Bartonelosis

Bartonelosis

Bartonelosis is an infectious disease caused by bacteria of the genus Bartonella. This disease is primarily transmitted to humans through vectors such as sandflies and fleas. Bartonelosis is known for its two main clinical forms: Carrion's disease and cat scratch disease.

Etiology

Bartonelosis is caused by different species of the Bartonella genus. The most notable species include:

• Bartonella bacilliformis - the causative agent of Carrion's disease.
• Bartonella henselae - associated with cat scratch disease.
• Bartonella quintana - known for causing trench fever.

Transmission

The transmission of Bartonelosis varies depending on the species involved:

• Bartonella bacilliformis is transmitted by the bite of infected sandflies, specifically of the genus Lutzomyia.
• Bartonella henselae is primarily transmitted through scratches or bites from infected cats, or through flea bites.
• Bartonella quintana is transmitted by the human body louse.

Clinical Manifestations

Carrion's Disease

Carrion's disease, caused by Bartonella bacilliformis, is endemic to certain regions of Peru, Ecuador, and Colombia. It presents in two phases:

• Acute Phase (Oroya fever): Characterized by high fever, severe anemia, and hemolytic jaundice. This phase can be life-threatening if not treated promptly.
• Chronic Phase (Verruga peruana): Characterized by the development of angiomatous skin lesions, which are often referred to as "Peruvian warts."

Cat Scratch Disease

Cat scratch disease, caused by Bartonella henselae, typically presents with:

• Regional lymphadenopathy near the site of a cat scratch or bite.
• Fever, fatigue, and headache.
• In some cases, more severe complications such as neuroretinitis or encephalopathy can occur.

Diagnosis

Diagnosis of bartonelosis can be challenging and often involves a combination of clinical evaluation and laboratory testing. Techniques include:

• Serological tests to detect antibodies against Bartonella species.
• Polymerase chain reaction (PCR) to identify bacterial DNA.
• Blood cultures, particularly for Bartonella bacilliformis.

Treatment

The treatment of bartonelosis depends on the specific form of the disease:

• For Carrion's disease, antibiotics such as chloramphenicol or ciprofloxacin are commonly used.
• Cat scratch disease often resolves without treatment, but severe cases may require antibiotics like azithromycin.

Prevention

Preventive measures include:

• Controlling vector populations, such as sandflies and fleas.
• Avoiding contact with stray or feral cats.
• Using insect repellent and protective clothing in endemic areas.

Epidemiology

Bartonelosis is most prevalent in regions where the vectors are endemic. Carrion's disease is primarily found in the Andean regions of South America, while cat scratch disease is more globally distributed, correlating with cat populations.

Also see

• Bartonella
• Carrion's disease
• Cat scratch disease
• Trench fever