Bartonella quintana - MegaMicro

a.        Infect erythrocytes, erythroblasts + tropism for endothelial cells

b.       Physiology: aerobic

c.        virulence factors

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.

a.        Serological cultures or nucleic acid amplification techniques.

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

a.        None other than laboratory

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

a.        Treatment usually consists of a 4- to 6-week course of doxycycline, erythromycin, or azithromycin.

b.       Cleanliness