Mansueto Pasquale, Di Lorenzo Gabriele, Rizzo Manfredi, Mazzola Giuseppe, Affronti Mario, Battista Rini Giovan, Mansueto Serafino
Dipartimento di Medicina Clinica e delle Patologie Emergenti, Università degli Studi di Palermo.
Recenti Prog Med. 2003 Apr;94(4):177-85.
In the last years the number of Bartonella species significantly raised, often with an epidemiological profile of emergent disease. B. bacilliformis is the etiological agent of Carrion's disease. B. clarridgeiae has been associated, together with B. henselae, to Cat-Scratch Disease (CSD), whereas B. elizabethae to endocarditis and B. grahamii to neuroretinitis. B. henselae has been associated to CSD and, in patients with immunodeficiency, together with B. quintana, to bacillary angiomatosis, to peliosis and to endocarditis. B. quintana is the etiological agent of "trench fever", in its "classical" and "urban" form. B. vinsonii subsp. arupensis and subsp. berkhoffii have been associated to bacteremia and endocarditis. The diagnosis foresees pathological examination of the lesions, germ isolation and use of specific serological test and of polymerase chain reaction. Prognosis is, generally, favourable. Therapy foresees the use of numerous antibacterial agents, like: penicillins, cephalosporins, aminoglycosides, tetracyclines, macrolides, quinolones, trimethoprim-sulfomethoxazole and rifampicin.
在过去几年中,巴尔通体物种的数量显著增加,其流行病学特征往往表现为新发疾病。杆菌状巴尔通体是卡里翁病的病原体。克拉氏巴尔通体与亨氏巴尔通体一起,与猫抓病(CSD)有关,而伊丽莎白巴尔通体与心内膜炎有关,格雷厄姆巴尔通体与视神经视网膜炎有关。亨氏巴尔通体与CSD有关,在免疫缺陷患者中,它与五日热巴尔通体一起,与杆菌性血管瘤、紫癜和心内膜炎有关。五日热巴尔通体是“战壕热”“经典”和“城市”形式的病原体。文森氏巴尔通体亚种阿鲁彭西斯和伯克霍夫亚种与菌血症和心内膜炎有关。诊断需要对病变进行病理检查、分离病菌,并使用特定的血清学检测和聚合酶链反应。一般来说,预后良好。治疗需要使用多种抗菌药物,如:青霉素、头孢菌素、氨基糖苷类、四环素、大环内酯类、喹诺酮类、甲氧苄啶-磺胺甲恶唑和利福平。