Drancourt M, Mainardi J L, Brouqui P, Vandenesch F, Carta A, Lehnert F, Etienne J, Goldstein F, Acar J, Raoult D
Unité des Rickettsies, Faculté de Médecine, Marseilles, France.
N Engl J Med. 1995 Feb 16;332(7):419-23. doi: 10.1056/NEJM199502163320702.
Bartonella (Rochalimaea) quintana is the agent of trench fever and is transmitted by the body louse. We searched for this organism in three alcoholic homeless men with endocarditis.
Blood samples were cultured on a human endothelial cell line and on blood agar. Bacteria were identified by sequencing the amplified 16S ribosomal RNA gene. The presence of bartonella in tissue was assessed by Gram's staining, immunostaining, and polymerase-chain-reaction amplification. Serologic studies for antibodies to bartonella species were performed by indirect immunofluorescence and Western immunoblotting.
B. quintana was isolated from one patient in the blood-agar culture and from the other two patients in the endothelial-cell culture. The organism was also identified by both immunostaining and molecular techniques in the valvular vegetations from the three patients and in a cervical lymph node from one patient. The 16S ribosomal RNA gene sequences of the three isolates were almost identical to that of the prototype strain of B. quintana. High titers of antibodies to B. quintana were detected in all three patients, but so were cross-reacting antibodies to chlamydia species. In all three patients studies were repeatedly negative for antibodies to the human immunodeficiency virus.
B. quintana is a cause of endocarditis in homeless patients and may be serologically misdiagnosed as a chlamydial infection.
五日热巴尔通体（罗卡利马氏体）是战壕热的病原体，通过体虱传播。我们在三名患有心内膜炎的酗酒无家可归男性中寻找这种病原体。
将血样接种于人类内皮细胞系和血琼脂上进行培养。通过对扩增的16S核糖体RNA基因进行测序来鉴定细菌。通过革兰氏染色、免疫染色和聚合酶链反应扩增来评估组织中巴尔通体的存在情况。采用间接免疫荧光和蛋白质免疫印迹法进行针对巴尔通体属抗体的血清学研究。
在血琼脂培养中从一名患者分离出五日热巴尔通体，在内皮细胞培养中从另外两名患者分离出该病原体。通过免疫染色和分子技术在三名患者的瓣膜赘生物以及一名患者的颈部淋巴结中也鉴定出了该病原体。三株分离株的16S核糖体RNA基因序列与五日热巴尔通体原型菌株的序列几乎相同。在所有三名患者中均检测到高滴度的针对五日热巴尔通体的抗体，但也检测到了针对衣原体属的交叉反应抗体。在所有三名患者中，针对人类免疫缺陷病毒的抗体检测结果均反复为阴性。
五日热巴尔通体是无家可归患者心内膜炎的病因，在血清学上可能会被误诊为衣原体感染。
