Intracellular Pathogens Research Laboratory, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.
Parasit Vectors. 2024 Oct 5;17(1):416. doi: 10.1186/s13071-024-06491-3.
Bartonella species are fastidious, intracellular bacteria responsible for an expanding array of human pathologies. Most are considered to be transmitted by direct inoculation with infected bodily fluids from a mammalian reservoir species or vector-transmitted through a variety of arthropod species and their excrement. However, there are mounting reports of infection in the absence of documented animal or vector contact. A variety of Bartonella species have been documented in conditions affecting both the peripheral and central nervous systems. More common conditions, including neuroretinitis, are often associated with Bartonella henselae. However, Bartonella quintana, the agent of trench fever, as well as emerging pathogens related to rodent reservoir species, B. grahamii and B. elizabethae, have also been documented. Encephalitis and encephalopathy, also most often associated with B. henselae, have been reported with B. quintana, B. washoensis (ground squirrels) and B. vinsonii subsp. vinsonii (voles) infections. Bartonella infections have also been associated with peripheral neuropathies, such as cranial nerve paresis and neuropathic pain, including infection with less commonly encountered species such as Bartonella koehlerae. Recently, molecular diagnostic testing revealed that DNA from Bartonella spp. was found to be more prevalent in blood of patients with neuropsychiatric disorders such as schizophrenia and psychoses compared to healthy controls.
A systematic literature search was conducted on PubMed, Google Scholar and Web of Science. Search terms included Bartonella and specific neurological conditions and focused on peer-reviewed case reports published after 2012 pursuant to a prior review, with limited exceptions for conditions not previously covered. Published diagnostic testing, serology, molecular testing or pathology, were necessary for inclusion, except for one case which had clinical and epidemiological evidence consistent with diagnosis along with follow-up.
Neurobartonelloses included neuralgic amyotrophy, complex regional pain syndrome, chronic inflammatory demyelinating polyneuropathy, cranial nerve paralysis, Guillain-Barré syndrome, peripheral vasculitic polyneuropathy, acute transverse myelopathy, neuroretinitis, encephalitis/encephalopathy, cerebral vasculitis/aneurysm and neuropsychiatric conditions.
The breadth of reported symptoms and clinical syndromes associated with an increasing number of Bartonella species continues to expand. Increased clinical awareness of this important zoonotic pathogen is necessary to advance One Health among the medical and veterinary communities.
巴尔通体（Bartonella）是一种严格的细胞内细菌，可引起多种人类疾病。大多数巴尔通体被认为通过直接接种受感染的哺乳动物储主物种的体液或通过多种节肢动物及其粪便传播的媒介传播。然而，越来越多的报道表明，在没有记录动物或媒介接触的情况下也会发生感染。已在影响周围神经系统和中枢神经系统的各种疾病中发现了多种巴尔通体。更常见的疾病，包括神经视网膜炎，通常与汉塞巴尔通体（Bartonella henselae）有关。然而，战壕热病原体巴尔通体 quintana 以及与啮齿动物储主物种相关的新兴病原体，包括伯氏巴尔通体（B. grahamii）和贝氏巴尔通体（B. elizabethae）也已被发现。脑炎和脑病也与汉塞巴尔通体最常相关，但巴尔通体 quintana、地松鼠巴尔通体（B. washoensis）和伏氏巴尔通体亚种（B. vinsonii subsp. vinsonii）感染也已被报道。巴尔通体感染还与颅神经麻痹和神经病理性疼痛等周围神经病变有关，包括感染较少见的物种，如考氏巴尔通体（Bartonella koehlerae）。最近，分子诊断测试显示，与健康对照组相比，精神神经疾病（如精神分裂症和精神病）患者的血液中更普遍存在巴尔通体 spp. 的 DNA。
在 PubMed、Google Scholar 和 Web of Science 上进行了系统的文献检索。搜索术语包括巴尔通体和特定的神经疾病，并重点关注 2012 年后发表的同行评议病例报告，除了以前未涵盖的疾病外，有有限的例外情况。包括神经痛性肌萎缩、复杂性区域性疼痛综合征、慢性炎症性脱髓鞘性多发性神经病、颅神经麻痹、格林-巴利综合征、周围血管炎性多发性神经病、急性横贯性脊髓炎、神经视网膜炎、脑炎/脑病、脑血管炎/动脉瘤和神经精神疾病等神经巴尔通体病在内的神经疾病。
与越来越多的巴尔通体物种相关的报告症状和临床综合征的范围不断扩大。提高对这种重要的人畜共患病原体的临床认识，对于推进医学和兽医界的“One Health”理念至关重要。
