Bartonella quintana and Bartonella vinsonii subsp. vinsonii bloodstream co-infection in a girl from North Carolina, USA

Med Microbiol Immunol. 2019 Feb;208(1):101-107. doi: 10.1007/s00430-018-0563-0. Epub 2018 Sep 24.


The genus Bartonella consists of globally distributed and highly diverse alpha-proteobacteria that infect a wide-range of mammals. Medically, Bartonella spp. constitute emerging, vector-borne, zoonotic, intravascular organisms that induce long-lasting bacteremia in reservoir-adapted (passive carrier of a microorganism) hosts. At times, these bacteria are accidentally transmitted by animal scratches, bites, needles sticks or vectors to animal or human hosts. We report the first documented human case of blood stream infection with Bartonella vinsonii subsp. vinsonii in a girl from North Carolina, USA, who was co-infected with Bartonella quintana. Limitations of Bartonella spp. serology and the challenges of microbiological culture and molecular diagnostic confirmation of co-infection with more than one Bartonella spp. are discussed. When and where these infections were acquired is unknown; however, exposure to rodents, fleas and cats in the peri-equestrian environment was a suspected source for transmission of both organisms.

Keywords: Bacteria; Bartonella quintana; Bartonella vinsonii subsp. vinsonii; Equestrian; Vector.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Bacteremia / diagnosis*
  • Bacteremia / microbiology
  • Bacteremia / pathology*
  • Bartonella / classification
  • Bartonella / genetics
  • Bartonella / isolation & purification*
  • Bartonellaceae Infections / diagnosis*
  • Bartonellaceae Infections / microbiology
  • Bartonellaceae Infections / pathology*
  • Cluster Analysis
  • Coinfection / diagnosis*
  • Coinfection / microbiology
  • Coinfection / pathology*
  • DNA, Bacterial / chemistry
  • DNA, Bacterial / genetics
  • DNA, Ribosomal Spacer / chemistry
  • DNA, Ribosomal Spacer / genetics
  • Female
  • Humans
  • Microbiological Techniques
  • Molecular Diagnostic Techniques
  • North Carolina
  • Phylogeny
  • Sequence Analysis, DNA
  • Serologic Tests


  • DNA, Bacterial
  • DNA, Ribosomal Spacer