Bartonella rod in humans: where to take an analysis, than to treat

Bartonella bacterium is a hemotrophic microorganism belonging to the same genus Bartonell, which, in turn, is a representative of the class of alpha proteobacteria.

The bacterium affects human erythrocytes, in chronic course, the endothelial tissue of the microcirculation system also suffers. The source of infection can serve as diseased animals (or carriers), more often - rodents, dogs, cats or monkeys.

[1], [2], [3], [4], [5]

Structure of the bartonella

Bartonella belongs to the gram (-) bacteria, under the microscope looks like a shortened stick, with approximate dimensions of 0.4 by 2 mm. In the section of affected tissues, the bacterium may appear curved, small, pleomorphic. Microorganisms tend to gather in small groups (clusters).

Round species of Bartonella have diametrical dimensions about one and a half millimeters. They can have flagella and a three-layer structure, with a small size of the genome.

Bartonella multiplies by simple cross-section.

At present, 25 species of Bartonella are known, but only half of them can be dangerous for humans.

The most common Bartonella Hensley, which causes an acute course of cat scratch disease, lymphadenopathy and angiomatosis, can be cultivated in a complex blood environment. Bartonella Hensley according to the nature of food is considered an obligate aerob. Infection with bacteria can be by contact through damage to the skin or through the eye mucosa.

Bartonella quintana can trigger the development of trench fever or endocarditis. This kind of bacteria is transmitted through lice, mice, ectoparasites and scabies mites.

Bartonella bacilliformis is the cause of the development of Carion's disease. Distributors are mosquitoes and, more rarely, mice.

Bartonella Claridgee can cause manifestations of angiomatosis, persistent fever, and lymphadenopathy. Bacteria is transmitted through carriers - cats.

Bartonella elizabeth becomes the cause of inflammation of the endocardium, while the carrier of this species of bacteria is not defined.

[6], [7], [8], [9], [10]

Life cycle of the bartonella

Getting into the body of the "master", Bartonella continues its development over the cellular structures, penetrates into the erythrocytes and the endothelium of the vessels and the endocardial layer. A typical difference of Bartonella is its ability to activate the cellular proliferation of the endothelium and increase capillaries, which can cause excessive overgrowth of the vessels.

Method of feeding Bartonella - aerobic hematotroph. Before entering the mammal, the bacterium can be cultivated inside insects (lice, mosquitoes, fleas), or on a solid medium or semi-liquid consistency, with the addition of up to 10% of blood elements.

In the secretions of lice Bartonella can remain viable for quite a long time - up to 1312 days. However, in lice, infection with bacteria does not cause any symptoms.

In the organisms of cats or dogs Bartonella can persist for more than 12 months, and inside insects - for life.

[11], [12], [13], [14]

Symptoms

The duration of the incubation period for Bartonella's damage is from 15 to 40 days, less often - up to 90-100 days.

Characteristic of the course of the disease in two stages. In the acute period (the so-called stage of the fever of Oroya), the temperature rises to 39 ° and even to 40 ° C, with the fever not falling off for 2-4 weeks, after which the symptoms subsided slowly.

In addition to febrile state, there are other signs:

• general intoxication;
• excessive sweating;
• severe pain in the head, muscles, joints, bones;
• sleep disorders;
• delusional and apathetic states;
• deterioration of appetite;
• dyspepsia.

On the surface of the skin can occur hemorrhages. Sclera can be yellow, against a background of enlarged liver.

In severe cases, the disease can end fatal (approximately 20% of patients). The most favorable outcome is expected when a latent stage occurs, which after 90-180 days is transformed in the period of skin rash (stage of Peruvian warts). This period is characterized by the formation of spots, tubercles, nodules on the skin: this stage can last 8-12 weeks.

[15], [16], [17]

Diagnostics

Diagnostic procedures are performed after the patient is identified in the infectious disease department of the hospital.

Often Bartonella's defeat can be suspected if the patient indicates a recent contact with the animal (especially if there have been scratches or bites).

To confirm the diagnosis, the doctor will prescribe additional studies. For example, you can send blood for analysis to Bartonella, tissue elements or excretions from pustules and papules.

Cultivation of Bartonella in a special nutrient medium is actually complicated and lasts at least 14 days of incubation (sometimes - up to one and a half months) prior to the first isolation. Among other things, if the bacterium is not present in the blood, then it becomes even more difficult to isolate it.

In most cases, the greatest diagnostic information is serology on Bartonella, or rather, on its antibodies. There are two ways to carry out a serological test: an enzyme immunoassay and a fluorescent assay. If in the process of research specialists will detect antibodies like IgM, then this indicates an acute course of pathology. Such antibodies can be in the bloodstream for more than three months from the time of infection. The type of antibodies IgG can be determined only after 6-7 months from the moment of infection. Approximately a quarter of patients have IgG antibodies that can remain in the bloodstream for more than 12 months.

The main purpose of the diagnosis is the detection of Bartonella in the tissue structures of the patient. As a rule, for the diagnosis, the main stages of polymerase chain reaction are used:

• amplification of the 16 S rRNA gene;
• amplification of the citrate synthase gene;
• stimulation of the HtrA gene of the bacterium.

The analysis for Bartonella is very specific, but infectious diseases determine its sensitivity of about 43-76%. The isolation of Bartonella from the elements taken during the PCR reaction is equivalent to the level of technical isolation of the culture.

In Ukraine, the analysis of Bartonella is carried out by such well-known laboratories as Sinevo and Dila.

In Russia, it takes an analysis on Bartonella Helix - a laboratory service.

[18], [19], [20], [21]

Treatment

• To treat the infection caused by Bartonella, in all cases prescribe antibiotic therapy:
• taking levomycetin 500 mg to 4 times a day;
• injections of streptomycin 500-1000 mg daily;
• reception tetracycline antibiotics on 200 mg up to 4 times a day.

At the stage of exacerbation Bartonella successfully use intravenous infusions of novarsenol - 300-450 mg once or twice a week.

In addition, fluoroquinolone preparations may be prescribed - for example, a 200 mg tarid twice a day in the form of intravenous infusion (for 4 days), with further ingestion of the drug inside (within a week).

As an auxiliary treatment, it is appropriate to use blood transfusion, anti-anemia drugs, as well as drugs to maintain liver function. Such drugs are often combined with vitamin therapy (tocopherol, ascorbic acid, cyanocobalamin, folic acid), the intake of cytochrome C, cyto-MAK, etc.

When infection of skin rashes are prescribed antiseptic solutions and antibacterial ointments, proteolytic enzyme preparations.

Prevention of the bartonella

Prevention measures include limiting personal contact with rodents, stray cats and dogs, preventing them from entering the house. In case of accidental contact, wash hands with household soap, under a sufficient amount of running water. If there are scratches and abrasions on the skin, you should treat them with a solution of hydrogen peroxide, or with any alcohol solution.

Preventive administration of antibiotics is considered impractical, as well as preventive treatment of animals.

[22], [23], [24]

Forecast

In most cases, the prognosis for patients with Bartonella's lesions is relatively good, except for cases when the patient for any reason does not receive medical care. Symptoms of infection can sometimes be observed for several months, with complications developing only in extreme cases. After competent antibiotic therapy Bartonella is eliminated without a trace, without repeated relapses.

[25], [26]