosis
A reactive vascular proliferation that is characterized by the multiple tumor-like lesions in skin, bone, brain, and other organs. Bacillary angiomatosis is caused by infection with gram-negative Bartonella bacilli (such as Bartonella henselae), and is often seen in AIDS patients and other immunocompromised hosts.
AIDS-defining Conditions:
A: Multiple red papules on the chest and abdomen
B: 2 nodules on the back
C: Papules on the face with a subcutaneous
mass
Mass
Three-dimensional lesion that occupies a space within the breast
Imaging of the Breast lesion over the left
zygomatic
Zygomatic
Either of a pair of bones that form the prominent part of the cheek and contribute to the orbit on each side of the skull.
Skull: Anatomy arch
Cat-scratch disease:
Active
skin
Skin
The skin, also referred to as the integumentary system, is the largest organ of the body. The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue.
Skin: Structure and Functions lesions, typically painless, are seen a few days to 2 weeks after inoculation in â…“ to â…” of
patients
Patients
Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures.
Clinician–Patient Relationship. Painful regional
lymphadenopathy
Lymphadenopathy
Lymphadenopathy is lymph node enlargement (> 1 cm) and is benign and self-limited in most patients. Etiologies include malignancy, infection, and autoimmune disorders, as well as iatrogenic causes such as the use of certain medications. Generalized lymphadenopathy often indicates underlying systemic disease.
Lymphadenopathy usually develops 1–3 weeks after inoculation.
Peripheral axillary lymphadenopathy Axillary Lymphadenopathy Lymphadenopathy in a 5-year-old child with cat-scratch disease
Image: “The significance of Bartonella henselae bacterias for oncological diagnosis in children” by Mazur-Melewska K, Jończyk-Potoczna K, Mania Mania A state of elevated excitement with over-activity sometimes accompanied with psychotic symptoms (e.g., psychomotor agitation, inflated self esteem and flight of ideas). It is often associated with mental disorders (e.g., cyclothymic disorder; and bipolar diseases). Bipolar Disorder A, Kemnitz P, Szydłowski J, Służewski W, Figlerowicz M. License: CC BY 4.0Histopathology,
silver stain
Silver stain
The use of silver, usually silver nitrate, as a reagent for producing contrast or coloration in tissue specimens.
Legionella/Legionellosis, and
PCR
PCR
Polymerase chain reaction (PCR) is a technique that amplifies DNA fragments exponentially for analysis. The process is highly specific, allowing for the targeting of specific genomic sequences, even with minuscule sample amounts. The PCR cycles multiple times through 3 phases: denaturation of the template DNA, annealing of a specific primer to the individual DNA strands, and synthesis/elongation of new DNA molecules.
Polymerase Chain Reaction (PCR) of cat scratch disease:
A: The affected
lymph
Lymph
The interstitial fluid that is in the lymphatic system.
Secondary Lymphatic Organs node shows
reactive follicular hyperplasia
Reactive follicular hyperplasia
Toxoplasma/Toxoplasmosis and multiple geographic microabscesses.
B: Numerous
neutrophils
Neutrophils
Granular leukocytes having a nucleus with three to five lobes connected by slender threads of chromatin, and cytoplasm containing fine inconspicuous granules and stainable by neutral dyes.
Innate Immunity: Phagocytes and Antigen Presentation are seen in the necrotic foci of the
lymph
Lymph
The interstitial fluid that is in the lymphatic system.
Secondary Lymphatic Organs node.
C: Some clumps of
bacteria
Bacteria
Bacteria are prokaryotic single-celled microorganisms that are metabolically active and divide by binary fission. Some of these organisms play a significant role in the pathogenesis of diseases.
Bacteriology are found in the
lymph
Lymph
The interstitial fluid that is in the lymphatic system.
Secondary Lymphatic Organs node (black
silver stain
Silver stain
The use of silver, usually silver nitrate, as a reagent for producing contrast or coloration in tissue specimens.
Legionella/Legionellosis).
D: Results of semi-nested
PCR
PCR
Polymerase chain reaction (PCR) is a technique that amplifies DNA fragments exponentially for analysis. The process is highly specific, allowing for the targeting of specific genomic sequences, even with minuscule sample amounts. The PCR cycles multiple times through 3 phases: denaturation of the template DNA, annealing of a specific primer to the individual DNA strands, and synthesis/elongation of new DNA molecules.
Polymerase Chain Reaction (PCR) for Bartonella henselae. Lanes 1 and 5 show the
DNA
DNA
A deoxyribonucleotide polymer that is the primary genetic material of all cells. Eukaryotic and prokaryotic organisms normally contain DNA in a double-stranded state, yet several important biological processes transiently involve single-stranded regions. DNA, which consists of a polysugar-phosphate backbone possessing projections of purines (adenine and guanine) and pyrimidines (thymine and cytosine), forms a double helix that is held together by hydrogen bonds between these purines and pyrimidines (adenine to thymine and guanine to cytosine).
DNA Types and Structure ladder marker; lane 2 shows a positive control, lane 3 a negative control, and lane 4
lymph
Lymph
The interstitial fluid that is in the lymphatic system.
Secondary Lymphatic Organs node tissue from the patient.
Histopathology specimen from a patient with
bacillary angiomatosis
Bacillary Angiomatosis
A reactive vascular proliferation that is characterized by the multiple tumor-like lesions in skin, bone, brain, and other organs. Bacillary angiomatosis is caused by infection with gram-negative Bartonella bacilli (such as Bartonella henselae), and is often seen in AIDS patients and other immunocompromised hosts.
AIDS-defining Conditions:
A dark-staining cluster of Bartonella quintana (indicated by an arrow) is revealed with Warthin-Starry staining of a tissue specimen.
Most cases of bartonellosis can be diagnosed through the detection of characteristic symptoms and physical findings and a complete medical history. Specialized laboratory tests are used to confirm the diagnosis.
Aside from supportive care, management is dependent on the specific species of Bartonella contracted and the severity of each case.