Abstract:
BACKGROUND: During a two year period, a 27-year-old female veterinarian experienced migraine headaches,
seizures, including status epilepticus, and other neurological and neurocognitive abnormalities. Prior to and during
her illness, she had been actively involved in hospital-based work treating domestic animals, primarily cats and
dogs, in Grenada and Ireland and anatomical research requiring the dissection of wild animals (including lions,
giraffe, rabbits, mongoose, and other animals), mostly in South Africa. The woman reported contact with fleas, ticks,
lice, biting flies, mosquitoes, spiders and mites and had also been scratched or bitten by dogs, cats, birds, horses,
reptiles, rabbits and rodents. Prior diagnostic testing resulted in findings that were inconclusive or within normal
reference ranges and no etiological diagnosis had been obtained to explain the patient’s symptoms.
METHODS: PCR assays targeting Anaplasma spp. Bartonella spp. and hemotopic Mycoplasma spp. were used to test
patient blood samples. PCR positive amplicons were sequenced directly and compared to GenBank sequences.
In addition, Bartonella alpha Proteobacteria growth medium (BAPGM) enrichment blood culture was used to
facilitate bacterial growth and Bartonella spp. serology was performed by indirect fluorescent antibody testing.
RESULTS: Anaplasma platys, Bartonella henselae and Candidatus Mycoplasma haematoparvum DNA was amplified
and sequenced from the woman’s blood, serum or blood culture samples. Her serum was variably seroreactive to
several Bartonella sp. antigens. Despite symptomatic improvement, six months of doxycycline most likely failed to
eliminate the B. henselae infection, whereas A. platys and Candidatus M. haematoparvum DNA was no longer
amplified from post-treatment samples.
CONCLUSIONS: As is typical of many veterinary professionals, this individual had frequent exposure to arthropod
vectors and near daily contact with persistently bacteremic reservoir hosts, including cats, the primary reservoir host
for B. henselae, and dogs, the presumed primary reservoir host for A. platys and Candidatus Mycoplasma
haematoparvum. Physicians caring for veterinarians should be aware of the occupational zoonotic risks associated
with the daily activities of these animal health professionals.
