Demonstration of Bartonella grahamii DNA in Ocular Fluids of a Patient with Neuroretinitis

We describe the clinical and laboratory features of a 55-year-old human immunodeficiency virus-negative female patient who presented with bilateral intraocular inflammatory disease (neuroretinitis type) and behavioral changes caused by a Bartonella grahamii infection. Diagnosis was based on the PCR analysis of DNA extracted from the intraocular fluids. DNA analysis of the PCR product revealed a 100% identity with the 16S rRNA gene sequence of B. grahamii. The patient was successfully treated with doxycycline (200 mg/day) and rifampin (600 mg/day) for 4 weeks. This is the first report that demonstrates the presence of a Bartonella species in the intraocular fluids of a nonimmunocompromised patient and that indicates that B. grahamii is pathogenic for humans.

本研究描述了1例55岁人类免疫缺陷病毒（HIV）阴性女性患者的临床与实验室特征：该患者罹患双侧眼内炎症性疾病（神经视网膜炎型），并出现由格拉汉姆巴尔通体（Bartonella grahamii）感染引发的行为异常。诊断基于对眼内液提取DNA的聚合酶链式反应（PCR）分析；对PCR产物的DNA序列分析显示，其与格拉汉姆巴尔通体的16S核糖体RNA（16S rRNA）基因序列一致性达100%。患者接受多西环素（200 mg/日）与利福平（600 mg/日）联合治疗4周后痊愈。本研究首次证实非免疫功能低下患者的眼内液中存在巴尔通体属菌种，并提示格拉汉姆巴尔通体对人类具有致病性。