Bartonellosis

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pathogen

• gram negative cocco-bacilli
• facultative intracellular bacterium
• very difficult to culture
• Bartonella bacilliformis
  • Peru, Columbia, Ecuador
  • "Oroya fever", "Carrion's disease"
  • sandfly-borne
• B. quintana
  • louse-borne
    • louse feces
  • trench fever
  • homelessness, wars, civil disruption
• B. henselae, Afipia felis
  • cat scratch fever
  • cat fleas, cat ticks

clinical features

• B. henselae, Afipia felis
  • cat scratch fever
  • incubation 3-10 days
  • cutaneous papule/pustule lasting 1-3 weeks
  • followed by regional lymphadenopathy
  • disseminated infections in HIV

treatment

• Bartonella bacilliformis
  • chloramphenicol
• B. henselae, Afipia felis
  • cat scratch fever
  • tetracycline, doxycycline, clarithromycin, quinolones, chloramphenicol