Bartonellosis pathophysiology: Difference between revisions
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Revision as of 21:05, 11 December 2012
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Bartonellosis Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Pathophysiology
Humans acquire it through flea or tick bites from infected dogs, cats, coyotes, foxes, and humans.[1] Once bitten the victim develops a localized infection. The first sign of infection is a raised skin papule which resolves on its own. As the illness progresses, symptoms including fatigue, headaches, memory loss, disorientation, insomnia, and loss of coordination develop. The bacteria blocks the normal immune response by suppressing the NF-κB apoptosis pathway.[2]Link Disease progression will be accelerated if the host is subsequently infected by an immunesuppressing virus such as Epstein Barr or XMRV and likewise, as the host's infectious load increases the immune system will be more prone to infection due to the weakening response.
In mammals, each Bartonella species is highly adapted to its reservoir host as the result of intracellular parasitism and can persist in the bloodstream of the host. Intraerythrocytic parasitism is only observed in the acute phase of Carrión´s disease. Bartonella also have a tropism for endothelial cells, observed in the chronic phase of Carrión´s disease (also known as Verruga Peruana) and bacillary angiomatosis. Pathological response can vary with the immune status of the host. Infection with Bartonella henselae can result in a focal suppurative reaction (CSD in immunocompetent patients), a multifocal angioproliferative response (bacillary angiomatosis in immunocompromised patients), endocarditis or meningitis.
Some of the diseases can resolve spontaneously without treatment.[3]
Microbiology
Members of the genus Bartonella are facultative intracellular bacteria, alpha 2 subgroup Proteobacteria. The genus comprises:
| Bartonella species | Reservoir | Disease |
|---|---|---|
| Bartonella bacilliformis | human | Carrion´s disease/Verruga peruana |
| Bartonella quintana | human | Trench fever, bacteremia, bacillary angiomatosis, endocarditis |
| Bartonella henselae | cats | Cat scratch disease, bacillary angiomatosis, bacteremia, endocarditis |
| Bartonella elizabethae | rats | Endocarditis |
| Bartonella grahamii | Retinitis | |
| Bartonella vinsoni | dogs | Endocarditis, bacteremia |
| Bartonella washonsis | rodents | Myocarditis |
| Bartonella clarridgiae | cats | Bacteremia |
| Bartonella rochalimae | human | Carrion's disease like syndrome |
References
- ↑ Breitschwerdt, EB. Bartonella sp. Bacteremia in Patients with Neurological and Neurocognitive Dysfunction. JOURNAL OF CLINICAL MICROBIOLOGY. Sept. 2008. 46(9): 2856–2861
- ↑ Faherty, CS. Staying alive: bacterial inhibition of apoptosis during infection. Trends in Microbiology (16:4). 175.
- ↑ Resto-Ruiz S, Burgess A, Anderson BE (2003). "The role of the host immune response in pathogenesis of Bartonella henselae". DNA Cell Biol. 22 (6): 431–40. doi:10.1089/104454903767650694. PMID 12906736. Unknown parameter
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