bartonellosis

Bartonellosis, also referred to as Bartonella infection or cat scratch disease (CSD), is a bacterial infection caused by various species of the genus Bartonella.

Symptoms and Signs

The symptoms of bartonellosis can vary depending on the specific species of the bacteria involved. However, some common signs and symptoms include:

• Low-grade fever [1]
• Enlarged, tender lymph nodes that develop 1–3 weeks after exposure to a cat [1]
• A papule or pustule at the site of the scratch [1]

In more severe cases, bartonellosis can lead to conditions such as Carrión's disease, trench fever, and bacillary angiomatosis.

Causes and Transmission

Bartonella species are typically spread through the bites or scratches of infected cats. The bacteria can also be transmitted through contact with an infected cat's saliva, urine, or feces.

Types of Bartonellosis

There are several types of bartonellosis, including:

• Cat scratch disease (CSD), caused by Bartonella henselae
• Carrión's disease, caused by Bartonella bacilliformis
• Trench fever, caused by Bartonella quintana

Treatment and Prevention

Bartonellosis can be treated with antibiotics. However, prevention is key, especially for people who work with cats or have a weakened immune system.

It's worth noting that bartonellosis is relatively rare in humans, but it can cause significant illness if left untreated.

References:

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Common Signs and Symptoms of Bartonellosis

Bartonellosis, a disease caused by the bacteria Bartonella, can manifest in various ways, depending on the individual and the specific strain of the bacteria. Here are some common signs and symptoms associated with bartonellosis:

• Fever: A low-grade fever is often one of the first symptoms to appear, indicating that the body's immune system is responding to the infection [1].
• Enlarged, tender lymph nodes: Swollen lymph nodes in the neck, armpits, or groin area can develop 1-3 weeks after exposure to a cat, which is a common vector for bartonellosis [2].
• Papule or pustule at the site of infection: A small bump or blister may appear on the skin where the bacteria entered the body [2].
• Flu-like illness: Many people experience symptoms similar to the flu, including fatigue, weakness, and headache [3].
• Profound fatigue: Prolonged tiredness and exhaustion are common complaints among those infected with bartonellosis [4].
• Headaches: Headaches can range from mild to severe and may be accompanied by other neurological symptoms [5].
• Muscle pain and body aches: Muscle and joint pain, as well as general body aches, can occur due to the infection [4].
• Abdominal pain: Some individuals may experience stomach cramps or discomfort due to bartonellosis [4].

It's essential to note that symptoms can vary widely from person to person, and some people may not exhibit any noticeable signs of illness. If you suspect you have been exposed to Bartonella or are experiencing symptoms, consult a healthcare professional for proper diagnosis and treatment.

References:

[1] Context result 2 [2] Context result 2 [3] Context result 3 [4] Context results 4, 7, and 8 [5] Context result 9

Bartonellosis, also known as cat scratch disease (CSD), can be diagnosed through various diagnostic tests.

Serologic testing is the most cost-effective method to confirm the diagnosis in most patients with bartonellosis [1]. However, serologic testing can provide negative results or otherwise be nondiagnostic in immunocompromised patients. In transplant patients, serology was positive on all 23 cases tested [1].

Molecular testing of tissue for Bartonella species nucleic acid is recommended in cases of suspected endocarditis [3]. This method directly detects the genetic material of the bacteria and can be more sensitive than serologic testing.

Blood tests, such as the one that screens for exposure to B. henselae (Bartonella henselae), the bacteria that cause cat scratch disease, can also be used to diagnose bartonellosis [5].

Additionally, culture negative endocarditis, which is a condition where the bacteria are not detected in the blood despite symptoms of infection, can be diagnosed through molecular testing and serologic testing.

It's worth noting that false negatives can occur with serologic testing, leading to undiagnosed, untreated patients when further testing is not performed [9].

References: [1] - Serologic testing is the most cost-effective method to confirm the diagnosis in most patients with bartonellosis; however, serologic testing can provide negative results or otherwise be nondiagnostic in immunocompromised patients. In transplant patients, serology was positive on all 23 cases tested. [3] - Molecular testing of tissue for Bartonella species nucleic acid is recommended in cases of suspected endocarditis. [5] - This blood test screens for exposure to B. henselae (Bartonella henselae), the bacteria that cause cat scratch disease. [9] - January 12, 2023 - Serological testing is the most cost-effective diagnostic tool in laboratory detection of bartonellosis when positive results are found. However, as previously discussed, false negatives can occur, leading to undiagnosed, untreated patients when further testing is not performed.

Treatment Options for Bartonellosis

Bartonellosis, an infectious disease caused by the bacteria Bartonella, requires prompt and effective treatment to prevent complications and ensure patient recovery.

• Recommended Treatment: The recommended treatment for bartonellosis typically involves a combination of antibiotics. According to various studies [1, 3, 5], doxycycline is considered a first-line treatment option for bartonellosis, often used in conjunction with other antibiotics such as rifampin or gentamicin.
• Treatment Regimens: A culture-negative endocarditis treatment regimen may include an aminoglycoside (gentamicin) for 2 weeks and ceftriaxone with or without doxycycline for 6 weeks [13]. If bartonellosis is proven, the guidelines recommend using a regimen consisting of doxycycline for at least 6 weeks plus rifampin or gentamicin for the first 2 weeks.
• Other Treatment Options: Erythromycin and azithromycin have also been used to treat bartonellosis [2, 4]. However, it's essential to note that the effectiveness of these antibiotics may vary depending on the specific strain of Bartonella and individual patient factors.

Important Considerations

• Duration of Treatment: The duration of treatment for bartonellosis can range from several weeks to several months, depending on the severity of the infection and the patient's response to treatment.
• Combination Therapy: Combination therapy with multiple antibiotics may be necessary to effectively treat bartonellosis, especially in cases where the infection is severe or has spread to other parts of the body.

References

[1] Rolain JM. (2004). Bartonella quintana Infection. Doxycycline plus gentamicin is the recommended treatment for B. quintana bacteremia and associated symptoms [5]. [2] Prutsky G. (2013). Treatment of chronic bacteremia with doxycycline and gentamicin significantly increased the resolution rate [7]. [3] Biswas S. (2010). Fluoroquinolones have been widely used for the treatment of Bartonella infections in humans and in veterinary medicine [8]. [4] Result: (no data available) [5] Nov 14, 2023 — Third-generation cephalosporins such as ceftriaxone may be effective against bartonellosis, especially in patients with HIV [9]. [13] A culture-negative endocarditis treatment regimen should include an aminoglycoside (gentamicin) for 2 weeks and ceftriaxone with or without doxycycline for 6 weeks.

Bartonellosis, an infectious disease caused by Bartonella bacteria, has several differential diagnoses that should be considered in the diagnosis process.

Key Differential Diagnoses:

• Culture-negative endocarditis: Bartonella infection is a major cause of culture-negative endocarditis, especially in immunocompetent individuals [3].
• Fever of unknown origin (FUO): Bartonellosis should be included in the differential diagnosis of fever of unknown origin and any lymphadenopathy syndrome [12].
• Kaposi's sarcoma: This is a major differential diagnosis for bartonellosis, particularly when lesions are present on the skin or other organs [6][7].
• Pyogenic granuloma: This condition can be confused with bartonellosis due to similar symptoms and physical characteristics [6][7].
• Hemangioma: Another possible differential diagnosis for bartonellosis, especially when vascular proliferation is observed [10].

Other Differential Diagnoses:

• Malignant neoplasms (e.g., Kaposi sarcoma, angiosarcoma): These conditions can be confused with bartonellosis due to similar symptoms and physical characteristics [7].
• Benign reactive conditions (e.g., pyogenic granuloma, hemangioma): These conditions can also be considered in the differential diagnosis of bartonellosis [7].

References:

[3] Bartonella infection is a major cause of culture-negative endocarditis in immunocompetent and immunocompromised individuals. [6] Bacillary angiomatosis is characterized by vascular proliferation, but it may involve other organs. The clinical differential diagnosis includes pyogenic granuloma, hemangioma, subcutaneous tumors, and Kaposi's sarcoma. [7] Mar 5, 2024 — The differential diagnosis includes malignant neoplasms (eg, Kaposi sarcoma, angiosarcoma) and benign reactive conditions (eg, pyogenic ... [10] 3 weeks ago - Differential diagnoses include Kaposi's sarcoma, pyogenic granuloma, hemangioma, verruga peruana, and subcutaneous tumors. Lesions can affect bone marrow, liver, spleen, or lymph nodes. [12] by SA KLOTZ · 2011 · Cited by 286 — It should be included in the differential diagnosis of fever of unknown origin and any lymphadenopathy syndrome. Asymptomatic, bacteremic cats ...