This review described a case of Bartonella vinsonii subspecies berkhoffii transmission from a dog to a veterinarian. A 7-year-old male Newfoundland dog with a history of ehrlichiosis was evaluated for highly undifferentiated epithelial neoplasia. Fine-needle aspiration procedures were used to confirm the diagnosis, and the veterinarian performing the procedures sustained a needle stick injury postaspirate. The Intracellular Pathogens Research Laboratory was consulted because of the ehrlichiosis history. Dogs infected with Ehrlichia canis in the Southeastern U.S. frequently sustain B vinsonii subspecies berkhoffii coinfection. Immunofluorescence assays (IFA) were performed for the detection of Bartonella and Ehrlichia antibodies. The Bartonella alpha-Proteobacteria growth medium (BAPGM) diagnostic platform was used for polymerase chain reaction (PCR) after direct blood/serum enrichment culture. B vinsonii subspecies berkhoffii (genotypes I, II, and III), B henselae, and E canis antibodies were not identified in postinoculation day (PID) 5 samples. In addition, Ehrlichia and Bartonella species were not detected by PCR on PID 5 samples. The exposed veterinarian had a healthy clinical history for at least 1 year prior to the needle stick injury, but reported headaches, fatigue, and intermittent left arm paresthesias by PID 34. B vinsonii subspecies berkhoffii genotype I was amplified and sequenced after direct DNA extraction on PID 34 samples; however, PCR samples from BAPGM enrichment cultures and subcultures were negative and there were no detectable antibodies. B vinsonii subspecies berkhoffii was amplified from blood cultures using BAPGM on PID 81 samples. B vinsonii subspecies berkhoffii genotypes I and III antibodies were identified on PID 81. All subsequent PCRs were negative. Antibodies for B vinsonii subspecies berkhoffii genotypes I and III were detected in later samples. Treatment with doxycycline and rifampin were implemented on PID 128. Clinical signs improved posttherapy and continued for a 1-year follow-up postinoculation.

Commentary: B vinsonii subspecies berkhoffii is an emerging zoonotic microbe, and dogs are the primary reservoir hosts. It may persist asymptomatically in healthy dogs and can cause a variety of clinical syndromes, including endocarditis, myocarditis, and lymphadenopathy. This behooves clinical veterinarians, particularly those in endemic areas, to exercise great caution when engaging in activities that could facilitate exposure to such pathogens.—Indu Mani, DVM, DSc

Suspected needle stick transmission of Bartonella vinsonii subspecies berkhoffii to a veterinarian. Oliveira AM, Maggi RG, Woods CW, Breitschwerdt EB. J VET INTERN MED 24:1229-1232, 2010.