Bartonella henselae and Coxiella burnetii Infection and the Kawasaki Disease

Abstract

It was reported that Bartonella henselae, B. quintana and Coxiella burnetii was not strongly associated with coronary artery disease but on the basis of geometric mean titer, C. burnetii infection might have a modest association with coronary artery disease. Serum antibodies to B. henselae from 14 patients with acute phase of Kawasaki disease were determined by the indirect fluorescence antibody assay .Serum antibodies to C. burnetii were also tried to detect. However, no positive results were obtained. I also examined 10 children and 10 pregnant women who had serum IgG antibody to B. henselae or to C. burnetii. No one showed abnormal findings of coronary artery. @JASEM Several Bartonella species cause illness and asymptotic infection in humans. B. henselae has been associated with an increasing spectrum of clinical syndromes including cat scratch disease. Although the clinical spectrum has not been completely clarified, B. quintana may cause blood-culture negative endocarditis in children (Barbe et al, 2000). Coxiella burnetii causes in humans a widespread zoonosis, Q fever, though in many cases infection is asymptomatic and confirmed by serologic diagnosis only (Kafetzis et al., 2001). Endocarditis is the most common presentation of chronic Q fever. B. henselae, B. quintana and C. burnetii also can adhere to and enter endothelial cells and cause local inflammation (Sawyer et al., 1987). Inflammation clearly plays an important role in the atherosclerotic process, and chronic intercellular infections due to these organisms were speculated to play an important role in this inflammatory pathogenesis (Ender et al., 2001). Vasculitis has some kind of role in the pathogenesis of atherosclerosis.Bacteremia or presence of infectious agents in blood stream has been associated vasculitis and endocarditis. An association between C. burnetii infection and long-term vascular complications was suggested (Dehio, 1999 MATERIALS AND METHODSCoronary artery disease is an inflammatory condition associated with several infections, including Chlamydia pneumoniae, cytomegalovirus, Helicobacter pylori and other intercellular bacteria (Danesh et al., 1997). Previous studies supported the possibility of certain populations having an association of infections and coronary artery disease Kawasaki disease (KD). KD with characteristic complication of coronary arteries in children has long been considered to have an infectious cause, but no association has been reported with Rickettsia conorii, Rickettsiae typhi, C. burnetii, or Ehrlichia phagocytophilia (Lovey et al., 1999). Serum IgG and IgM antibodies to the Houston-1 isolate of B. henselae (ATCC 49882) from 14 patients with acute phase of KD were determined by the indirect fluorescence antibody assay (IFA) as described previously (Numazaki et al., 2000). Serum antibody titers greater than 1:64 for IgG and 1:16 for IgM against B. henselae were considered positive. Serum IgG and IgM antibodies to C. burnetii Nine Mile phase II were also tried to detect. Serum antibody titers gre...