Clinical Manifestations Associated with Bartonella henselae Infection in a Tropical Region

Abstract

Bartonella henselae is a zoonotic Gram-negative Bacillus associated with self-limited regional lymphadenopathy. In recent decades, an expanding spectrum of clinical manifestations has been described, in part, due to improved diagnostics. However, updated epidemiological data are sparse. We retrospectively reviewed the clinical features of 31 patients with B. henselae infection over 15 years from 2005 to 2019, in the tropical Top End of Australia. Our annual disease incidence of 1.3 cases per 100,000 population is lower than that in the national database surveillances in the United States, but the hospitalization incidence of 0.9 per 100,000 population in our region is higher than those reported in the literature, with an average length of stay of 9 days. Patients were more commonly male, aboriginal, and aged less than 14 years (median age: 7 years), living in a rural setting with presentation during our monsoon season. The disease spectrum included lymph node disease (74%), organ peliosis, endocarditis, cutaneous lesions, parapharyngeal abscess, parotitis, and neurologic and ocular syndromes. Lymph node disease was far commoner in children than the more serious systemic B. henselae infections associated with adults (P = 0.074). Although no deaths were reported, significant morbidities were observed. Two endocarditis cases presented with glomerulonephritis, and hematological and neurological features mimicking vasculitis, and consequently received immunosuppressants. One case was only diagnosed after representation with serial embolic strokes. Given the heterogeneity of disease manifestations with nonspecific symptoms and significant consequences, a timely and accurate diagnosis is needed to avoid unnecessary treatments or interventions.

The Etiological Bacterial Spectrum of Neck Abscesses of Lymph Node Origin - Gram-Positive and Gram-Negative Bacteria

“…Bartonella henselae (n=7) causes cat scratch disease (CSD). In most cases, in the neck region in the adult individual, it manifests itself with serous inflamed lymph nodes, and rarely, it reaches the stage of purulent involvement [16]. More often, the formation of purulent exudate in the cervical lymph nodes is reached in children [17].…”

A Rare Case of Bartonella henselae Infective Endocarditis Causing an Embolic Cerebrovascular Accident

“…Nevertheless, the occurrence of an embolic stroke caused by B. henselae is considered rare. Following a comprehensive review of the literature, it appears that only a small number of articles have reported on the correlation between cerebral vascular accidents and Bartonella IE [20][21][22][23][24]. However, that association should not be overlooked.…”

Pleural and pericardial effusions with fever and altered mental status: an atypical presentation of bartonellosis

“…Bartonellosis refers to a group of infectious diseases caused by Bartonella, a gram-negative coccobacillus with tropism for endothelial cells. Bartonella henselae , quintana and bacilliformis are responsible for the majority of human diseases 1 2. The most common symptoms of B. henselae and B. quintana present 7 to 10 days after inoculation and include cutaneous rash, localised lymphadenopathy, fever and malaise 1.…”