Concurrent Infection of the Central Nervous System by Borrelia burgdorferi and Bartonella henselae

Abstract

Our data implicate B henselae as a potential human tick-borne pathogen. Patients with a history of neuroborreliosis who have incomplete resolution of symptoms should be evaluated for B henselae infection.

Transmission ofBartonella henselaebyIxodes ricinus

“…(11,12,19,23,25,28,29). This suggestion was based on indirect data for detection of bacterial DNA in ticks (18,19,24), humans exposed to tick bites (30), or serologic evidence of co-infection of humans with pathogens known to be transmitted by ticks (11,36). Diffi culties in rearing I. ricinus and lack of a rodent model for B. henselae infection may explain the absence of data demonstrating the role of this tick as a vector of B. henselae.…”

“…B. henselae causes cat-scratch disease, possibly the most common zoonosis acquired from domestic animals in industrialized countries and is becoming increasingly associated with other syndromes, particularly ocular infections and endocarditis (2)(3)(4)(5)(6). Although cat fl eas are well-established vectors for B. henselae (7)(8)(9)(10), transmission by other arthropods, in particular ticks, has been suggested (11)(12)(13). Ixodes ricinus is the most widespread and abundant ixodid tick in western Europe and is frequently associated with bites in humans.…”

“…In humans, several case studies have reported patients with concurrent Bartonella seropositivity and detection of Bartonella spp. DNA in their blood, along with B. burgdorferi infection of the central nervous system after tick bites (11,29). Moreover, Bartonella spp.…”

Evidence of Bartonella sp. in questing adult and nymphal Ixodes ricinus ticks from France and co-infection with Borrelia burgdorferi sensu lato and Babesia sp.

“…Furthermore, there are several reports of co-segregation of Bartonella sp. with known tick-borne pathogens [4,16,24,39], emphasising the putative role of ticks in Bartonella transmission. It has been shown that Bartonella co-segregates in ticks with Borrelia burgdorferi sensu lato [21,39], the causative agent of Lyme borreliosis and co-segregation of Bartonella with protozoan parasites of the genus Babesia is also suspected [21,24,42].…”

“…Babesia sp., the causative agents of babesiosis are transmitted by ixodid ticks and are capable of infecting a wide variety of vertebrate hosts including humans and cattle [20]. Co-infections of Borrelia burgdorferi sensu lato with Bartonella henselae have been found in patients presenting symptoms of atypical neuroborreliosis [16,35] while mice have been found to be naturally co-infected with Borrelia burgdorferi, Babesia microti and a novel Bartonella sp. in the USA [21].…”