Multimodal Imaging Assisting the Early Diagnosis of Cat-Scratch Neuroretinitis

To describe how a multifocal fundus imaging system assisted the early diagnosis of cat scratch neuroretinitis in a case of a 27-year-old male with unilateral visual loss, neuroretinitis, and a peripapillary angiomatous lesion. Multimodal fundus imaging analysis was an essential contributor to the clinical diagnosis of cat scratch neuroretinitis during the early stage of the disease.     

蚤、蜱中巴尔通体的分离培养及检测鉴定

目的了解蚤、蜱在我国作为巴尔通体传播媒介的可能性，获得其自然状态下存在于吸血节肢动物中的证据。方法采集家猫、狗、牛及鼠类动物体表寄生蚤、蜱，采用含5％去纤维兔血脑心浸液（brain heart infusion，BHI）培养基置于35℃含5％ CO2培养箱中从蚤、蜱中分离巴尔通体，疑似菌落应用聚合酶链反应技术（Polymerase Chain Reaction，PCR）扩增巴尔通体特异基因片段，阳性产物测序并用同源性比较及系统发育分析等方法分析确定巴尔通体的亲缘关系。结果分别从猫栉首蚤、微小牛蜱中各分离出1株巴尔通体，用5对巴尔通体属特异性引物进行PCR反应，扩增产物均产生阳性目标带，证实为巴尔通体属微生物。序列同源性比较发现蚤、蜱分离株之间同源性较小，tRNA^Ile-tRNA^Ala地基因间隔区序列为58．2％、ftsZ基因序列为72．8％；这两株菌分别与云南鼠类宿主血液中分离的巴尔通体菌株RT222SM、RT221SM同源性最大，与其它已知巴尔通体同源性均较小。蚤培养物与RT222SM的tRNA^Ile-tRNA^Ala基因间隔区的同源性是77．9％、与ftsZ是96．2％；蜱培养物与RT221SM的tRNA^Ile-tRNA^Ala基因间隔区的同源性是99．4％，与云南鼠血中分离的Rf1561yn的gltA基因338bp核酸序列同源性为99．1％，基于gltA种系发育分析提示与Rfl561yn亲缘关系最近。结论从猫栉首蚤、微小牛蜱中分离培养出巴尔通体，为蚤、蜱作为巴尔通体传播媒介提供了线索，同时为在我国进一步开展媒介生物中巴尔通体感染情况调查提供了实验方法的参考依据。同源性搜索、比较及系统发育分析支持这2株巴尔通体与中国云南分离的巴尔通体基因型相似，而与国外的巴尔通体分离株亲缘关系较远。     

内蒙古小型兽类巴尔通体感染情况调查

目的 了解我国内蒙古部分地区小型兽类的巴尔通体(Bartonella)感染情况,为该地区人群巴尔通体感染的预防控制提供科学依据.方法 2012、2013年用夹夜法在内蒙古不同地区捕获小型兽类,无菌操作取鼠肝和脾,用聚合酶链反应(PCR)检测巴尔通体,对阳性产物测序,将所测核酸序列提交到GenBank,做相似性比较及序列分析.同时分别用肝和脾各30份样品分离培养巴尔通体,疑似菌株提取DNA,对gltA基因测序并根据序列进行系统发育分析,确定巴尔通体属种,并分析不同脏器、不同鼠种的阳性率.结果 2012年在内蒙古锡林郭勒盟二连浩特市共捕鼠8种117只,各鼠种均培养出巴尔通体菌,培养阳性率为56.41％(66/117),肝脏DNA直接PCR阳性率为57.26％(67/117),二者差异无统计学意义(P=0.945).30份肝样品培养阳性21份,30份脾样品培养阳性13份,二者差异亦无统计学意义(P=0.331).2013年捕获并培养分离小型兽类13种86只,有8种检出巴尔通体,培养阳性率为38.37％(33/86),其中达乌尔黄鼠最高(75.00％),其次为五趾跳鼠(71.43％)和布氏田鼠(64.29％).经分析达乌尔黄鼠、五趾跳鼠与布氏田鼠的巴尔通体阳性率差异无统计学意义(P=0.883).序列分析表明内蒙古部分地区小型兽类中共检出4个巴尔通体种群:B.jaculi、B.grahamii、B.washoensis和B.vinsonii,有明显的宿主特异性.结论 巴尔通体在内蒙古部分地区小型兽类中广泛存在,存在对人群致病的风险,序列分析显示出巴尔通体基因型别的多样性,为内蒙古及我国北方其他地区巴尔通体的研究奠定了基础.     

Cat scratch disease encephalopathy in an immunocompetent patient

Cat scratch disease (CSD) is typically a self-limited regional lymphadenopathy in children and young adults that is caused by Bartonella henselae. The majority of CSD cases resolve spontaneously; however, many systemic complications have been described. We report an unusual case of CSD presenting as an epitrochlear arm mass and complicated by encephalopathy. Identification of B. henselae DNA in the affected lymph node and cerebrospinal fluid confirmed the diagnosis of CSD. Systemic antibiotic therapy was administered and the patient improved without any neurological deficit.     

探讨基于不同基因设计的巴尔通体特异引物

巴尔通体是一群革兰染色阴性、营养要求苛刻兼性细胞内寄生的需氧多形杆菌,呈全球性分布的新发现的病原体,重要性不断增加。巴尔通体培养较难,表型特征少,其鉴定主要根据基因扩增。合适的引物尤为重要。在巴尔通体检测、鉴定和种系发生研究中,设计和应用引物较多,主要基于16SrDNA、16S～23SrRNAITS、gltA、rpoB、ribC、groEL和fisZ基因等。该文就几种常被选择基因及所设计的引物在巴尔通体研究中的运用做一综述。     

Risk Factors for Human Lice and Bartonellosis among the Homeless,San Francisco,California, USA

Homeless persons in San Francisco, California, USA, have been shown to have head and body lice infestations and Bartonella quintana infections. We surveyed a self-selected population of homeless persons in San Francisco to assess infestations of head and body lice, risks of having body lice, and presence of B. quintana in lice. A total of 203 persons who reported itching were surveyed during 2008–2010 and 2012: 60 (30%) had body lice, 10 (4.9%) had head lice, and 6 (3.0%) had both. B. quintana was detected in 10 (15.9%) of 63 body lice pools and in 6 (37.5%) of 16 head lice pools. Variables significantly associated (p<0.05) with having body lice in this homeless population included male sex, African–American ethnicity, and sleeping outdoors. Our study findings suggest that specific segments of the homeless population would benefit from information on preventing body lice infestations and louseborne diseases.