Bartonellosis

Abstract

Bartonella spp are fastidious bacteria that occur in the blood of man and mammals; they are usually vector borne but can also be transmitted by animal scratches and bites. The bartonelloses of medical importance comprise Carrión's disease, trench fever, cat-scratch disease, bacillary angiomatosis, and peliosis hepatis. Carrión's disease, known as Oroya fever in the acute phase and verruga peruana (Peruvian wart) in its chronic form, has curious manifestations that, until recently, have been restricted in their geographic distribution to dwellers of the high, dry Andean valleys, but new sites of disease are emerging. Trench fever is associated with louse-borne disease and homelessness. Cat-scratch disease, bacillary angiomatosis, and peliosis hepatis are increasingly being recognized as causes of human disease, especially in susceptible population groups such as HIV-infected persons. The Bartonella spp are considered emerging human pathogens. The clinical manifestations, differential diagnosis, laboratory diagnosis, and treatment of these conditions are discussed.

Bartonella and Brucella--Weapons and Strategies for Stealth Attack

“…This results in fever, hepatosplenomegaly (enlargement of the liver and spleen), lymphadenopathy, anemia (Fisman 2000;Janka 2007), and ultimately fatal suffocation or septicemia killing more than 80% of the untreated invalids (Ricketts 1948;Maguina et al 2009). The second, chronic phase of Carrion's disease, called verruga peruana, is characterized by vasoproliferative skin lesions that clinically resemble bacillary angiomatosis caused by B. henselae and B. quintana (Maguina et al 2009). …”

“…The symptoms are a 5-d cyclic fever, bone pain, and headache (Byam and Lloyd 1920;Ohl and Spach 2000). A sequel of CSD and trench fever is bacillary angiomatosis: an outgrowth of vasoproliferative tumors affecting mainly the skin but also the liver (bacillary peliosis), spleen, bone marrow, eyes, or other organs and leading to extraerythrocytic bacteremia, neuroretinitis, infective endocarditis, and various neurological symptoms such as encephalitis (Maguina et al 2009). B. bacilliformis, which is endemic in the Andes, where the natives show persistent asymptomatic bacteremia and might thus serve as a reservoir for infection (Ricketts 1948), is transmitted by the sand fly (Lutzomyia verrucarum), and is the sole Bartonella pathogen eliciting a biphasic life-threatening illness called Carrion's disease.…”

“…B. bacilliformis, which is endemic in the Andes, where the natives show persistent asymptomatic bacteremia and might thus serve as a reservoir for infection (Ricketts 1948), is transmitted by the sand fly (Lutzomyia verrucarum), and is the sole Bartonella pathogen eliciting a biphasic life-threatening illness called Carrion's disease. During the acute phase of this disease, which is termed Oroya fever and is rarely developed by the natives of the endemic regions, B. bacilliformis can infect a majority of the erythrocytes (Maguina et al 2001), triggering a hemolytic anemia attributable to the hemophagocytosis of the infected erythrocytes by mononuclear phagocytes in spleen, lymph nodes, and liver (Walker and Winkler 1981;Maguina et al 2009). This results in fever, hepatosplenomegaly (enlargement of the liver and spleen), lymphadenopathy, anemia (Fisman 2000;Janka 2007), and ultimately fatal suffocation or septicemia killing more than 80% of the untreated invalids (Ricketts 1948;Maguina et al 2009).…”

“…During the acute phase of this disease, which is termed Oroya fever and is rarely developed by the natives of the endemic regions, B. bacilliformis can infect a majority of the erythrocytes (Maguina et al 2001), triggering a hemolytic anemia attributable to the hemophagocytosis of the infected erythrocytes by mononuclear phagocytes in spleen, lymph nodes, and liver (Walker and Winkler 1981;Maguina et al 2009). This results in fever, hepatosplenomegaly (enlargement of the liver and spleen), lymphadenopathy, anemia (Fisman 2000;Janka 2007), and ultimately fatal suffocation or septicemia killing more than 80% of the untreated invalids (Ricketts 1948;Maguina et al 2009). The second, chronic phase of Carrion's disease, called verruga peruana, is characterized by vasoproliferative skin lesions that clinically resemble bacillary angiomatosis caused by B. henselae and B. quintana (Maguina et al 2009).…”

“…1). B. bacilliformis and Bartonella quintana are an exception in having humans as the reservoir host (Maguina et al 2009). In their mammalian reservoir hosts, Bartonella spp.…”