{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T18:34:59Z","timestamp":1788287699466,"version":"build-2803163510"},"reference-count":39,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:00:00Z","timestamp":1741737600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:00:00Z","timestamp":1741737600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Bartonella\/Vector Borne Diseases Research Fund at the North Carolina State University College of Veterinary Medicine"},{"DOI":"10.13039\/100016230","name":"Steven & Alexandra Cohen Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100016230","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100023078","name":"State of North Carolina","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100023078","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Cent Nerv Syst Dis"],"published-print":{"date-parts":[[2025,9]]},"abstract":"\n Background<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n 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\u2019s bedroom was assessed by fungal culture and urinary mycotoxin assays. Beginning in January 2022,\n Bartonella<\/jats:italic>\n 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\n Bartonella<\/jats:italic>\n spp. bloodstream and central nervous system (brain biopsy) infection. In 2024, using recently developed PCR and DNA sequencing targets,\n Babesia<\/jats:italic>\n species infection was retrospectively assessed due to the rash observed in 2018.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Although there was historical cat and suspected tick exposures, serological testing for\n Bartonella henselae<\/jats:italic>\n and\n Borrelia burgdorferi<\/jats:italic>\n were repeatedly negative. Sequential neurodiagnostic testing partially supported a diagnosis of Rasmussen\u2019s encephalitis. Astrogliosis was the only brain biopsy histopathological abnormality.\n Bartonella henselae<\/jats:italic>\n DNA was amplified and sequenced from enrichment cultures of brain tissue. Retrospectively,\n Babesia odocoilei<\/jats:italic>\n and\n Babesia divergens<\/jats:italic>\n -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.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Infection with\n B<\/jats:italic>\n .\n henselae<\/jats:italic>\n ,\n B<\/jats:italic>\n .\n odocoilei<\/jats:italic>\n , and\n B<\/jats:italic>\n .\n divergens<\/jats:italic>\n -like MO-1, complicated by mycotoxin exposure, created a complex clinical scenario for this child, his parents, and his doctors.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/11795735251322456","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T12:58:13Z","timestamp":1741784293000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Bartonella henselae<\/i>\n ,\n Babesia odocoilei<\/i>\n and\n Babesia divergens<\/i>\n -like MO-1 infection in the brain of a child with seizures, mycotoxin exposure and suspected Rasmussen's encephalitis"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3506-0279","authenticated-orcid":false,"given":"Edward B.","family":"Breitschwerdt","sequence":"first","affiliation":[{"name":"North Carolina State University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo G.","family":"Maggi","sequence":"additional","affiliation":[{"name":"North Carolina State University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2264-307X","authenticated-orcid":false,"given":"Cynthia","family":"Robveille","sequence":"additional","affiliation":[{"name":"North Carolina State University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7871-7519","authenticated-orcid":false,"given":"Emily","family":"Kingston","sequence":"additional","affiliation":[{"name":"North Carolina State University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,3,12]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/nature06536"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1089\/vbz.2018.2432"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1435233"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ttbdis.2020.101607"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0004539"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid2203.150269"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.12659\/AJCR.942160"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2024.1388442"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjid.2024.103743"},{"key":"e_1_3_6_11_2","first-page":"69","article-title":"Human bartonellosis: an underappreciated public health problem?","volume":"4","author":"Cheslock MA","year":"2019","unstructured":"Cheslock MA, Embers ME. 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