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General Medicine

Bartonella Infections

Robert Ellis, MD and Carrie Lynn Ellis, DVM, MS Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Fastidious intracellular anaerobic gram-negative bacilli:

    • >30 distinct species, at least 13 known to cause disease in humans (1,2)

    • Bartonella henselae and Bartonella quintana are mo...

DIAGNOSIS

HISTORY

  • Typical CSD (up to 90% of cases)

    • Several days after inoculation, 2- to 3-mm nontender papules at the trauma site progress to reddened vesicles with or without crust.

    • Tender regional ade...

TREATMENT

Many cases of CSD are self-limited; antibiotic treatment guided by clinical presentation and disease severity 

MEDICATION

  • Antipyretics and analgesics for symptom management

  • Antibiotic choice de...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Immunocompromised patients have increased risk for relapse. Extended periods of antibiotics are recommended. 

DIET

No diet modifications needed 

PATIENT EDUCATION

REFERENCES

1
Kaiser PO, Riess T, O'Rourke F, et al. Bartonella spp.: throwing light on uncommon human infections. Int J Med Microbiol.  2011;301(1):7–15. [View Abstract on OvidMedline]
2
Angelakis E...

ADDITIONAL READING

Prutsky G, Domecq JP, Mori L, et al. Treatment outcomes of human bartonellosis: a systematic review and meta-analysis. Int J Infect Dis.  2013;17(10):e811–e819. 

CODES

ICD10

  • A44.9 Bartonellosis, unspecified

  • A28.1 Cat-scratch disease

  • A79.0 Trench fever

  • A44.1 Cutaneous and mucocutaneous bartonellosis

  • A44.8 Other forms of bartonellosis

  • A44.0 Systemic bartonellosis

ICD9

  • 0...

CLINICAL PEARLS

  • Diagnosing Bartonella infections require a high degree of clinical suspicion.

  • CSD is self-limited in most immunocompetent patients.

  • Immunocompromised patients are at increased risk for c...

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FIGURE 26-1 Acquisition and courses of infection with Bartonella henselae.
FIGURE 26-1 Acquisition and courses of infection with Bartonella henselae.
FIGURE 53.14. Early histologic lymph node changes in cat scratch disease caused by Bartonella henselae. Note the vague rim of granulomatous inflammation surrounding a region of karyorrhexis and necrosis. Bacilli are most likely to be detected by staining techniques in early lesions such as this. H&E, original magnification, 4003.
FIGURE 53.14. Early histologic lymph node changes in cat scratch disease caused by Bartonella henselae. Note the vague rim of granulomatous...
FIGURE 53.15. Bartonella henselae in cat scratch disease demonstrated by silver impregnation. This region corresponds to the region of necrosis and karyorrhexis shown in Fig. 11. The organisms were proven B. henselae by PCR. Wharthin-Starry stain, original magnification 1,0003.
FIGURE 53.15. Bartonella henselae in cat scratch disease demonstrated by silver impregnation. This region corresponds to the region of necr...
FIG. 11.67. Catscratch disease. A: This boy developed an enlarged, epitrochlear lymph node on the medial aspect of his upper extremity and axillary involvement. B: Neither node is tender or erythematous.
FIG. 11.67. Catscratch disease. A: This boy developed an enlarged, epitrochlear lymph node on the medial aspect of his upper extremity and ...
FIG. 11.67. Catscratch disease. A: This boy developed an enlarged, epitrochlear lymph node on the medial aspect of his upper extremity and axillary involvement. B: Neither node is tender or erythematous.
FIG. 11.67. Catscratch disease. A: This boy developed an enlarged, epitrochlear lymph node on the medial aspect of his upper extremity and ...
Figure 27-10 Cat scratch inoculation site on the extremity of a 9-year-old.
Figure 27-10 Cat scratch inoculation site on the extremity of a 9-year-old.
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