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Headlines: Less Common Bartonellosis Presentations * Identifying Lyme Disease Patients * Testing Synovial Fluid vs. Serum * More
Moving beyond the “one pathogen one disease” model captures the complete picture in the case studies featured this week. Patients presented with everything from no symptoms with the suggestion for future monitoring to classic symptoms of another disease process while also being affected by Lyme disease or bartonellosis.
Less Common Bartonellosis Presentations
Optic Neuritis and Vertebral Osteomyelitis: An Uncommon Presentation of Cat-Scratch Disease, by A Carujo et al., publishing from Portugal – A 52-year-old woman developed optic neuritis after contact with cats. She was seropositive for bartonellosis. She also had vertebral osteomyelitis with spondylodiscitis which improved with the antibiotic treatment, suggesting that Bartonella infection also caused the bone and tissue infection. While Bartonella species infection in bone is seen, the combination of optic neuritis and osteomyelitis is extremely rare.
A Man in His Forties with Recurrent Cat-Scratch Disease by S López-Rueda et al., publishing from Mexico City – A man treated for cat scratch disease two years prior was unwell and had swollen lymph nodes. A biopsy by an oncologist didn’t find bacteria by microscopy. Tissue PCR may have identified the infection but was not done. Serology two months later was positive. Antibiotic treatment resolved his symptoms.
Find out more about collecting tissue samples to submit to Galaxy Diagnostics for PCR testing.
Cat Scratch Endocarditis by J De Cristofaro et al., publishing from the Cardiac Intensive Care Unit, San Raffaele University Hospital, Milan, Italy – A man with a history of smoking had multiple clots in his brain. Smoking increases the risk of ischemic stroke as much as six times. However, multiple causes can contribute. In this case, the origin of the clots was found in the patient’s heart, where a valve was infected with Bartonella henselae. Patients with this kind of infection are sometimes treated with surgery. In the paper, the authors discuss decisions about surgery. In this case, antibiotic treatment without surgery stopped new clots from developing.
Identifying Lyme Disease Patients
Case Presentation and Management of Lyme Disease Patients: A 9-Year Retrospective Analysis in France by E Perthame et al., publishing from France – This survey of physicians in France collected information on all presentations of Borrelia burgdorferi sl infection. The survey surfaced several different groups of presentations, including asymptomatic seropositive cases. The researchers weren’t able to look at treatment outcomes for the patients and suggested further research into long-term outcomes.
Isolated Intracranial Hypertension as a Presentation of Pediatric Lyme Borreliosis: A Case Report and Literature Review by JM Mah, C Lo and MD O’Connor, publishing from the University of Ottawa – A teen boy had vision problems and a headache 6 weeks after multiple tick bites. Abnormal findings from an eye exam and brain MRI led to a lumbar puncture with elevated opening pressure. The teen had elevated intracranial pressure. Both serum and cerebrospinal fluid were seropositive for Lyme disease. He improved with antibiotics.
Borrelia is more than just B. burgdorferi, the most common cause of Lyme disease in the US. In 2021, we wrote about the other human pathogens in the Borrelia genus.
Testing Synovial Fluid vs. Serum – Galaxy Diagnostics Scientists Co-authors
Antibodies to Borrelia burgdorferi and Bartonella Species in Serum and Synovial Fluid from People with Rheumatic Diseases by L Kim, E Lashnites, EB Breitschwerdt, A Elam, N Grade, J Miller and AR Shikhman, publishing from the University of Wisconsin at Madison, North Carolina State University and Galaxy Diagnostics – This study tested synovial and serum specimens from patients with joint effusion (swollen joints with excess fluid). Two-tier B. burgdorferi and B. henselae / B. quintana IFA tests were conducted. B. burgdorferi was detected more frequently in synovial fluid, while Bartonella species were detected more frequently in serum.
More: Lyme Disease Testing for Conduction Disorders in Denmark * Next-Generation Sequencing to Speed Bartonellosis Diagnosis * One Health and SARS-CoV-2 * Tick News * Nominations: WHO DTAG for Neglected Tropical Diseases * Galaxy Diagnostics Closed March 29
Lyme Disease Testing for Conduction Disorders in Denmark
Risk of Cardiac Conduction Disorders, and Pacemaker Implantations Among Individuals Tested for Serum Borrelia burgdorferi Antibodies, a Nationwide, Matched, Population-based Cohort Study by MM Tetens and a multi-institution team, publishing from Denmark – A study of patients in Denmark who had been tested for Lyme disease found that they had an increased short-term risk of AV block if positive. A breadth of conduction disorders were associated with negative test results. This suggests that physicians are including serology testing in their work-up of heart rhythm disorders, increasing the likelihood of identifying cases of Lyme disease.
Next-Generation Sequencing to Speed Bartonellosis Diagnosis
Detection of Invasive Bartonella Infections with Next-Generation Sequencing of Microbial Cell-Free DNA by FH Centeno et al., publishing from Baylor College of Medicine – This case series reports on 8 patients who received a faster diagnosis because of this technique.
One Health and SARS-CoV-2
Researchers from the University of Missouri teamed up with USDA to better understand the One Health issues related to wildlife, including rats in New York City. Among other findings, their research demonstrated that the rats can be infected with SARS-CoV-2. These findings are reported in SARS-CoV-2 Exposure in Norway Rats (Rattus norvegicus) from New York City by Y Wang et al.
Tick News
Density of Host-Seeking Ixodes scapularis Nymphs by Region, State, and County in the Contiguous United States Generated through National Tick Surveillance by E Foster, KM Holcomb & RJ Eisen, publishing from the US CDC – Tick surveys in the US remain haphazard, but the existence of a national tick tracking database initiated in 2018 has created some order from the chaos and information can be pulled from the system.
What to Watch for with Asian Longhorned Ticks and Theileria in Ohio in 2024 by T McDermott, Farm and Dairy – Asian longhorned ticks reached Ohio in 2020. Since then, four cases of Theileria, a tick-borne pathogen of cattle that has no treatment in the US, have been found in cattle. Ohio now has five species of ticks that transmit pathogens. Lyme disease cases are found year-round. Like many states, Ohio is facing a rapidly changing risk map for tick-borne disease.
A Pill that Kills Ticks Is a Promising New Weapon against Lyme Disease by E Mullin, Wired – A product already on the market as an eye drop for treating mites in humans is in human trials as a pill to kill biting ticks. The intention is the bite would be shorted, reducing the risk of disease transmission.
Call for Nomination of Experts – WHO Diagnostic Technical Advisory Group (DTAG) for Neglected Tropic Diseases
The call is for the One Health subgroup: neglected zoonotic disease. More here.
Conferences
RESI South 2024 – Cofounder and CEO Dr. Amanda Elam will pitch Galaxy Diagnostics on Monday, March 25 at 4PM.
CED Venture Connect – Completed! “Our Chief Business Officer Nicole Bell rocked the stage pitching Galaxy Diagnostics. CED did an amazing job bringing entrepreneurs, investors, and ecosystem partners together at this event!” – Dr. Elam
Galaxy Diagnostics Closed March 29
Galaxy Diagnostics will be closed Friday, March 29. The last day to ship samples is Wednesday, March 27.
