Bartonella Infections

Abstract

Most cases of cat-scratch disease are caused by Bartonella (Rochalimaea) henselae, a small, pleomorphic, Gram-negative, and rod-shaped bacterium. Cat-scratch disease presents as fever with unilateral regional lymphadenopathy. A variety of clinical syndromes have been reported in immunocompetent patients with B. henselae infection, including unilateral lymphadenitis, encephalopathy with adenopathy and seizures, Leber's stellate neuroretinitis, Parinaud's oculoglandular syndrome (conjunctival granuloma with preauricular adenopathy), a chronic fatigue syndrome-like disease, and aseptic meningitis with relapsing fever. In human immunodeficiency virus (HIV)-infected individuals, Bartonella species have been isolated from cutaneous bacillary angiomatosis lesions. Disseminated disease may involve skin, lymph nodes, liver, spleen, the gastrointestinal or respiratory tract, and the central nervous system. Cognitive difficulty and dementia in HIV-infected individuals has been associated with serum antibodies to Bartonella, suggesting Bartonella infection may be a treatable cause of dementia in some HIV-infected individuals. Diagnosis is made by the detection of antibodies in serum or cerebrospinal fluid to Bartonella species or isolation of the organism from blood or tissue specimens. Cat-scratch disease with neurological complications is treated with antibiotics.