BARTONELLA HENSELAE INFECTION

BARTONELLA HENSELAE INFECTION

Bartonella is a group of bacteria that causes infectious diseases and are mainly transmitted by carriers such as fleas, lice, or sandflies. These carriers are also called vectors. One species of the Bartonella bacteria is the Bartonella henselae that causes a bacterial infection known as cat scratch fever or cat scratch disease. The name was derived from the main cause of contracting Bartonella henselae infection which are cats. Bartonella henselae infects cats through infected fleas. The infected cats may transmit the bacteria to humans through bites and scratches. It can also be transmitted when the infected cat licks an open wound or its saliva gets on the surface of the whites of the eyes. Cat owners are the number one at risk to have the cat scratch disease. Anyone can have it but it most commonly occurs in children between 5 and 9 years old. Males are most likely to be hospitalized even though females are the majority to be diagnosed with cat scratch disease. People with a weak immune system, pregnant women, and people with diseases such as cancer, diabetes, HIV/AIDS, and those who have undergone organ transplants are also at risk. Cat scratch disease increases the risk of becoming severely ill.

Cat scratch disease cases occur worldwide, but the incidence is greater in areas with higher temperatures and humidity since it supports heavy populations of fleas.

SYMPTOMS

There are a variety of symptoms of cat scratch disease. The symptoms may be grouped as common, less common, and rare.

Common symptoms include:

  • A bump at the site of infection that starts as a flat red spot (macule) and after 3 to 10 days, the lesion may elevate (papule). This papule is painless but it may become filled with fluid.
  • Lymphadenopathy or the swelling of the lymph nodes within 1 to 3 weeks after being bitten or scratched.
  • Body aches and malaise or the general feeling of discomfort
  • Headaches
  • Fever

Less common symptoms include:

  • Loss of appetite
  • Weight loss
  • Sore throat

Rare symptoms which typically occur on people with a weak immune system include:

  • Abdominal pain
  • Joint pain
  • Chills
  • Backache
  • Rash
  • Prolonged fever

Complications, although rare, are also possible to arise with people with weak immune systems at a greater risk. These complications may include:

  • Encephalopathy, a neurologic condition when the bacteria spread to the brain.
  • Neuroretinitis which is an inflammation of the optic nerve and retina when the bacteria spread to the eye
  • Osteomyelitis, a disease when the bacteria infects the bones.
  • Bacillary peliosis when blood-filled cavities became present in the liver
  • Parinaud’s oculoglandular syndrome is another disease resulting when the bacteria entered the eye directly or when the bacteria traveled through the bloodstream and reaching the eye.

DIAGNOSIS

Diagnosis may be difficult by looking only at the symptoms, since there are other conditions with the same symptoms. A physical examination will be conducted to diagnose cat scratch disease. An accurate diagnosis may be obtained by performing a polymerase chain reaction (PCR) blood test where the Bartonella henselae bacteria may be seen.

TREATMENT

Cat scratch disease usually doesn’t require treatment but antibiotics may treat severe cases and may help people with weak immune systems. The prescription of antibiotics can last from 5 days up to 2 weeks. Antibiotics may include:

  • Azithromycin which is typically prescribed for 5 days to decrease the volume of lymph node quickly
  • Ciprofloxacin
  • Rifampin
  • Tetracycline
  • Trimethoprim-sulfamethoxazole

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