Prevalence of Bartonella infection among human immunodeficiency virus-infected patients with fever. 2003

Jane E Koehler, and Melissa A Sanchez, and Sherilyn Tye, and Claudia S Garrido-Rowland, and Frederick M Chen, and Toby Maurer, and Judy L Cooper, and James G Olson, and Arthur L Reingold, and W Keith Hadley, and Russell R Regnery, and Jordan W Tappero
Department of Medicine, University of California at San Francisco, San Francisco, CA 94143, USA. jkoehler@medicine.ucsf.edu

Bartonella infection can be difficult to diagnose, especially when it manifests as bacteremia, which is usually accompanied by nonspecific symptoms, such as fever. Therefore, we hypothesized that Bartonella infection represents an underrecognized cause of febrile illness. To determine the prevalence of Bartonella infection among patients presenting with fever, we evaluated 382 patients in San Francisco. Overall, 68 patients (18%) had evidence of Bartonella infection detected by culture, indirect fluorescent antibody testing, or polymerase chain reaction (PCR). Twelve patients (3%) had either Bartonella henselae or Bartonella quintana isolated from specimens of blood, tissue, or both or had DNA detected in tissue; all 12 had concomitant human immunodeficiency virus (HIV) infection. Bartonella antibodies were detected in 17% of febrile patients, including 75% of culture-positive or PCR-positive patients. In a nested, matched case-control study aimed at identifying clinical features of febrile illness associated with Bartonella infection, only bacillary angiomatosis and elevated alkaline phosphatase levels were associated with Bartonella infection (P< or =.03 for both). The prevalence of Bartonella infection among patients with late-stage HIV infection and unexplained fever is much greater than has previously been documented.

UI MeSH Term Description Entries
D004781 Environmental Exposure The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. Exposure, Environmental,Environmental Exposures,Exposures, Environmental
D005334 Fever An abnormal elevation of body temperature, usually as a result of a pathologic process. Pyrexia,Fevers,Pyrexias
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001473 Bartonella A genus of gram-negative bacteria characteristically appearing in chains of several segmenting organisms. It occurs in man and arthropod vectors and is found only in the Andes region of South America. This genus is the etiologic agent of human bartonellosis. The genus Rochalimaea, once considered a separate genus, has recently been combined with the genus Bartonella as a result of high levels of relatedness in 16S rRNA sequence data and DNA hybridization data. Rochalimaea
D001474 Bartonella Infections Infections by the genus BARTONELLA. Bartonella bacilliformis can cause acute febrile anemia, designated Oroya fever, and a benign skin eruption, called verruga peruana. BARTONELLA QUINTANA causes TRENCH FEVER, while BARTONELLA HENSELAE is the etiologic agent of bacillary angiomatosis (ANGIOMATOSIS, BACILLARY) and is also one of the causes of CAT-SCRATCH DISEASE. Bartonellosis,Carrion's Disease,Oroya Fever,Rochalimaea Infections,Verruga Peruana,Bartonella bacilliformis Infection,Carrion Disease,Infections, Bartonella,Infections, Rochalimaea,Bartonella Infection,Bartonella bacilliformis Infections,Bartonelloses,Disease, Carrion,Disease, Carrion's,Fever, Oroya,Infection, Bartonella,Infection, Bartonella bacilliformis,Infection, Rochalimaea,Rochalimaea Infection
D012698 Serologic Tests Diagnostic procedures involving immunoglobulin reactions. Serodiagnosis,Serologic Test,Serological Tests,Test, Serologic,Tests, Serologic,Serodiagnoses,Serological Test,Test, Serological,Tests, Serological
D012923 Social Class A stratum of people with similar position and prestige; includes social stratification. Social class is measured by criteria such as education, occupation, and income. Caste,Social Gradients,Socioeconomic Level,Socioeconomic Status,Middle Class Population,Castes,Class, Social,Gradient, Social,Level, Socioeconomic,Middle Class Populations,Population, Middle Class,Social Classes,Social Gradient,Socioeconomic Levels,Status, Socioeconomic
D015658 HIV Infections Includes the spectrum of human immunodeficiency virus infections that range from asymptomatic seropositivity, thru AIDS-related complex (ARC), to acquired immunodeficiency syndrome (AIDS). HTLV-III Infections,HTLV-III-LAV Infections,T-Lymphotropic Virus Type III Infections, Human,HIV Coinfection,Coinfection, HIV,Coinfections, HIV,HIV Coinfections,HIV Infection,HTLV III Infections,HTLV III LAV Infections,HTLV-III Infection,HTLV-III-LAV Infection,Infection, HIV,Infection, HTLV-III,Infection, HTLV-III-LAV,Infections, HIV,Infections, HTLV-III,Infections, HTLV-III-LAV,T Lymphotropic Virus Type III Infections, Human
D015995 Prevalence The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time. Period Prevalence,Point Prevalence,Period Prevalences,Point Prevalences,Prevalence, Period,Prevalence, Point,Prevalences
D016022 Case-Control Studies Comparisons that start with the identification of persons with the disease or outcome of interest and a control (comparison, referent) group without the disease or outcome of interest. The relationship of an attribute is examined by comparing both groups with regard to the frequency or levels of outcome over time. Case-Base Studies,Case-Comparison Studies,Case-Referent Studies,Matched Case-Control Studies,Nested Case-Control Studies,Case Control Studies,Case-Compeer Studies,Case-Referrent Studies,Case Base Studies,Case Comparison Studies,Case Control Study,Case Referent Studies,Case Referrent Studies,Case-Comparison Study,Case-Control Studies, Matched,Case-Control Studies, Nested,Case-Control Study,Case-Control Study, Matched,Case-Control Study, Nested,Case-Referent Study,Case-Referrent Study,Matched Case Control Studies,Matched Case-Control Study,Nested Case Control Studies,Nested Case-Control Study,Studies, Case Control,Studies, Case-Base,Studies, Case-Comparison,Studies, Case-Compeer,Studies, Case-Control,Studies, Case-Referent,Studies, Case-Referrent,Studies, Matched Case-Control,Studies, Nested Case-Control,Study, Case Control,Study, Case-Comparison,Study, Case-Control,Study, Case-Referent,Study, Case-Referrent,Study, Matched Case-Control,Study, Nested Case-Control

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