Mozayeni Bobak Robert, Maggi Ricardo Guillermo, Bradley Julie Meredith, Breitschwerdt Edward Bealmear
Translational Medicine Group PC, North Bethesda, Maryland.
Intracellular Pathogens Research Laboratory, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC.
Medicine (Baltimore). 2018 Apr;97(17):e0465. doi: 10.1097/MD.0000000000010465.
Systemic Bartonella spp. infections are being increasingly reported in association with complex medical presentations. Individuals with frequent arthropod exposures or animal contact appear to be at risk for acquiring long standing infections with Bartonella spp.
This case report describes infections with Bartonella koehlerae and Bartonella henselae in a female veterinarian whose symptoms were predominantly rheumatologic in nature. Infection was confirmed by serology, polymerase chain reaction (PCR), enrichment blood culture, and DNA sequencing of amplified B koehlerae and B henselae DNA. Long-term medical management with antibiotics was required to achieve elimination of these infections and was accompanied by resolution of the patient's symptoms. Interestingly, the patient experienced substantial improvement in the acquired joint hypermobility mimicking Ehlers-Danlos Syndrome (EDS) type III.
To facilitate early and directed medical interventions, systemic bartonellosis should potentially be considered as a differential diagnosis in patients with incalcitrant rheumatological symptoms and frequent arthropod exposures or extensive animal contact.
系统性巴尔通体属感染与复杂的医学表现相关的报道日益增多。频繁接触节肢动物或与动物接触的个体似乎有感染巴尔通体属长期感染的风险。
本病例报告描述了一名女性兽医感染科氏巴尔通体和汉氏巴尔通体，其症状主要为风湿性。通过血清学、聚合酶链反应（PCR）、富集血培养以及对扩增的科氏巴尔通体和汉氏巴尔通体DNA进行DNA测序确诊感染。需要长期使用抗生素进行医学管理以消除这些感染，并伴随着患者症状的缓解。有趣的是，患者在获得性关节过度活动方面有显著改善，类似于Ⅲ型埃勒斯-当洛综合征（EDS）。
为便于早期和有针对性的医学干预，对于有顽固性风湿症状且频繁接触节肢动物或广泛接触动物的患者，系统性巴尔通体病可能应作为鉴别诊断考虑。
