Life-threatening angioedema of the tongue: the detection of the RNA ofB henselaein the saliva of a male patient and his dog as well as of the DNA of threeBartonellaspecies in the blood of the patient

Abstract

Non-hereditary angioedema is a common disease with a prevalence between 5% and 19% and approximately half of the patients experience a swelling of the tongue. We report a case of a 49-year-old Caucasian man with a gross life-threatening angioedema of the tongue, whose attacks occurred every 4 weeks. The most frequent causes of angioedema were excluded. We detected DNA and RNA from Bartonella henselae in the blood and saliva of the patient and in the saliva of the patient's hunting dog. Treatment with azithromycin plus minocycline cleared the blood and saliva of RNA and DNA of Bartonella species, and the patient has been free from angioedema for 1 year. None of the therapy modalities used to treat the hereditary form or ACE or allergy-induced angioedema affect the detrimental course caused by Bartonella species. We therefore suggest that a molecular Bartonella test be included in the analysis of angioedema.

Detection ofBartonellaspp. in dogs after infection withRickettsia rickettsii

“…DNA on oral swabs . Bartonella henselae DNA was found in the saliva of a man with angioedema of the tongue and in his healthy dog, and in eastern China Bartonella exposure was associated with dog bites . However, the extent to which saliva might be infectious has not been established and direct transmission among dogs has not been reported.…”