2025-03-19 ノースカロライナ州立大学(NCState)
◆今回の症例では、患者が2歳時に野良猫に顔を引っかかれ、その2年後に昆虫刺傷と発疹を経験した後、発作を発症しました。2022年に行われた脳生検サンプルの分子検査により、前述の病原体のDNAが検出されました。この発見は、BartonellaやBabesiaが神経疾患の潜在的な共因子である可能性を示唆し、さらなる研究が必要とされています。
<関連情報>
- https://news.ncsu.edu/2025/03/19/case-study-bartonella-babesia-found-in-brain-tissue-of-child-with-seizures/
- https://journals.sagepub.com/doi/10.1177/11795735251322456
痙攣、マイコトキシン曝露、ラスムッセン脳炎が疑われた小児の脳におけるバルトネラ・ヘンセラエ、バベシア・オドコイレイ、バベシア・ディバーゲンス様MO-1感染症 Bartonella henselae, Babesia odocoilei and Babesia divergens-like MO-1 infection in the brain of a child with seizures, mycotoxin exposure and suspected Rasmussen’s encephalitis
Edward B. Breitschwerdt, Ricardo G. Maggi, […], and Emily Kingston
Journal of Central Nervous System Disease Published:March 12, 2025
DOI:https://doi.org/10.1177/11795735251322456
Abstract
Background
In conjunction with more sensitive culture and molecular diagnostic testing modalities, simultaneous or sequential infection with more than 1 vector borne zoonotic pathogen is being increasingly documented in human patients. On a frequent basis, many people are exposed to apparently healthy, but infected, domestic and wild animals, the arthropod vectors with which these animals have co-evolved, and the bacterial, protozoal and other pathogens for which various animals are reservoirs. Unsuspected zoonotic transmission by scratch, bite, or vector exposures can result in chronic, indolent, or potentially life-threatening infections.
Methods
In December 2016, at 2 years of age, a male child residing in Ontario, Canada received facial scratches from a feral cat. In August 2018, seizures began 8 days after the child developed a focal, suspected insect bite rash. In June 2019, potential mold toxicity in the child’s bedroom was assessed by fungal culture and urinary mycotoxin assays. Beginning in January 2022, Bartonella spp. serology (indirect fluorescent antibody assays), polymerase chain reaction (PCR) amplification, DNA sequencing, and enrichment blood and brain cultures were used on a research basis to assess Bartonella spp. bloodstream and central nervous system (brain biopsy) infection. In 2024, using recently developed PCR and DNA sequencing targets, Babesia species infection was retrospectively assessed due to the rash observed in 2018.
Results
Although there was historical cat and suspected tick exposures, serological testing for Bartonella henselae and Borrelia burgdorferi were repeatedly negative. Sequential neurodiagnostic testing partially supported a diagnosis of Rasmussen’s encephalitis. Astrogliosis was the only brain biopsy histopathological abnormality. Bartonella henselae DNA was amplified and sequenced from enrichment cultures of brain tissue. Retrospectively, Babesia odocoilei and Babesia divergens-like MO-1 infections were confirmed by amplification and sequencing of DNA extracted from enrichment blood cultures processed in January 2022, from blood and brain tissue cultures in June 2022, and blood in January and June 2023.
Conclusions
Infection with B. henselae, B. odocoilei, and B. divergens-like MO-1, complicated by mycotoxin exposure, created a complex clinical scenario for this child, his parents, and his doctors.
