Vet Dermatol 2018 DOI: 10.1111/vde.

12695

Bartonella henselae in a dog with ear tip vasculitis

Brittany L. Southern*, Pradeep Neupane†, Marna E. Ericson‡, Jamie C. Dencklau‡, Keith E. Linder§ ,
Julie M. Bradley†, Gabriel P. McKeon*, Charles T. Long¶ and Edward B. Breitschwerdt†
*Laboratory Animal Resources, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC 27607, USA
†Intracellular Pathogens Research Laboratory, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University,
1050 William Moore Drive, Raleigh, NC 27607, USA
‡Dermatology Imaging Center, Department of Dermatology, University of Minnesota, 2-145 Jackson Hall, 321 Church St. S.E, Minneapolis, MN
55455, USA
§Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive,
Raleigh, NC 27607, USA
¶Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, 1100 Bioinformatics Building, Chapel Hill, NC
27599, USA
Correspondence: Edward B. Breitschwerdt, Laboratory Animal Resources, College of Veterinary Medicine, North Carolina State University, 1060
William Moore Drive, Raleigh, NC 27607, USA. E-mail: ed_breitschwerdt@ncsu.edu

Background – Bartonella henselae, a Gram-negative, zoonotic, alpha-proteobacteria has been previously impli-
cated in association with cutaneous vasoproliferative lesions (bacillary angiomatosis), nodular panniculitis and
multifocal erythema (erythema multiforme) in dogs.
Objective – Describe clinical, microbiological and histological lesions in a dog with ear margin vasculitis and
B. henselae infection.
Animals – A 12-month-old, specific pathogen-free intact female beagle dog maintained in a vector-free labora-
tory animal resource facility.
Methods and materials – Bartonella and Rickettsia serological evaluation, Bartonella and Rickettsia PCR, Bar-
tonella alpha-proteobacteria growth medium (BAPGM) enrichment blood culture/PCR, histopathological investi-
gation and confocal immunohistochemical evaluation.
Results – Serological investigation (seroreversion) and PCR testing of aural tissue biopsies failed to support Rick-
ettsia rickettsii as a cause of the aural vasculitis; however, B. henselae, genotype San Antonio 2 DNA was ampli-
fied and sequenced from both ear tip margins and from normal-appearing abdominal skin. Seroconversion to
B. henselae was documented retrospectively by IFA testing. Bartonella henselae organisms were visualized by
confocal immunostaining within all three biopsies. Histopathology revealed small vessel necrotizing vasculitis
and dermal necrosis. Bartonella henselae seroreversion and complete resolution of skin lesions occurred in con-
junction with administration of oral doxycycline and enrofloxacin for six weeks.
Conclusions and Clinical Importance – Bartonella henselae is an emerging zoonotic pathogen that has been
associated with leucocytoclastic vasculitis in humans and may have had a contributing or causative role in the
development of the cutaneous aural margin vasculitis in this beagle.

other highly adaptive intracellular vector-transmitted

Introduction
Bartonella spp. cause chronic intra-erythrocytic and
endotheliotropic infections in mammals, potentially span-
ning weeks, months or years in duration.1–3 Similar to
Accepted 14 August 2018
Conflicts of interest: In conjunction with Sushama Sontakke
and North Carolina State University, Edward B. Breitschwerdt
holds US patent number 7,115,385; Media and Methods for culti-
vation of micro-organisms, which was issued October 3, 2006.
He is a co-founder, shareholder and Chief Scientific Officer for
Galaxy Diagnostics, a company that provides advanced diagnos-
tic testing for the detection of Bartonella species infections. The
remaining authors have no competing interests.
Sources of funding: This study was supported in part by IDEXX
Laboratories and by unrestricted donations to the NCSU-CVM
Foundation for Bartonella/Vector Borne Diseases Research,
Raleigh, NC, USA.
© 2018 ESVD and ACVD, Veterinary Dermatology
pathogens, factors that result in disease manifestations
are most likely multifactorial and variable among individual
patients.
After the “rediscovery” of the genus Bartonella in asso-
ciation with the AIDS epidemic, research focused on the
pathogenesis of vascular endothelial proliferative lesions
such as bacillary angiomatosis, peliosis hepatis or peliosis
splenis.3 Researchers have emphasized a dermal niche,
as well as the previously described vascular niche, as an
important component of the pathophysiology of Bar-
tonella infections.4 We report a novel clinical presentation
in a beagle infected with B. henselae genotype San Anto-
nio 2 (BhSA2), while being maintained in a vector-free
environment.
Case report
A 12-month-old, intact female beagle dog was obtained
from Covance Laboratories, a commercial vendor in
1
Southern et al.

Cumberland, VA, USA. Subsequently, the dog was main-

tained in our AAALAC-accredited facility in accordance
with the Animal Welfare Act and Guide for the Care and
Use of Laboratory Animals. All procedures for animal use
were approved by the North Carolina State University
(NCSU) Institutional Animal Care and Use committee.
The dog was housed in an indoor, limited access facility,
fed a commercial diet twice daily (Laboratory Canine Diet
5006, LabDiet; St Louis, MO, USA), and received daily
environmental and social enrichment activities.
After an acclimation period, six dogs were infected
intradermally with Rickettsia rickettsii to generate
sequentially timed blood specimens to facilitate opti-
mization of Rocky Mountain Spotted Fever (RMSF)
diagnosis in naturally infected dogs. When retrospec-
tively tested, the R. rickettsii inoculum used for this
study was PCR negative for Bartonella spp. DNA. As
planned, infection resulted in a short duration illness,
accompanied by self-limiting fever and thrombocytope-
nia, with spontaneous recovery beginning three days
after R. rickettsii inoculation. All dogs in the study
remained afebrile and clinically normal for the next six
weeks, during which time sequential blood specimens
were collected and R. rickettsii seroconversion was
documented in all six dogs. Figure 1. Beagle dog with Bartonella henselae associated skin
By post-infection day (PID) 46, one of the six dogs lesions.
developed moist dermatitis with haemorrhage along the (a) Scaling and alopecia of the outer pinna margins at 10 weeks post-
right aural margin. Assuming a minor traumatic injury to Rickettsia rickettsii infection. (b) Scaling, mild crusting and alopecia
the ear, treatment for seven days with a combination of concave pinna margin, and (c) progressive alopecia and hyperpig-
mentation along pinna 12 weeks post-Rickettsia rickettsii infection.
antibiotic, antifungal and anti-inflammatory topical oint-
(d) Healed outer pinna after treatment 57 weeks post-R. rickettsii
ment (Quadritop, Henry Schein Inc.; Melville, NY, USA) infection.
resulted in complete lesion resolution. Approximately one
month later (PID 80) aural margin dermatitis involving
both pinnae reoccurred (Figure 1). The lesions pro-
gressed despite treatment with a topical moisturizer
spray once daily (Douxo Seborrhea, Ceva Animal Health;
Lenexa, KS, USA). By PID 108, alopecia, scaling, mild
crusting and hyperpigmentation involved both the inner
and outer aural margins (Figure 1a and b). Hairs were
easily epilated from the skin over the ears. The moistur-
izer spray was stopped. An in-house dermatophyte test
was negative for fungal culture. At PID 128, the only
abnormality in the complete blood count was a mild non-
regenerative anaemia {haematocrit 36% [reference inter-
val (RI) 39.2–55.9], absolute reticulocytes 51,800/lL
(RI < 60,000)}, a decrease from a 47% haematocrit pre-
infection with R. rickettsii and 49% on PID 39. A serum
biochemical panel and thyroid (T4 and free T4 equilibrium
dialysis) results were unremarkable (Antech Diagnostics; Figure 2. Beagle dog with Bartonella henselae associated skin
Southhaven, MS, USA). lesions.
Laser scanning confocal projection of the left ear margin skin biopsy
As per the R. rickettsii study protocol, sequential blood
obtained 12 weeks post-Rickettsia rickettsii infection. Immunoreac-
and serum samples were collected during the study per- tive Bartonella spp. organisms (green) are predominantly associated
iod (from pre-inoculation day 38 to PID 39). When one of with a vessel wall (red) which is immunoreactive to collagen type IV.
five dogs developed cutaneous aural margin lesions after
completion of the R. rickettsii study (one dog was 128, skin biopsies were obtained aseptically from each
adopted out after the completion of the R. rickettsii study aural margin and abdominal skin.
and was lost to follow-up), additional blood and serum Testing procedures used to assess exposure (serological
samples were collected on PID 113, 123, 201, 204 and investigation) and infection (PCR/DNA sequencing) for
206. Due to lesion progression, biopsies were obtained R. rickettsii, B. henselae and for other vector-borne
from both aural margins and from normal-appearing ven- organisms in the dog with aural margin vasculitis are
tral abdominal skin. Skin lesions were never observed in described in Data S1.5–7 The dog seroconverted to
the other five dogs. Following general anaesthesia on PID R. rickettsii (IFA titre <1:16 pre-infection, peak titre
2 © 2018 ESVD and ACVD, Veterinary Dermatology

Figure 3. Beagle dog with Bartonella henselae associated ear mar-
gin skin lesions.
Histological evaluation revealed a necrotizing small vessel vasculitis.
Small swollen pale vessels (arrowhead) in the dermis are obscured
by lytic necrosis, mild haemorrhage and degenerate neutrophils (ar-
rows). Haematoxylin and eosin; 9400.
1:4,096 on PID 11) and remained R. rickettsii seroreac-
tive with titres progressively decreasing (seroreversion)
to 1:256 by PID 206. Based upon retrospective sero-
logical testing, B. henselae antibodies were not
detected in the dog’s pre-R. rickettsii infection (four
time points tested) sera, but were detectable (≥1:64)
on PID 9, 113, 123, 201, 204 and 206. All EDTA blood
specimens were Bartonella spp. and Rickettsia spp.
PCR negative throughout the study. Bartonella spp.
DNA was not amplified from BAPGM enrichment blood
cultures processed between PID 113 and 206.
By targeting the 16S–23S ITS region, B. henselae SA2
DNA was PCR amplified and successfully sequenced
from each of the dog’s three tissue biopsies (100% simi-
larity, 550 of 550 bp to GenBank accession # AF369529).
The ITS result was further confirmed by PCR amplifica-
tion and DNA sequencing of the partial ssrA gene from
the left aural margin and abdominal biopsy (PCR negative
for right aural margin DNA extraction).
By laser confocal immunohistochemical evaluation,
Bartonella organisms were visualized within dermal blood
vessels in the dog’s aural lesions; illustrated in a z-stack
projection of 83, 0.45 lm optical sections (total thick-
ness = 37 lm) (Figure 2).8
With serial tissue sectioning, histopathological investi-
gation revealed mild, multifocal necrotizing small vessel
vasculitis (Figure 3) with degenerate neutrophils and
fewer macrophages associated with small foci of lytic der-
mal necrosis. Mild perivascular infiltrates of lymphocytes
and plasma cells were present in some areas. Warthin–
Starry silver staining of three stepped histological sections
of lesions was negative or equivocal for the presence of
bacteria. Bartonella henselae IFA seroconversion (<1:16
to 1:128 on PID 113 and 1:1,024 on PID 123) was docu-
mented. Rickettsia rickettsii DNA was not amplified from
the dog’s three cutaneous biopsies.
© 2018 ESVD and ACVD, Veterinary Dermatology
Bartonella and cutaneous vasculitis
Based on B. henselae serological investigation and tis-
sue PCR results, the dog was treated with oral doxycy-
cline (10 mg/kg twice daily) and enrofloxacin (10 mg/kg
once daily) for six weeks. While awaiting diagnostic test
results and prior to administering antibiotics, the skin
lesions improved with hair regrowth beginning along both
pinnae. Following the course of antibiotics, both ears
appeared normal. Bartonella seroreversion (B. henselae
IFA titre decreased from 1:1,024 on PID 123 to 1:256 on
PID 201) was documented, and the nonregenerative
anaemia had resolved (haematocrit 47%). One year later,
the dog remained healthy without developing additional
cutaneous lesions.
Discussion
We describe a dog that developed aural margin vasculitis,
accompanied by alopecia, scaling, crusting and hyperpig-
mentation. Bartonella henselae infection was confirmed
by seroconversion, PCR amplification/DNA sequencing
targeting two B. henselae genes, visualization of
organisms using immunohistochemical investigation and
seroreversion in conjunction with antibiotic administra-
tion. Vasculitis secondary to B. henselae infection has
been associated with dermal lesions, cerebral infarction
and splenic infarction in dogs and humans.9,10 In dogs,
cutaneous vasculitis can be caused by infectious agents,
drug reactions, autoimmune diseases or remain idio-
pathic.11 Diagnosis is based on biopsy and histological
examination; therapy is directed at the underlying cause.
In this case, the aural dermatitis resolved in conjunction
with antibiotic administration with no recurrence within a
12 month follow-up period, supporting our suspicions for
an infectious aetiology. Although case reports cannot
prove causation, the findings in this dog may be useful to
clinicians evaluating similar dermatological aural lesions.
It is of interest that the initial right aural lesion resolved
with a short course of topical medications, only to have
more severe aural lesions reoccur bilaterally approxi-
mately one month later. Whether these aural lesions
would have resolved spontaneously or additional reoccur-
rences would have developed if the dog were not treated
with antibiotics is unknown.
Several arthropod vectors, including fleas and ticks, can
transmit Bartonella species to dogs and humans. The bac-
terium is most often transmitted through the contamina-
tion of a bite or scratch with Bartonella spp. contained
within the vectors faeces. The dog in this case report
lived in a barrier facility with no access to vectors or the
outside environment, but did interact with five other dogs
and human caretakers. Thus, access to vectors or vector
faeces was unlikely. The exact mode of infection for this
dog was not determined, but one other dog in the R. rick-
ettsii study group was B. henselae IFA and Western
immunoblot seroreactive prior to infection with R. rick-
ettsii. That seroreactive dog was clinically healthy with no
skin lesions, but may have been a source for horizontal
transmission of B. henselae. Bartonella spp. DNA has
been amplified from dog saliva, but a potential role for
salivary transmission is unknown.12 Once infected, the
oozing aural lesions may have posed a risk for bacterial
transmission to other dogs or humans. Bartonella spp.
3
Southern et al.

have been transmitted to humans through dog bites and
by needle stick,1,2 but it is unknown if direct contact with
B. henselae infected skin lesions could result in zoonotic
bacterial transmission. We conclude that additional
research is needed to further define modes of transmis-
sion and the potential role of Bartonella spp. as a cause of
vasculitis, thromboembolism and cutaneous aural lesions
in dogs.
Acknowledgements
We express our gratitude to the NCSU-CVM Laboratory
Animal Resources technical staff for their assistance and
outstanding care of the study dogs.
References
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spect Med 2013; 3: a010231.
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diagnosis of Bartonella infection in 61 dogs from the United
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6. Kidd L, Qurollo B, Lappin M et al. Prevalence of vector-borne
pathogens in southern California dogs with clinical and laboratory
abnormalities consistent with immune-mediated disease. J Vet
Intern Med 2017; 31: 1,081–1,090.
7. Varanat M, Maggi RG, Linder KE et al. Cross-contamination in
the molecular detection of Bartonella from paraffin-embedded
tissues. Vet Pathol 2009; 46: 940–944.
8. Ericson M. Imaging tools in discovery and development of phy-
tochemical chemopreventive agents. In: Bode AM, Dong Z, eds.
Cancer prevention dietary factors and pharmacology. New York,
NY: Humana Press, Springer Science Business Media, 2014;
249–264.
9. Balakrishnan N, Ericson M, Maggi R et al. Vasculitis, cerebral
infarction and persistent Bartonella henselae infection in a child.
Parasit Vectors 2016; 9: 254.
10. Friedenberg SG, Balakrishnan N, Guillaumin J et al. Splenic vas-
culitis, thrombosis, and infarction in a febrile dog infected with
Bartonella henselae. J Vet Emerg Crit Care 2015; 25: 789–794.
11. Nichols PR, Morris DO, Beale KM. A retrospective study of
canine and feline cutaneous vasculitis. Vet Dermatol 2001; 12:
255–264.
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Supporting Information
Additional Supporting Information may be found in the
online version of this article.
Data S1. Testing procedures and screening for other vec-
tor-borne pathogens.

Re
sume

Contexte – Bartonella henselae, une alpha-prote
obacte
rie, gram ne
gative, zoonotique qui a e
te

pre

ce
dem-
ment associe
e a des le

sions vasoprolife
ratives cutane
es (angiomatose bacillaire), une panniculite nodulaire
et un e
rytheme multifocal (e
rythe
me polymorphe) chez les chiens.
Objectifs – De
crire les le

sions cliniques, microbiologiques et histologiques chez un chien avec vascularite
des bords des pavillons auriculaires et une infection  a B. henselae.
Sujets – Un chien beagle femelle entie re, indemne de pathoge nes spe
cifiques, maintenue dans un labora-
toire exempt de vecteur.
Mate
riel et me
thode – L’e
valuation se

rologique pour Bartonella et Rickettsia, la PCR pour Bartonella et
Rickettsia, la PCR/ culture sur sang enrichi BAPGM (Bartonella alpha-proteobacteria growth medium),
l’examen histopathologique et l’e
valuation immunohistochimique confocal.
Re
sultats – La se
roconversion se
rologique et les PCR de biopsies de tissu auriculaire n’ont pas permis la
mise en e
vidence de Rickettsia rickettsii en tant que cause des le
sions de vascularite auriculaire; cepen-
dant, B. henselae, ge
notype ADN San Antonio 2 a e
te

amplifie
et se

quence
a partir de la pointe des pavil-
lons auriculaires et de la peau abdominale d’apparence normale. La se
roconversion  a B. henselae a e
te


rapporte
e re

trospectivement par test IFA. Les organismes Bartonella henselae ont e
te

visualise
s par immu-
nomarquage confocal au sein des trois biopsies. L’histopathologie a re
ve

le

une vascularite ne
crosante des
petits vaisseaux et une ne
crose dermique. La se
roconversion de Bartonella henselae et la re
solution
comple te des le
sions cutane
es sont intervenus apre s un traitement de six semaines  a la doxycycline et

rythromycine.
l’e
Conclusion et importance clinique – Bartonella henselae est un pathoge ne zoonotique e
mergent qui a

te
e
associe
a une vascularite leucocytoclastique chez l’homme et pourrait avoir un ro ^le contributeur ou cau-
satif dans le de
veloppement des vascularite cutane
e des marges auriculaires chez ce beagle.

Resumen
Introduccio
n – Bartonella henselae, una alfa-proteobacteria Gram-negativa, zoono
tica, ha sido implicada
previamente en asociacio
n con lesiones vasoproliferativas cut
aneas (angiomatosis bacilar), paniculitis
nodular y eritema multifocal (eritema multiforme) en perros.

gicas e histolo
Objetivo – describir las lesiones cl
ınicas, microbiolo
gicas en un perro con vasculitis del mar-

n por B. henselae.
gen de o
ıdo e infeccio

4 © 2018 ESVD and ACVD, Veterinary Dermatology

 Bartonella and cutaneous vasculitis

Animales – una perra entera Beagle de 12 meses de edad, mantenida en una instalacio
n de animales de
laboratorio libre de vectores.
Me
todos y materiales – evaluacio
n serolo
gica de Bartonella y Rickettsia, PCR de Bartonella y Rickettsia,
cultivo en medio para Bartonella alfa-proteobacteria enriquecido con sangre (BAPGM)/PCR, investigacio
n




histopatologica y evaluacion inmunohistoquımica confocal.
Resultados – la investigacio
n serolo
gica (seroreversio
n) y la prueba de PCR de biopsias de tejido aural no
obtuvieron Rickettsia rickettsii como causa de la vasculitis aural; sin embargo DNA de B. henselae genotipo
San Antonio 2 se amplifico
y se secuencio
a partir de los m
argenes de la punta de la oreja y de la piel abdo-
minal de apariencia normal. La seroconversio
n para B. henselae se documento
retrospectivamente med-
iante pruebas IFA. Los organismos Bartonella henselae se visualizaron mediante inmunotincio
n confocal
en las tres biopsias. La histopatolog
ıa revelo
vasculitis necrotizante de vasos pequen ~os y necrosis de
rmica.
La seroreversio
n para Bartonella henselae y la resolucio
n completa de las lesiones cut
aneas se produjeron
junto con la administracio
n de doxiciclina oral y eritromicina durante seis semanas.
Conclusiones e Importancia Cl
ınica – Bartonella henselae es un pato
geno zoono
tico emergente que se
ha asociado con vasculitis leucocitocl
astica en humanos y puede haber tenido un papel contribuyente o
causal en el desarrollo de la vasculitis del margen auditivo cut
aneo en este Beagle.

Zusammenfassung
Hintergrund – Bartonella hendselae, ein Gram-negatives, zoonotisches, alpha-Proteobakterium ist schon
zu einem fru €heren Zeitpunkt mit kutanen vasoproliferativen L€asionen (bazill€
arer Angiomatose), nodul€ arer
Pannikulitis und multifokalem Erythem (Erythema multiforme) bei Hunden in Zusammenhang gebracht
worden.
Ziel – Eine Beschreibung der klinischen, mikrobiologischen und histologischen Ver€ anderungen bei einem
Hund mit einer Ohrrandvaskulitis und einer B. henselae Infektion.
Tiere – Eine 12 Monate alte, speziell Pathogen-freie intakte Beaglehu€ndin, die in einer Vektor-freien Labor-
einrichtung gehalten wurde.
Methoden und Material – Eine serologische Evaluierung von Bartonella und Rickettsia, Bartonella und
Rickettsia PCR, Bartonella alpha-Proteobakterium Wachstumsmedium (BAPGM) mit Blutkulturanreiche-
rung /PCR, histopathologische Untersuchung und confokale immunhistochemische Evaluierung.
Ergebnisse – Die serologische Untersuchung (Serokonversion) und PCR Untersuchung des Gewebes der
Ohrrandbiopsien konnte Rickettsia rickettsii nicht als Ursache fu €r die Ohrrandvaskulitis best€ atigen; es
wurde jedoch B. henselae, Genotyp San Antonio 2 DNA von beiden Ohrr€ andern, sowie von normal erschei-
nender Haut amplifiziert und sequenziert. Die Serumkonversion fu €r B. henselae wurde retrospektiv mittels
IFA Analyse dokumentiert. Bartonella henselae Organismen konnten mittels confokaler Immunf€ arbung in
allen drei Biopsien nachgewiesen werden. Histopathologisch zeigten sich eine Vaskulitis der kleinen Blut-
gef€aße und eine dermale Nekrose. Bartonella henselae Seroreversion und eine komplette Abheilung der
Hautver€anderungen trat in Zusammenhang mit der Verabreichung von Doxycyclin per os sowie von Ery-
thromycin fu€r sechs Wochen auf.
Schlussfolgerungen und klinische Bedeutung – Bartonella henselae ist ein zunehmendes zoonotisches
Pathogen, dass mit einer leukozytoklastischen Vaskulitis beim Menschen in Zusammenhang gesehen wird
und eine beitragende bzw urs€achliche Rolle in der Entwicklung der kutanen Ohrrandvaskulitis dieses Bea-
gles gehabt haben ko €nnte.

要約
背景 – グラム陰性、人獣共通感染症の、a-プロテオバクテリア網である Bartonella hensela は、皮膚の血管
増殖性病変(細菌性血管腫症)、結節性脂肪織炎および多巣性紅斑(多形紅斑)との関連が示唆されている。
目的 – 本研究の目的は、耳輪皮膚症および B. hensela 感染症を有する犬における臨床、微生物学および組
織学的病変を記述することである。
被験動物 – 媒介動物のいない実験動物資源施設により飼育し特定の病原体を保有しない 12 ヶ月齢の未避
妊雌ビーグル犬1頭。
材料および方法 – バルトネラおよびリケッチアの血清学的評価、バルトネラおよびリケッチアに対する
PCR 法、バルトネラaプロテオバクテリア増殖培地 (BAPGM) 血液栄養強化培養および PCR 法、病理組織
学的調査および共焦点免疫組織化学的評価を実施した。
結果 – 血清学的調査 (seroreversion) および耳組織生検による PCR 法では、耳輪皮膚症の原因として
Rickettsia rickettsii を支持する結果を得られなかった。しかし、B. henselae を示す遺伝子型 San Antonio 2
遺伝子が増幅され、耳の先端および正常に見える腹部皮膚の両方から配列決定された。B. henselae に対す
る Seroconversion を IFA 検査により遡及的に実証した。 Bartonella henselae は、3箇所すべての生検箇所に
おいて共焦点免疫染色法により視覚化された。病理組織学的検査では小血管壊死性血管炎および真皮壊
死を明らかにした。 B. henselae の seroreversion および皮膚病変の完全消散は、経口ドキシサイクリンお
よびエリスロマイシンno同時 6 週間投与によって生じた。

© 2018 ESVD and ACVD, Veterinary Dermatology 5

Southern et al.

結論と臨床的重要性 – Bartonella hensela は、人における白血球破砕性血管炎に関連した新興人獣共通病原

体であり、本研究に供したビーグルにおける耳輪皮膚症の発症に寄与するまたは原因となる可能性があ
る。

摘要
背景 – 汉氏巴尔通体 (Bartonella henselae) 是一种革兰氏阴性、人畜共患的a-变形菌,曾经被认为导致犬皮
肤血管增生性病变(杆菌性血管瘤病)、结节性脂膜炎和多灶性红斑(多形红斑)。
目的 – 描述有耳缘血管炎和汉氏巴尔通体感染犬的临床表现、微生物学和组织学病变。
动物 – 一只 12 月龄、无特定病原体未绝育比格母犬,饲养在无病媒实验室中。
材料和方法 – 进行巴尔通体和立克次体血清学评估,巴尔通体和立克次体 PCR 检测,巴尔通体a-变形杆菌生
长培养基 (BAPGM) 富血培养/ PCR, 组织病理学调查和共聚焦免疫组化评估。
结果 – 耳组织活检的血清学检测(血清学转归)和 PCR 检测结果,证明立氏立克次体不是导致耳血管炎的原
因; 然而,从耳尖边缘和正常腹部皮肤分离出的巴尔通体,圣安东尼奥 2 号 DNA 基因型被成功扩增并测序。
经 IFA 测试回顾性研究证实巴尔通体血清转归。在三个活检样本的共聚焦免疫染色中,观察到汉氏巴尔通体
(Bartonella henselae) 病原体,组织病理学显示小血管坏死性血管炎和皮肤坏死。强力霉素和红霉素联合口
服给药六周后,汉氏巴尔通体血清学转归和皮肤病变完全消退同时发生。
结论和临床价值 – 汉氏巴尔通体 (Bartonella henselae) 是一种新出现的人畜共患病原体,可引起人的白细胞
分裂性血管炎,并且可能直接导致了这只比格犬的皮肤耳缘血管炎,或在其中起着关键作用。

Resumo
Contexto – A Bartonella henselae, uma alpha-proteobacteria Gram-negativa zoono
tica j

a foi associada a
leso~es cut^aneas vasoproliferativas (angiomatose bacilar), paniculite nodular e eritema multifocal (eritema
multiforme) em c~aes.
Objetivo – Descrever as leso ~es cl
ınicas, microbiolo

gicas e histolo
gicas em um c~ ao com vasculite de bor-
das de pavilh~ao auricular e infeccß~ao por B. hanselae.
Animais – Uma cadela da racßa beagle de 12 meses de idade, livre de pato
genos espec
ıficos, mantida em
um laborato
rio de experimentacß~ao animal livre de vetores.
Me
todos e materiais – Avaliacß~ao sorolo
gica para Bartonella e Rickettsia, PCR para Bartonella e Rickettsia,
cultura/PCR em meio
agar sangue enriquecido com meio de crescimento para Bartonella e alpha-proteo-
bacteria (MCBAP), investigacß~ao histopatolo
gica e avaliacß~
ao imunohistoqu
ımica confocal.
Resultados – A partir dos resultados da investigacß~ ao sorolo
gica (soroconvers~ ao) e da PCR de tecidos auri-
culares oriundos de bio
psia, n~ao houve associacß~ ao da Rickettsia rickettsii como uma causadora de vasculite
aural; entretanto, o geno
tipo San Antonio 2 DNA de B. hanselae foi amplificado e sequenciado das margens
dos pavilho ~es auriculares bilateral e da pele aparentemente normal do abdo ^men. A soroconvers~ ao para B.
hanselae foi documentada retrospectivamente por teste IFA. Microrganismos Bartonella hanselae foram
visualizados por imunocorantes confocais em todas as tre ^s bio

psias. A histopatologia revelou vasculite
necrotizante de pequenos vasos e necrose dermica. A soro-revers~

ao para Bartonella hanselae e resolucß~ao
completa das leso ~es cut^aneas ocorreu em conjunto  a administracß~ao de doxiciclina e eritromicina por via
oral, por seis semanas.
Concluso ~ es e importa ^ncia cl
ınica – Bartonella hanselae e
um pato
geno emergente que tem sido associ-
ado a vasculites leucocitocl
asticas em humanos e pode ter um papel causal ou de contribuicß~ ao no desen-
volvimento de vasculite cut^anea de bordas auriculares neste beagle.

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