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Bartonellosis Meal BARTONELLOSIS meal. Bacteremia for Bartonella henselae is Bartonella bacteria will attach to red blood cells (2 CE Hours) intermittent, and only blood from the bacteremic and endothelial cells of capillary walls, enter phase will be infective. these cells and produce inflammatory tissue Learning objectives damage throughout the body. In particular, ! Flea feces appear as black specks, often comma List the risk factors for Bartonella infections. they will affect the mucosae of the respiratory ! shaped, on the cat fur. Eggs produced by the Explain how and where humans and animals system, including the oral cavity, the eye, the flea are white. They may fall off the cat along can become infected. skin and lymph nodes, liver and spleen. The ! with the flea feces, and the hatching larvae may Explain how to diagnose, treat and prevent incidence of seropositivity in cats is greater than consume the feces and thus become infected. cat scratch disease. the rates for bacteremia. ! List recommendations you can provide to pet When the cat scratches the fleabite area, it picks owners about treatment and prevention. up the infectious flea deposits in its claws and Even though Bartonella henselae does not appear ! List the contraindications when prescribing nail beds. It can pass on the disease and continue to be of serious concern for human health, it medications for cat scratch disease. its spread by scratching other cats. is the one most widely known. In the typical cat scratch disease of man, the initial signs of The presence of Bartonella henselae DNA in the the disease are single or multiple small bumps, Introduction saliva of the cat has been confirmed by PCR and developing to erythematous papules within about Zoonoses are infectious diseases that are demonstrated the possible infectiousness of the 3-12 days after the infection, near the cat scratch transmitted from animal to man. More than cat bite. In fact, there have been suggestions that or cat bite site, usually at hands, arms or face. 60 percent of emerging human pathogens is the organism may cause plasma cell stomatitis, a These papules may progress, become pustules zoonotic. Causative groups of agents include progressive oral disease of the cat. The transmission and ulcerate. The individual may show symptoms parasites, fungi, bacteria, and viruses. Often of of Bartonella henselae from cat to human happens of fever, headache and anorexia. minor importance and producing only minor by cat scratch or bite, although there has been symptoms, they may lead to severe disease, the occasional suggestion that the flea might Within about three weeks, the regional, usually especially in the very young and those in pass it on as well. There is one report suggesting epitrochlear, cervical, axillary lymph nodes weakened condition. transplacental transfer from mother to child. become inflamed, increase in size and become painful to the touch. In about one quarter of The diseases caused by the various members Body lice transmit Bartonella quintana, causing the cases, they may abscess and burst. In the of the group Bartonella vary from insignificant trench fever. While found in the unsanitary and immunocompetent individual, healing will take a in man to deadly: Bartonella bacilliformis crowded conditions of the trenches of World War I, few weeks, and within a few more weeks lead to (Carrion’s disease), Bartonella quintana (trench today it causes disease in the homeless, the drug- full recovery. fever), Bartonella elizabethae (endocarditis), addicted and those immunosuppressed by disease Bartonella grahamii (retinitis), Bartonella or chemotherapy. In the HIV/AIDS population About one out of 10 infected patients may exhibit vinsoni (endocarditis), Bartonella washonsis in particular, one frequently finds bacillary atypical symptoms, such as encephalitis, which (myocarditis), Bartonella clarridgiae angiomatosis and bacillary peliosis hepatis. occurs in 2-4 percent of all cases. Encephalitis (bacteremia), Bartonella rochalimae (Carrion’s is reflected by headache, confusion, altered There is some evidence of bartonellosis in dogs, diseaselike syndrome) and Bartonella henselae mental status, restlessness, combativeness, usually associated with granulomatous disease (cat scratch disease). disorientation, coma and evidence of meningitis and endocarditis in larger breed dogs. Bartonella and transient nuchal rigidity. This encephalitis There are more than 20 known species of is also found in the blood of numerous animal usually follows the natural course of the disease, bartonella. Bartonella henselae is distributed species, including gray squirrels, flying squirrels, but it can also occur without precursory evidence. worldwide. The cat scratch disease it produces is groundhog, wood rat, cattle, deer, elk, and sheep, Fortunately, it seems to be self-limiting, not the most widely recognized form of bartonellosis. each having their own species without showing requiring special treatment and rarely leaving The main host of this strain of Bartonella is the an active disease. Being able, as suggested in one lasting impairment. cat, and it is passed from cat to cat via the feces report, to pass the placental barrier in man, the of the cat flea (Ctenocephalides felis). impact of Bartonellosis is not well understood Other atypical events, often following and deserves further study. lymhadenopathy and generalized influenza-like Causative agent symptoms, are neuroretinitis, characterized by Many arthropods have been shown to carry Bartonella henselae is a curved, pleomorphic, unilateral vision loss; papilledema, swelling of bartonella in addition to cat fleas: sand flies, human rod shaped gram-negative, facultative the optic disk and macular exudates; Parinaud’s body lice, rodent fleas, biting flies and ticks. intracellular bacterium infecting the cat. It oculoglandular syndrome (granulomatous Whether they are actively involved in passing the is of little consequence in the cat with little conjunctivitis and regional, same side organism to mammalian hosts is not confirmed. symptamotology. Other species of Bartonella lymphadenopathy) appearing in 6 percent of the infecting domestic cats are Bartonella Pathogenesis patients; osteomyelitis (0.3 percent), prolonged clarridgeiae, Bartonella koehlerae and While Bartonella henselae may be the fever; joint pain; respiratory symptoms; and Bartonella bovis. most common species in the cat, Bartonella abdominal pain due to hepatitis (hepatic In man, it produces a self-limiting disease varying clarridgeiae and Bartonella koehlerae are granuloma 0.3 percent) and splenitis. from painful regional lymphadenopathy after sometimes compromised as well, and co- If complicated by simultaneously being scratched or bitten by a cat to bacillary infections are possible. As many as six different occurring immunosuppressive disease angiomatosis and peliosis hepatis, neuroretinitis, strains of Bartonella have cohabited in the or immunosuppressive treatment of endocarditis, relapsing fever with bacteremia and same cat. Chronic recurrent bacteremia in the organ recipients or radiation and cancer central nervous system complications. cat is frequent (25-41 percent) and often long chemotherapy, the severity of the disease will lasting, even years. Bacteremic phases will be be greatly exacerbated. It will lead to systemic Transmission interspersed with a-bacteremic ones, and the generalization, involvement of visceral organs Direct transmission from cat to cat is not known; isolation of bacteria from the blood will depend and central nervous system complications, it requires an arthropod vector. The carrier is the on the presence of bacteria at the time of sample. convulsions and coma. cat flea (Ctenocephalides felis), although ticks Bacteremic cats do not necessarily show antibody, have been considered possible vectors as well. Pathology and antibody does not necessarily interfere with The cat flea sucks blood from the infected cat Infected cats are usually asymptomatic, although bacteria in the bloodstream, possibly protected and deposits the digested blood in its feces onto there may be the occasional evidence of stomatitis. within erythrocytes and other host cells. the fur coat of its host while taking up its blood Rarely there are signs of uveitis and endocarditis. Elite Page 1 Even in the absence of overt signs of the disease, transplantation) the situation may become much Aside from identifying the bacterium itself or there is a high incidence of bacteremia and more serious, if not life threatening. its DNA, the presence of antibody to Bartonella antibody to the infecting agent. Bartonella is henselae antigen is additional proof of its presence, responsible for gingivitis, stomatitis, oral ulcers, Diagnosis as long as you are aware that 11 percent of cats upper respiratory disease, rhinitis, sinusitis, In cats, Bartonella henselae is usually with bacteremia do not have detectable antibody. conjunctivitis, uveitis, chorioretinitis, corneal asymptomatic. Fever of unknown origin and In the past, delayed hypersensitive skin testing ulcers, keratitis, inflammatory bowel disease, suspected heart disease suggest bartonellosis. You had been found useful in man: known antigen diarrhea and vomiting, heart disease, lymphoid may find evidence of meningitis or encephalitis is placed on a fresh skin scratch and if positive, hyperplasia, dermatitis and undefined fevers. as expressed by abnormal behavior, aggression, there will be a measurable reaction within 48 seizures, and myelopathy and neuropathy.
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