scholarly journals Bartonella quintana Infection Manifesting as Leucocytoclastic Vasculitis Rash

2021 ◽  
Author(s):  
Brian J Hopkins ◽  
Bonnie C Prokesch
Keyword(s):  
Lower Extremity ◽  
Skin Biopsy ◽  
Bartonella Henselae ◽  
Fibrinoid Necrosis ◽  
Leucocytoclastic Vasculitis ◽  
Rapid Improvement ◽  
Bartonella Quintana ◽  
Presenting Symptoms ◽  
First Case ◽  
Abdominal Lesion

Abstract We present the first case described in the literature of leucocytoclastic vasculitis due to Bartonella quintana infection. A 73-year-old woman presented to the hospital with persistent fevers, retro-orbital headache, generalized weakness, and left lower thigh pain for one week. She was found to have truncal and proximal lower extremity papules and small plaques. Serology revealed Bartonella quintana IgM titer of 1:256 with undetectable Bartonella quintana IgG and undetectable Bartonella henselae IgG and IgM. Skin biopsy of an abdominal lesion revealed fibrinoid necrosis of vessel walls in the superficial and mid-dermis consistent with leucocytoclastic vasculitis. Doxycycline 100 mg orally twice daily was initiated, after which she had defervescence within 36 hours and rapid improvement of other presenting symptoms.

Painful, reappearing eruption in a medically complex 4-year-old

2021 ◽  
Vol 14 (2) ◽  
pp. e239310
Author(s):  
Meredith Sooy ◽  
Rachel L Randell ◽  
Dmitry Tchapyjnikov ◽  
Klaus Werner ◽  
Kristina Nazareth-Pidgeon
Keyword(s):  
Skin Biopsy ◽  
Growth Retardation ◽  
Clinical Presentation ◽  
Heart Defects ◽  
Pathogenic Mutation ◽  
Rare Disorder ◽  
Frequent Episodes ◽  
First Case

A 4-year-old boy with atypical, complete DiGeorge and CHARGE (coloboma, heart defects, atresia choanae, growth retardation, genital abnormalities and ear abnormalities) syndromes presented with frequent episodes of a painful, markedly erythematous eruption associated with swelling. Evaluation revealed non-specific findings on skin biopsy at the time of eruption and no pathogenic mutation in the SCN9A gene. The patient was diagnosed with secondary erythromelalgia based on clinical presentation. Erythromelalgia is a rare disorder characterised by recurrent episodes of pain and erythema typically affecting the distal extremities. This case represents the first case of erythromelalgia in the setting of DiGeorge and CHARGE syndromes.

scholarly journals The Bartonella vinsonii subsp. arupensis Immunodominant Surface Antigen BrpA Gene, Encoding a 382-Kilodalton Protein Composed of Repetitive Sequences, Is a Member of a Multigene Family Conserved among Bartonella Species

2005 ◽  
Vol 73 (5) ◽  
pp. 3128-3136 ◽  
Author(s):  
Robert D. Gilmore ◽  
Travis M. Bellville ◽  
Steven L. Sviat ◽  
Michael Frace
Keyword(s):  
Bartonella Henselae ◽  
Repetitive Sequences ◽  
Expression Library ◽  
Gene Encoding ◽  
Significant Similarity ◽  
Bartonella Quintana ◽  
Genomic Expression ◽  
Genes Encoding ◽  
Multiple Regions ◽  
Adhesin Protein

ABSTRACT Bartonella proteins that elicit an antibody response during an infection are poorly defined; therefore, to characterize antigens recognized by the host, a Bartonella genomic expression library was screened with serum from an infected mouse. This process led to the discovery of a Bartonella vinsonii subsp. arupensis gene encoding a 382-kDa protein, part of a gene family encoding large proteins, each containing multiple regions of repetitive segments. The genes were termed brpA to -C (bartonella repeat protein) and bore significant similarity to genes encoding the BadA adhesin protein and members of the variably expressed outer membrane protein family of proteins from Bartonella henselae and Bartonella quintana, respectively.

scholarly journals Characterization of Human Immunoglobulin (Ig) Isotype and IgG Subclass Response to Bartonella henselae Infection

1998 ◽  
Vol 66 (12) ◽  
pp. 5915-5920 ◽  
Author(s):  
Svena L. McGill ◽  
Russell L. Regnery ◽  
Kevin L. Karem
Keyword(s):  
Western Blot ◽  
Blot Analysis ◽  
Western Blot Analysis ◽  
Bartonella Henselae ◽  
Negative Control ◽  
Cross Reactivity ◽  
Antibody Activity ◽  
Igg Subclass ◽  
Banding Patterns ◽  
Bartonella Quintana

ABSTRACT Serologic parameters of cat scratch disease (CSD) were evaluated by Western blot analysis. Sera from patients with serologically confirmed CSD antigen were screened for immunoglobulin (Ig) isotype-specific as well as IgG subclass-specific reactivity against Bartonella henselae whole-cell antigen. Bartonella-negative control sera were used to determine baseline antibody activity. Heterogeneous B. henselae-specific IgG reactivity with numerous protein bands, ranging from >150 to <17 kDa, was observed. Though individual banding patterns were variable, one approximately 83-kDa B. henselae protein (Bh83) was immunoreactive with all CSD sera tested, suggesting it is a conserved antigen during infection. Bh83 was not recognized by reference human antisera againstRickettsia rickettsii, Chlamydia group positive, Treponema pallidum, Orientia tsutsugamushi, Fransciscella tularensis,Ehrlichia chaffeensis, Mycoplasma pneumoniae, and Escherichia coli, although other cross-reactive proteins were evident. Significantly, CSD sera failed to recognize the 83-kDa protein when tested against Bartonella quintanaantigen, though sera from B. quintana-infected patients did react to Bh83. This cross-reactivity suggests epitope conservation during infection with B. henselae or B. quintana. Western blot analysis further revealed similar banding patterns when B. henselae was reacted against the Ig isotypes IgG and IgG1 and both secretory and alpha chains of IgA. Neither IgM nor IgE reacted significantly toBartonella antigen by our Western blot analysis. Dissection of the antibody response at the IgG subclass level indicated that prominent antigen recognition was limited to IgG1. These observations provide insight into induced immunity during CSD and provide evidence for conserved epitope expression during infection withB. henselae or B. quintana.

Takotsubo cardiomyopathy associated with adrenal insufficiency in the context of long-term steroid use mimicking acute coronary syndrome

2021 ◽  
Vol 14 (1) ◽  
pp. e234983
Author(s):  
Timothy Bagnall ◽  
Ying Ran Tow ◽  
Nicholas Bunce ◽  
Zoe Astroulakis
Keyword(s):  
Acute Coronary Syndrome ◽  
Adrenal Insufficiency ◽  
Takotsubo Cardiomyopathy ◽  
Left Ventricular ◽  
Lv Function ◽  
Rapid Improvement ◽  
Steroid Use ◽  
Coronary Syndrome ◽  
First Case

Takotsubo cardiomyopathy (TCMP) is an important, though under-recognised, syndrome which mimics acute coronary syndrome (ACS) presenting with similar clinical, biochemical and ECG features. A 68-year-old man was referred as ACS for emergency coronary angiography; however, a history of lethargy, weight loss and electrolyte abnormalities prompted further investigations. Angiography was postponed, adrenal insufficiency confirmed and steroid replacement commenced. Echocardiography demonstrated reduced left ventricular (LV) function (45%) with regional wall motion abnormalities, although angiography confirmed unobstructed arteries. Steroid replacement induced a rapid improvement in symptoms and LV function. Few cases of TCMP associated with adrenal insufficiency have been reported. This appears to be the first case describing TCMP precipitated by new-onset secondary adrenal insufficiency following long-term steroid use in a male patient, and highlights the importance of considering TCMP in patients presenting with suspected ACS. Here, prompt recognition and treatment of a serious underlying disorder prevented a potentially life-threatening Addisonian crisis.

scholarly journals Acquired smooth muscle hamartoma: A case report on the lower extremity with hidrosis

2019 ◽  
Vol 7 ◽  
pp. 2050313X1989383
Author(s):  
Malika A Ladha ◽  
Todd Remington
Keyword(s):  
Smooth Muscle ◽  
Case Report ◽  
Lower Extremity ◽  
Smooth Muscle Cells ◽  
English Literature ◽  
Surgical Excision ◽  
Muscle Cells ◽  
Clinical Spectrum ◽  
Rare Entity ◽  
First Case

Smooth muscle hamartomas are benign dermal proliferations of smooth muscle cells. Smooth muscle hamartomas are sub-divided into congenital or acquired; the latter is a rare entity with less than 20 cases being reported in the English literature. Most often asymptomatic, acquired smooth muscle hamartomas follow an indolent course. Treatment in the form of surgical excision can be utilized for symptomatic or cosmetic purposes. Here, we report the first case of an acquired smooth muscle hamartomas of the shin which also uniquely presented with hidrosis. This case highlights the varied clinical spectrum of acquired smooth muscle hamartomas.

Determination of the rpoB gene sequences of Bartonella henselae and Bartonella quintana for phylogenic analysis

2000 ◽  
Vol 151 (10) ◽  
pp. 831-836 ◽  
Author(s):  
Patricia Renesto ◽  
Daniel Gautheret ◽  
Michel Drancourt ◽  
Didier Raoult
Keyword(s):  
Bartonella Henselae ◽  
Rpob Gene ◽  
Gene Sequences ◽  
Bartonella Quintana ◽  
Phylogenic Analysis
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