E. Eskow et al., Concurrent infection of the central nervous system by Borrelia burgdorferiand Bartonella henselae - Evidence for a novel tick-borne disease complex, ARCH NEUROL, 58(9), 2001, pp. 1357-1363
Objectives: To investigate Bartonella henselae as a potential human tick-bo
rne pathogen and to evaluate its role as a coinfecting agent of the central
nervous system in the presence of neuroborreliosis.
Design: Case report study.
Setting: A primary health care center in Flemington, NJ, and the Department
of Research and Development at Medical Diagnostic Laboratories LLC in Mt L
aurel, NJ.
Subjects: Two male patients (aged 14 and 36 years) and 2 female patients (a
ged 15 and 30 years, respectively) with a history of tick bites and Lyme di
sease.
Main Outcome Measures: Laboratory and diagnostic findings before and after
antimicrobial therapy.
Results: Patients residing in a Lyme-endemic area of New Jersey with ongoin
g symptoms attributed to chronic Lyme disease were evaluated for possible c
oinfection with Bartonella species. Elevated levels of B henselae-specific
antibodies were found in these patients using the immunofluorescent assay.
Bartonella henselae-specific DNA was detected in their blood. None of these
patients exhibited the clinical characteristics of cat-scratch disease. Fi
ndings of cerebrospinal fluid analysis revealed the presence of both B hens
elae- and Borrelia burgdorferi-specific DNA. Bartonella henselae-specific D
NA was also detected in live deer ticks obtained from the households of 2 o
f these patients.
Conclusions: Our data implicate B henselae as a potential human tick-borne
pathogen. Patients with a history of neuroborreliosis who have incomplete r
esolution of symptoms should be evaluated for B henselae infection.