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[Cat-scratch disease and other infections caused by Bartonella species]
1Rijksinstituut voor Volksgezondheid en Milieu, Laboratorium voor Bacteriologie en Antimicrobiële Middelen, Bilthoven.
Abstract:
Bartonella henselae, the causative agent of cat-scratch disease, was identified recently by DNA amplification techniques. Several other Bartonellae (most of which were called Rochalimaea before) cause disease in humans: B. bacilliformis (Carrion's disease), B. elizabethae (endocarditis) and B. quintana (bacillary angiomatosis and peliosis, chronic bacteraemia and endocarditis, trench fever). B. henselae is transmitted to humans by scratch or bite of a bacteraemic, but asymptomatic, cat, which event may be followed by regional lymphadenitis (classical cat-scratch disease), bacillary angiomatosis or peliosis of liver and spleen (in immune compromised, e.g. HIV-infected individuals) or chronic bacteraemia and endocarditis (in elderly individuals). The incidence in the Netherlands of cat-scratch disease is > 2/100,000/year. If a Bartonella infection is suspected, specific immuno-assays and polymerase chain reaction assay may be applied for diagnosis. Culture of the organism is difficult. Macrolides and tetracyclines have been shown to be effective in treatment of disseminated infections. The natural (self-limiting) course of regional lymphadenitis however is not affected by antibiotic treatment.
Insights
Bartonella henselae causes cat-scratch disease and other infections in humans. While antibiotics treat disseminated Bartonella infections, they do not alter the self-limiting course of regional lymphadenitis.
Area of Science:
- Infectious Diseases
- Bacteriology
- Medical Microbiology
Context:
- Bartonella henselae is the primary cause of cat-scratch disease.
- Other Bartonella species cause various human illnesses, including Carrion's disease and endocarditis.
- Bartonella infections present diverse clinical manifestations depending on host immunity.
Purpose:
- To review the epidemiology, diagnosis, and treatment of Bartonella infections.
- To highlight the role of Bartonella henselae in cat-scratch disease and other conditions.
- To discuss diagnostic methods and therapeutic options for Bartonella infections.
Summary:
- Bartonella henselae, identified via DNA amplification, causes cat-scratch disease, bacillary angiomatosis, and peliosis.
- Transmission occurs through cat scratches or bites, leading to lymphadenitis, or disseminated disease in immunocompromised individuals.
- Diagnosis involves immuno-assays and PCR; culture is challenging.
- Macrolides and tetracyclines are effective for disseminated infections, but not for self-limiting lymphadenitis.
Impact:
- Informs clinicians about the spectrum of Bartonella infections and diagnostic approaches.
- Provides guidance on antibiotic treatment for disseminated Bartonella disease.
- Emphasizes the limitations of antibiotic therapy for regional lymphadenitis.