Galaxy Radar – Week of September 9, 2024

Bartonella Eye Symptoms – Clotting in One Case, Bleeding in Another

Cat Scratch Disease Presenting with Right Branch Retinal Artery Occlusion and Left Neuroretinitis by S Jafari & JA Micieli publishing from Toronto, Canada

A man had flu-like symptoms after exposure to a stray kitten. He then had a blocked artery in one eye and neuroretinitis (an inflamed nerve and retina) in the other. He was tested for a variety of infectious diseases as well as brain and heart abnormalities and other abnormalities that might cause clotting. His Bartonella henselae IgG serology test was positive.

Like another case we highlighted last week, he did not develop a macular star until late in the course of his disease. His positive serology continued as well, so he was treated with antibiotics and his vision returned to 20/20. Developing symptoms in both eyes is very unusual, and BRAO (the artery block) associated with bartonellosis is very rarely reported.

Atypical Haemorrhagic Presentation of Neuro-Retinitis and Serous Retinal Detachment Secondary to Cat-Scratch Disease by HC Skrehot et al. publishing from Baylor College of Medicine

A 14-year-old girl had bleeding and subretinal fluid with retinal detachment two weeks after being scratched by a cat, along with more typical symptoms of Bartonella henselae infection affecting the eye. Consistent with the lack of research information about antibiotic selection, every case presented this week was treated with different antibiotics. In this case, a prednisone taper was added.

Bartonella Osteomyelitis in a Child

Bartonella henselae Hepatic Abscesses and Associated Osteomyelitis in a Pediatric Patient by M Antonson, L Klingemann & K Neemann publishing from University of Nevada Medical Center

After some missteps, a 2-year-old with fever and a limp was admitted to the hospital. Imaging found bone infection and abscesses in his liver and pelvic area. The child lived in a house infested with mice, and a cat had recently died and two kittens had been brought into the home. The child had also recently been on a trip to Guatemala. The abscesses did not culture, but serology and PCR tests were positive for Bartonella henselae.

In the discussion, the authors note the importance of a cat history in diagnosing unexplained fever and musculoskeletal pain in children. They also point out the lack of trial data on the best antibiotics to use to treat disseminated Bartonella infection.

Galaxy Diagnostics uses patented BAPGM sample enrichment for detection of low-abundance Bartonella species infections. Find out more.

Lyme Arthritis and Genetic Traits in the Patient

Disease-specific T Cell Receptors Maintain Pathogenic T Helper Cell Responses in Postinfectious Lyme Arthritis by J Dirks et al. publishing from Germany

Research on Lyme disease and its associated disease process is complicated by genetic variation at every step: the pathogen, the vector, the reservoir species, and the human host. Here, researchers studying Lyme disease-associated arthritis that does not respond to antibiotics found that European patients had a genetic grouping that was not found in North American patients.

In fact, this same genetic trait had previously been found to be protective against this condition in North America. Most Lyme disease in the United States is caused by Borrelia burgdorferi s.s. (a wide range of genotypes), but most European Lyme disease cases are caused by B. afzelii. Is this the reason for the difference? Or is there more going on in the human genetics? The full explanation of this difference is not yet understood.

Lyme Dual Detect at Galaxy Diagnostics uses both direct and indirect testing methods. Find out more about our revolutionary direct detection method.

Babesiosis in a Patient without a Spleen

Asplenia-Associated Babesiosis: A Quagmire Traversed by Exchange Transfusion by MUR Gondal et al. publishing from the USA and Pakistan

Patients who have had their spleen removed are at risk for severe infections. In this case, a man who had his spleen removed after a car accident some time in the past was now very ill with a fever and other symptoms. A variety of infectious disease tests were performed and he was positive for Babesia microti.

Unfortunately, despite IV antibiotic treatment, his infection level continued to rise past 10%, associated with severe disease. Red blood cell exchange transfusion was used for four days to get his infection level down. He was then able to go home with oral antibiotics to continue his recovery.

Continuing Education with Dr. Breitschwerdt

Part 1 | Bridging the Gap: A Panel Discussion on Human and Animal Health on Invisible Education – Dr. Breitschwerdt is a member of this panel. CME pending.

Coinfection Complexity Demonstrated in Mice

Co-infection Dynamics of B. afzelii and TBEV in C3H Mice: Insights and Implications for Future Research by S Porcelli et al. publishing from France and the Czech Republic

Co-infections are not simply the sum of their parts. In this study, researchers infected mice with Borrelia afzelii (a cause of Lyme disease in Europe) and tick-borne encephalitic virus (TBEV, another disease found in Europe). When they tried to infect mice with both at the same time, they had trouble causing a TBEV infection. They caution that this may have been an issue with their methods and not necessarily that B. afzelii infection blocks simultaneous infection with TBEV.

When they infected the mice with TBEV shortly after the B. afzelii, the symptoms were worse, with higher viral levels. However, if they waited 21 days, the TBEV symptoms were milder. The authors note that tick-borne disease coinfection is very common for people with Lyme disease and much more needs to be known about all possible coinfections.

Reservoir Species’ Ecological Role

The Economic Impacts of Ecosystem Disruptions: Costs from Substituting Biological Pest Control by EG Frank from the Harris School of Public Policy at the University of Chicago publishing in Science

Zoonotic disease sometimes shines a spotlight on a reservoir species that ends up being made out to be the enemy. We see that with cats and Bartonella, and bats fall victim to this for coronaviruses and other pathogens around the world.

However, a recent study of the die-off of bats in North America from white-nose disease points out that ecological health is more complicated than any one pathogen. The death of the bats led to an increase in pesticide use. A researcher has linked this to increases in infant mortality as well as changes in wildlife health.

Worldwide Response to Zoonotic Disease

COVID, Mpox, Bird Flu: Why Viruses Are Jumping from Animals to Humans by D Clarence publishing from New Delhi – Concern about zoonotic disease is worldwide, with India Today publishing an explainer about why new zoonotic diseases seem to be becoming more frequent.

Tripartite and US CDC Supported One Health Zoonotic Diseases Prioritization Workshop in Sri Lanka – At this meeting, 51 zoonotic diseases of highest concern were identified, with brucellosis among the top 10.

Galaxy Calendar

ILADS Annual Scientific Conference, November 7-10, 2024 – Galaxy Diagnostics speakers will include CEO Nicole Bell. Find us in the exhibitor hall.