Bartonella bacilliformis

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Bartonella bacilliformis
Scientific classification Red Pencil Icon.png
Domain: Bacteria
Phylum: Proteobacteria
Class: Alphaproteobacteria
Order: Rhizobiales
Family: Bartonellaceae
Genus: Bartonella
Species:
B. bacilliformis
Binomial name
Bartonella bacilliformis
(Strong et al. 1913) Strong et al. 1915
Synonyms
  • Bartonia bacilliformisStrong et al. 1913

Bartonella bacilliformis is a proteobacterium, Gram negative aerobic, pleomorphic, flagellated, motile, coccobacillary, 2–3 μm long, 0.2–0.5 μm wide, and a facultative intracellular bacterium.

Proteobacteria phylum of Gram-negative bacteria

Proteobacteria is a major phylum of gram-negative bacteria. They include a wide variety of pathogens, such as Escherichia, Salmonella, Vibrio, Helicobacter, Yersinia, Legionellales and many other notable genera. Others are free-living (non-parasitic) and include many of the bacteria responsible for nitrogen fixation.

Aerobic organism

An aerobic organism or aerobe is an organism that can survive and grow in an oxygenated environment. In contrast, an anaerobic organism (anaerobe) is any organism that does not require oxygen for growth. Some anaerobes react negatively or even die if oxygen is present.

In microbiology, pleomorphism(from greek πλέω- more, and -μορφή form) is the ability of some micro-organisms to alter their shape or size in response to environmental conditions. Pleomorphism has been observed in some members of the Deinococcaceae family. The modern definition of pleomorphism in the context of bacteriology is based on variation of size or shape of the cell, rather than a change of shape as previously believed.

Contents

History

The bacterium was discovered by Peruvian microbiologist Alberto Barton in 1905, but it was not published until 1909. Barton originally identified them as endoglobular structures, which actually were the bacteria living inside red blood cells. Until 1993, the Bartonella genus contained only one species; there are now more than 23 identified species, all of them within family Bartonellaceae. [1]

Peru republic in South America

Peru, officially the Republic of Peru, is a country in western South America. It is bordered in the north by Ecuador and Colombia, in the east by Brazil, in the southeast by Bolivia, in the south by Chile, and in the west by the Pacific Ocean. Peru is a megadiverse country with habitats ranging from the arid plains of the Pacific coastal region in the west to the peaks of the Andes mountains vertically extending from the north to the southeast of the country to the tropical Amazon Basin rainforest in the east with the Amazon river.

Alberto Barton, was a Peruvian microbiologist who discovered the etiologic agent of Carrion´s disease or Oroya fever. The bacteria was named: Bartonella bacilliformis, in his honor. It is the type species of the genus Bartonella, and family Bartonellaceae.

Red blood cell most common type of blood cell

Red blood cells, also known as RBCs, red cells, red blood corpuscles, haematids, erythroid cells or erythrocytes (from Greek erythros for "red" and kytos for "hollow vessel", with -cyte translated as "cell" in modern usage), are the most common type of blood cell and the vertebrate's principal means of delivering oxygen (O2) to the body tissues—via blood flow through the circulatory system. RBCs take up oxygen in the lungs, or gills of fish, and release it into tissues while squeezing through the body's capillaries.

Epidemiology

Bartonella bacilliformis is found only in Peru, Ecuador, and Colombia. [2] It is endemic in some areas of Peru, with outbreaks of the disease occurring in new epidemic areas. [3] The bacterium is transmitted by sandflies of the genus Lutzomyia .

Ecuador Republic in South America

Ecuador, officially the Republic of Ecuador, is a country in northwestern South America, bordered by Colombia on the north, Peru on the east and south, and the Pacific Ocean to the west. Ecuador also includes the Galápagos Islands in the Pacific, about 1,000 kilometres (620 mi) west of the mainland. The capital city is Quito and the largest city as well.

Colombia Country in South America

Colombia, officially the Republic of Colombia, is a sovereign state largely situated in the northwest of South America, with territories in Central America. Colombia shares a border to the northwest with Panama, to the east with Venezuela and Brazil and to the south with Ecuador and Peru. It shares its maritime limits with Costa Rica, Nicaragua, Honduras, Jamaica, Haiti, and the Dominican Republic. Colombia is a unitary, constitutional republic comprising thirty-two departments, with the capital in Bogota.

In epidemiology, an infection is said to be endemic in a population when that infection is constantly maintained at a baseline level in a geographic area without external inputs. For example, chickenpox is endemic in the UK, but malaria is not. Every year, there are a few cases of malaria reported in the UK, but these do not lead to sustained transmission in the population due to the lack of a suitable vector. While it might be common to say that AIDS is "endemic" in Africa, meaning found in an area, this is a use of the word in its etymological, rather than epidemiological, form. AIDS cases in Africa are increasing, so the disease is not in an endemic steady state. It is correct to call the spread of AIDS in Africa an epidemic.

Microbiology

For its isolation, special cultures are required, containing complemental soy agar, proteases, peptones, some essential amino acids, and blood. The optimum growing temperature is 19–29 °C. Colonies grow in Columbia blood agar supplemented with 10% defibrinated bovine blood incubated at 19–25 °C for 2 weeks.

Agar thickening agent used in microbiology and food

Agar or agar-agar is a jelly-like substance, obtained from red algae.

Protease enzyme, type of hydrolase

A protease is an enzyme that helps proteolysis: protein catabolism by hydrolysis of peptide bonds. Proteases have evolved multiple times, and different classes of protease can perform the same reaction by completely different catalytic mechanisms. Proteases can be found in all forms of life and viruses.

Amino acid Organic compounds containing amine and carboxylic groups

Amino acids are organic compounds containing amine (-NH2) and carboxyl (-COOH) functional groups, along with a side chain (R group) specific to each amino acid. The key elements of an amino acid are carbon (C), hydrogen (H), oxygen (O), and nitrogen (N), although other elements are found in the side chains of certain amino acids. About 500 naturally occurring amino acids are known (though only 20 appear in the genetic code) and can be classified in many ways. They can be classified according to the core structural functional groups' locations as alpha- (α-), beta- (β-), gamma- (γ-) or delta- (δ-) amino acids; other categories relate to polarity, pH level, and side chain group type (aliphatic, acyclic, aromatic, containing hydroxyl or sulfur, etc.). In the form of proteins, amino acid residues form the second-largest component (water is the largest) of human muscles and other tissues. Beyond their role as residues in proteins, amino acids participate in a number of processes such as neurotransmitter transport and biosynthesis.

Pathophysiology

As the sandflies bite, the bacteria are inoculated into the capillaries, where in a variable period of time (around 21 days) it invades the red blood cells producing severe intravascular hemolytic anemia (acute phase of Carrion's disease). [4] This phase is a potentially life-threatening infection, and it is associated with high fever, anemia, and transient immunosuppression. The acute phase typically lasts two to four weeks. Peripheral blood smears show anisomacrocytosis with many coccobacilli adhered to red blood cells. Thrombocytopenia is also seen and can be severe. Neurological involvement is sometimes seen (neurobartonellosis) and the prognosis in this case is poor. The most feared complications are super-infections, mainly by enterobacteria such as Salmonella , or parasites such as Toxoplasma gondii and Pneumocystis .

Fever common medical sign characterized by elevated body temperature

Fever, also known as pyrexia and febrile response, is defined as having a temperature above the normal range due to an increase in the body's temperature set point. There is not a single agreed-upon upper limit for normal temperature with sources using values between 37.5 and 38.3 °C. The increase in set point triggers increased muscle contractions and causes a feeling of cold. This results in greater heat production and efforts to conserve heat. When the set point temperature returns to normal, a person feels hot, becomes flushed, and may begin to sweat. Rarely a fever may trigger a febrile seizure. This is more common in young children. Fevers do not typically go higher than 41 to 42 °C.

Immunosuppression decreased resistance to infection; reduction of the activation or efficacy of the immune system

Immunosuppression is a reduction of the activation or efficacy of the immune system. Some portions of the immune system itself have immunosuppressive effects on other parts of the immune system, and immunosuppression may occur as an adverse reaction to treatment of other conditions.

Blood film

A blood film—or peripheral blood smear—is a thin layer of blood smeared on a glass microscope slide and then stained in such a way as to allow the various blood cells to be examined microscopically. Blood films are examined in the investigation of hematological (blood) disorders and are routinely employed to look for blood parasites, such as those of malaria and filariasis.

When the bacterium invades endothelial cells, it produces the chronic manifestation of the disease known as verruga peruana. This phase consists of a benign skin eruption with raised, reddish-purple nodules (angiomatous tumours). Visualization of the bacteria is possible using silver stain (the Warthin–Starry method) on biopsies.

In medicine, nodules are solid, elevated areas of tissue or fluid inside or under the skin with a diameter greater than 0.5 centimeters. Nodules may form on tendons and muscles in response to injury. The vocal cords may also develop nodules. Nodules are normally benign and often painless, although they can affect the functioning of the organ.

Angioma Wikimedia category

Angiomas are benign tumors derived from cells of the vascular or lymphatic vessel walls (endothelium) or derived from cells of the tissues surrounding these vessels.

Disease

Bartonella bacilliformis is the etiologic agent of Carrion's disease or Oroya fever (acute phase of infection), and verruga peruana or Peruvian wart (chronic phase of infection). The acute phase of the disease is a life-threatening disease characterized by massive invasion of Bartonella to human red blood cells and consequently acute hemolysis and fever. If the infection is not treated, the case fatality rate is 40 to 85% [5] Patients in this phase of the infection can be complicated by overwhelming infections, primarily by enterobacteria (Salmonella spp) and parasites (Toxoplasma gondii, Pneumocystis jirovecii). The chronic phase is characterized by benign eruptive lesions that are pruritic and bleeding, and other symptoms like malaise and osteoarticular pain. [2] Bartonella can be isolated from blood cultures and secretion of the lesions in people from endemic areas. [6]

Treatment

Before the antibiotic era, the only treatment for the acute phase was blood transfusion, but the effectiveness of this treatment was poor and the mortality rate was high. [7] Later, with the discovering of new antibiotics, penicillin, chloramphenicol, tetracycline, and erythromycin have been used successfully. However, because of the risk of overwhelming infections by enterobacteria, quinolones are preferred. Therapeutic failures and persistent bacteremia have been reported with chloramphenicol, and successful treatment with this drug does not appear to eliminate the patient's risk for development of the eruptive phase. So, the drug of choice is ciprofloxacin.

In the chronic phase, the treatment used traditionally has been streptomycin for 10 days. Since 1975, rifampin has become the drug of choice for verruga peruana. However, failures of rifampin treatment have also been reported and resistance can develop. Recently macrolides have been used with similar effectiveness.

Related Research Articles

Chagas disease human disease

Chagas disease, also known as American trypanosomiasis, is a tropical parasitic disease caused by the protist Trypanosoma cruzi. It is spread mostly by insects known as Triatominae, or "kissing bugs". The symptoms change over the course of the infection. In the early stage, symptoms are typically either not present or mild, and may include fever, swollen lymph nodes, headaches, or local swelling at the site of the bite. After 8–12 weeks, individuals enter the chronic phase of disease and in 60–70% it never produces further symptoms. The other 30–40% of people develop further symptoms 10–30 years after the initial infection, including enlargement of the ventricles of the heart in 20–30%, leading to heart failure. An enlarged esophagus or an enlarged colon may also occur in 10% of people.

Typhoid fever A bacterial infectious disorder contracted by consumption of food or drink contaminated with Salmonella typhi. This disorder is common in developing countries and can be treated with antibiotics.

Typhoid fever, also known simply as typhoid, is a bacterial infection due to Salmonella typhi that causes symptoms. Symptoms may vary from mild to severe and usually begin six to thirty days after exposure. Often there is a gradual onset of a high fever over several days; weakness, abdominal pain, constipation, headaches, and mild vomiting also commonly occur. Some people develop a skin rash with rose colored spots. In severe cases there may be confusion. Without treatment, symptoms may last weeks or months. Diarrhea is uncommon. Other people may carry the bacterium without being affected; however, they are still able to spread the disease to others. Typhoid fever is a type of enteric fever, along with paratyphoid fever.

Group A streptococcal infection

A group A streptococcal infection is an infection with group A streptococcus (GAS). Streptococcus pyogenes comprises the vast majority of the Lancefield group A streptococci, and is often used as a synonym for GAS. However, S. dysgalactiae can also be group A. S. pyogenes is a beta-hemolytic species of Gram positive bacteria that is responsible for a wide range of both invasive and noninvasive infections.

Osteomyelitis bone inflammation disease that has material basis in infection located in bone or located in bone marrow

Osteomyelitis (OM) is an infection of bone. Symptoms may include pain in a specific bone with overlying redness, fever, and weakness. The long bones of the arms and legs are most commonly involved in children, while the feet, spine, and hips are most commonly involved in adults.

<i>Bartonella henselae</i> species of bacterium

Bartonella henselae, formerly Rochalimæa, is a proteobacterium that is the causative agent of cat-scratch disease (bartonellosis).

<i>Bartonella</i> genus of bacteria

Bartonella is a genus of Gram-negative bacteria. It is the only genus in the family Bartonellaceae. Facultative intracellular parasites, Bartonella species can infect healthy people, but are considered especially important as opportunistic pathogens. Bartonella species are transmitted by vectors such as ticks, fleas, sand flies, and mosquitoes. At least eight Bartonella species or subspecies are known to infect humans.

Carrions disease infectious disease produced by Bartonella bacilliformis infection

Oroya fever or Carrion's disease is an infectious disease produced by Bartonella bacilliformis infection.

<i>Lutzomyia</i> genus of insects

Lutzomyia is a genus of phlebotomine sand flies consisting of nearly 400 species, at least 33 of which have medical importance as vectors of human disease. Species of the genus Lutzomyia are found only in the New World, distributed in southern areas of the Nearctic and throughout the Neotropic zone. Lutzomyia is one of the two genera of the subfamily Phlebotominae to transmit the Leishmania parasite, with the other being Phlebotomus, found only in the Old World. Lutzomyia sand flies also serve as vectors for the bacterial Carrion’s disease and a number of arboviruses.

Eosinophilic pneumonia (EP) is a disease in which an eosinophil, a type of white blood cell, accumulates in the lung. These cells cause disruption of the normal air spaces (alveoli) where oxygen is extracted from the atmosphere. Several different kinds of eosinophilic pneumonia exist and can occur in any age group. The most common symptoms include cough, fever, difficulty breathing, and sweating at night. EP is diagnosed by a combination of characteristic symptoms, findings on a physical examination by a health provider, and the results of blood tests and x-rays. Prognosis is excellent once most EP is recognized and treatment with corticosteroids is begun.

Bartonellosis is an infectious disease produced by bacteria of the genus Bartonella. Bartonella species cause diseases such as Carrión´s disease, trench fever, cat-scratch disease, bacillary angiomatosis, peliosis hepatis, chronic bacteremia, endocarditis, chronic lymphadenopathy, and neurological disorders.

Interstitial nephritis type of nephritis affecting the interstitium of the kidneys surrounding the tubules

Interstitial nephritis, also known as tubulointerstitial nephritis, is inflammation of the area of the kidney known as the interstitium, which consists of a collection of cells, extracellular matrix, and fluid surrounding the renal tubules. In addition to providing a scaffolding support for the tubular architecture, the interstitium has been shown to participate in the fluid and electrolyte exchange as well as endocrine functions of the kidney. There are a variety of known factors that can provoke the inflammatory process within the renal interstitium, including pharmacologic, environmental, infectious and systemic disease contributors. The spectrum of disease presentation can range from an acute process to a chronic condition with progressive tubular cell damage and renal dysfunction.

Lábrea fever is a lethal tropical viral infection discovered in the 1950s in the city of Lábrea, in the Brazilian Amazon basin, where it occurs mostly in the area south of the Amazon River, in the states of Acre, Amazonas and Rondônia. The disease has also been diagnosed in Colombia and Peru.

Splenic infarction condition in which oxygen supply to the spleen is interrupted

Splenic infarction is a condition in which blood flow supply to the spleen is compromised, leading to partial or complete infarction in the organ.

Daniel Alcides Carrión Peruvian medical student

Daniel Alcides Carrión García was a Peruvian medical student after whom Carrion's disease is named.

<i>Anaplasma phagocytophilum</i> species of bacterium

Anaplasma phagocytophilum is a Gram-negative bacterium that is unusual in its tropism to neutrophils. It causes anaplasmosis in sheep and cattle, also known as tick-borne fever and pasture fever, and also causes the zoonotic disease human granulocytic anaplasmosis.

Bartonella rochalimae is a recently discovered strain of Gram-negative bacteria in the genus Bartonella, isolated by researchers at the University of California, San Francisco (UCSF), Massachusetts General Hospital, and the United States Centers for Disease Control and Prevention. The bacterium is a close relative of Bartonella quintana, the microbe which caused trench fever in thousands of soldiers during World War I. Named after Brazilian scientist Henrique da Rocha Lima, B. rochalimae is also closely related to Bartonella henselae, a bacterium identified in the mid-1990s during the AIDS epidemic in San Francisco as the cause of cat scratch fever, which still infects more than 24,000 people in the United States each year.

Bartonella quintana, originally known as Rochalimaea quintana, and "Rickettsia quintana", is a micro-organism transmitted by the human body louse. This microorganism is the causative agent of the well known trench fever. This bacterium caused outbreaks of trench fever affecting 1 million soldiers in Europe during World War I.

Cat-scratch disease Human disease

Cat-scratch disease (CSD) is an infectious disease that results from a scratch or bite of a cat. Symptoms typically include a non-painful bump or blister at the site of injury and painful and swollen lymph nodes. People may feel tired, have a headache, or a fever. Symptoms typically begin within 3-14 days following infection.

Bartonella ancashensis is a bacterium from the genus of Bartonella which has been isolated from blood from patients who suffered from verruga peruana in Caraz in Peru.Bartonella ancashensis is a human pathogen which may cause verruga peruana.

References

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  2. 1 2 Maguiña C, Garcia PJ, Gotuzzo E, Cordero L, Spach DH (September 2001). "Bartonellosis (Carrión's disease) in the modern era". Clin. Infect. Dis. 33 (6): 772–9. doi:10.1086/322614. PMID   11512081.
  3. Maco V, Maguiña C, Tirado A, Maco V, Vidal JE (2004). "Carrion's disease (Bartonellosis bacilliformis) confirmed by histopathology in the High Forest of Peru". Rev. Inst. Med. Trop. São Paulo. 46 (3): 171–4. doi:10.1590/S0036-46652004000300010. PMID   15286824.
  4. Maguiña C. Bartonellosis o enfermedad de Carrión. Nuevos aspectos de una vieja enfermedad. AFA edit. Lima-Peru
  5. Maguiña C, Gotuzzo E (March 2000). "Bartonellosis. New and old". Infect. Dis. Clin. North Am. 14 (1): 1–22, vii. doi:10.1016/S0891-5520(05)70215-4. PMID   10738670.
  6. Chamberlin J, Laughlin LW, Romero S, et al. (October 2002). "Epidemiology of endemic Bartonella bacilliformis: a prospective cohort study in a Peruvian mountain valley community". J. Infect. Dis. 186 (7): 983–90. doi:10.1086/344054. PMID   12232839.
  7. Schultz MG (July 1968). "A history of bartonellosis (Carrión's disease)". Am. J. Trop. Med. Hyg. 17 (4): 503–15. doi:10.4269/ajtmh.1968.17.503. PMID   4876803.