Bartonella quintana - MegaMicro

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Bartonella quintana

Micro > Bacteriology > Gram-negative bacteria > Gram-negative bacilli > Bartonella
 1.       Structure
a.        Bacteria: gram-negative, short rod-shaped
                                                  i.      Catalase and oxidase negative
                                                 ii.      Media/cell cultures: axenic media and cocultivated in cell culture
2.       Pathobiology:
a.        Infect erythrocytes, erythroblasts + tropism for endothelial cells
b.       Physiology: aerobic
c.        virulence factors
3.       Epidemiology
a.        Reservoir: Human Body
b.       Vectors: primary vector= Pediculus humanus variety corporis (aka human body louse)
 i.      Feed 5 times a day and inject their bites with biological proteins, including an anesthetic that provokes an allergic reaction and leads to scratching, which facilitates the fecal transmission of B. quintana, and persistent B. quintana bacteremia facilitates its spread by lice
  ii.      Possibly cats as well, not as well studied
c.        Risk Factors: poverty, alcoholism and homelessness
d.       Location: Infection has been seen on every continent except Antarctica
e.       History: This bacterium resulted in over 1 million soldiers in Europe during World War I being infected with trench fever. Now is a re-emerging pathogen in homeless populations in cities in US and Europe.
4.       Laboratory diagnosis
a.        Serological cultures or nucleic acid amplification techniques.
                                                  i.      To differentiate between different species: immunofluorescence assays
                                                 ii.      DNA hybridization
                                               iii.      Restriction fragment length polymorphisms
                                               iv.      C gene sequencing
5.       Disease manifestations
a.        Symptoms: acute onset of a febrile episode, relapsing febrile episodes, or as a persistent typhoidal illness; commonly seen are maculopapular rashes, conjunctivitis, headache, and myalgias, with splenomegaly being less common.
i.      Most patients present with pain in the lower legs (shins), sore muscles of the legs and back, and hyperesthesia of the shins. Rarely is B. Quintana infection fatal, unless endocarditis develops and goes untreated. Weight loss, and thrombocytopenia are sometimes also seen. Recovery can take up to a month.
ii.      Trench Fever: Primary infection. 1-3 days of sudden onset of headache, dizziness, pain in the shins, and elevated temperature. Then will recur every 4-6 days.
1.       Incubation period = 15-25 days
2.       Chronic bacteremia will develop in some patients (asymptomatic)
                                               iii.      Endocarditis: Chronic blood culture negative
1.       Fever and most require valve surgery
                                               iv.      Bacillary Aniomatosis
1.       proliferative vascular disease
                                                 v.      Lymphadenopathy
6.       Diagnostic methods
a.        None other than laboratory
7.       Differential diagnosis
a.        Bartonellosis is any type of disease caused by aerobicgenus of bacteria bartonella
b.       Differentiated from bacillary angiomatosis which is caused by same organism but seen in the immunocompromised therapy
8.        Prevention and control
a.        Treatment usually consists of a 4- to 6-week course of doxycycline, erythromycin, or azithromycin.
b.       Cleanliness
Key Words:
Pediculus humanus
Trench Fever
Doxycycline
Erythromycin
Azithromycin

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