BARTONELLA
Concurrent Infection of the Central Nervous System by Borrelia burgdorferi and Bartonella henselae
Evidence for a Novel Tick-borne Disease Complex
(From the American Medical Association�s Archives of Neurology - Arch Neurol. 2001;58:1357-1363)Authors: Eugene Eskow, MD; Raja-Vemkitesh S. Rao, PhD; Eli Mordechai, PhD
Objectives:
To investigate Bartonella henselae as a potential human tick-borne pathogen and to evaluate its role as a coinfecting agent of the central nervous system in the presence of neuroborreliosis.Design Case report study.
Setting A primary health care center in Flemington, NJ, and the Department of Research and Development at Medical Diagnostic Laboratories LLC in Mt Laurel, NJ.Subjects:
Two male patients (aged 14 and 36 years) and 2 female patients (aged 15 and 30 years, respectively) with a history of tick bites and Lyme disease.Main Outcome Measures:
Laboratory and diagnostic findings before and after antimicrobial therapy.Results:
Patients residing in a Lyme-endemic area of New Jersey with ongoing symptoms attributed to chronic Lyme disease were evaluated for possible coinfection with Bartonella species. Elevated levels of B henselae�specific antibodies were found in these patients using the immunofluorescent assay. Bartonella henselae�specific DNA was detected in their blood. None of these patients exhibited the clinical characteristics of cat-scratch disease. Findings of cerebrospinal fluid analysis revealed the presence of both B henselae� and Borrelia burgdorferi�specific DNA. Bartonella henselae�specific DNA was also detected in live deer ticks obtained from the households of 2 of these patients.Conclusions:
Our data implicate B henselae as a potential human tick-borne pathogen. Patients with a history of neuroborreliosis who have incomplete resolution of symptoms should be evaluated for B henselae infection.
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