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      Bartonella quintana Characteristics and Clinical Management

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          Abstract

          The pathogen is reemerging in the United States and Europe and is responsible for a number of clinical conditions.

          Abstract

          Bartonella quintana, a pathogen that is restricted to human hosts and louse vectors, was first characterized as the agent of trench fever. The disease was described in 1915 on the basis of natural and experimental infections in soldiers. It is now recognized as a reemerging pathogen among homeless populations in cities in the United States and Europe and is responsible for a wide spectrum of conditions, including chronic bacteremia, endocarditis, and bacillary angiomatosis. Diagnosis is based on serologic analysis, culture, and molecular biology. Recent characterization of its genome allowed the development of modern diagnosis and typing methods. Guidelines for the treatment of B. quintana infections are presented.

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          Recommendations for treatment of human infections caused by Bartonella species.

          J M Rolain, P Brouqui, J E Koehler … (2004)
          Article 0 comments Cited 127 times – based on 0 reviews     Review now
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            The body louse as a vector of reemerging human diseases.

            D Raoult, Ana V. Diez Roux (1999)
            The body louse, Pediculus humanus humanus, is a strict human parasite, living and multiplying in clothing. Louse infestation is associated with cold weather and a lack of hygiene. Three pathogenic bacteria are transmitted by the body louse. Borrelia recurrentis is a spirochete, the agent of relapsing fever, recently cultured on axenic medium. Historically, massive outbreaks have occurred in Eurasia and Africa, but currently the disease is found only in Ethiopia and neighboring countries. Bartonella quintana is now recognized as an agent of bacillary angiomatosis bacteremia, trench fever, endocarditis, and chronic lymphadenopathy among the homeless. Rickettsia prowazekii is the agent of epidemic typhus. The most recent outbreak (and the largest since World War II) was observed in Burundi. A small outbreak was also reported in Russia in 1997. Louse infestation appears to become more prevalent worldwide, associated with a decline in social and hygienic conditions provoked by civil unrest and economic instability.
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              The louse-borne human pathogen Bartonella quintana is a genomic derivative of the zoonotic agent Bartonella henselae.

              C. M. Alsmark, A Frank, E. Karlberg … (2004)
              We present the complete genomes of two human pathogens, Bartonella quintana (1,581,384 bp) and Bartonella henselae (1,931,047 bp). The two pathogens maintain several similarities in being transmitted by insect vectors, using mammalian reservoirs, infecting similar cell types (endothelial cells and erythrocytes) and causing vasculoproliferative changes in immunocompromised hosts. A primary difference between the two pathogens is their reservoir ecology. Whereas B. quintana is a specialist, using only the human as a reservoir, B. henselae is more promiscuous and is frequently isolated from both cats and humans. Genome comparison elucidated a high degree of overall similarity with major differences being B. henselae specific genomic islands coding for filamentous hemagglutinin, and evidence of extensive genome reduction in B. quintana, reminiscent of that found in Rickettsia prowazekii. Both genomes are reduced versions of chromosome I from the highly related pathogen Brucella melitensis. Flanked by two rRNA operons is a segment with similarity to genes located on chromosome II of B. melitensis, suggesting that it was acquired by integration of megareplicon DNA in a common ancestor of the two Bartonella species. Comparisons of the vector-host ecology of these organisms suggest that the utilization of host-restricted vectors is associated with accelerated rates of genome degradation and may explain why human pathogens transmitted by specialist vectors are outnumbered by zoonotic agents, which use vectors of broad host ranges.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Emerg Infect Dis
                Journal ID (iso-abbrev): Emerging Infect. Dis
                Journal ID (publisher-id): EID
                Title: Emerging Infectious Diseases
                Publisher: Centers for Disease Control and Prevention
                ISSN (Print): 1080-6040
                ISSN (Electronic): 1080-6059
                Publication date (Print): February 2006
                Volume: 12
                Issue: 2
                Pages: 217-223
                Affiliations
                [* ]Université de la Méditerranée, Marseille, France
                Author notes
                Address for correspondence: Didier Raoult, Unité des Rickettsies CNRS UMR 6020, Faculté de Médecine, Université de la Méditerranée, 27 Bd Jean Moulin, 13385 Marseille, CEDEX 05, France; fax: 33-4-91-83-03-90; email: didier.raoult@ 123456medecine.univ-mrs.fr
                Article
                Publisher ID: 05-0874
                DOI: 10.3201/eid1202.050874
                PMC ID: 3373112
                PubMed ID: 16494745
                SO-VID: 8ea69346-b0b1-4786-bacc-9bb977e617e7
                History
                Categories
                Subject: Synopsis
                Subject: Synopsis

                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: diagnosis,bartonella quintana,homeless,treatment,bacillary angiomatosis,bacteremia,endocarditis,trench fever
                Data availability:
                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: diagnosis, bartonella quintana, homeless, treatment, bacillary angiomatosis, bacteremia, endocarditis, trench fever

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