Bartonellosis

Bartonelloses represent a group of infectious diseases caused by Bartonella spp are gram-negative bacteria that are conditionally intracellular parasites.

Three species of these infectious organisms can cause disease in humans, although other species are now recognized as important because they can cause infection in humans.

The range of infection with these bacteria ranges from the mild lymphadenopathy seen in cat-scratch disease to life-threatening systemic disease in immunocompromised patients.

Infections with Bartonella bacteria /bartonellosis/

Bartonella spp. have been isolated from various species of mammals, most often rodents, ruminants and carnivores. Transmission occurs most often through arthropod vectors, i.e. arthropods.

Infections caused by Bartonella spp. include:

• Cat bite disease – B. Henselae;
• Swine fever or trench fever – B. Quintana;
• Bacillary angiomatosis – B. henselae and B. Quintana;

Bacillary angiomatosis and peliosis hepatitis

Both bacteria B. henselae and B. Quintana can cause bacillary angiomatosis, which is most common in HIV-positive patients. But in order to become infected these people must have HIV antibodies and the CD4 count must be significantly reduced.

Bacillary angiomatosis is characterized by proliferation of blood vessels, leading to the formation of tumor-like masses in the skin and other organs.

This disease is often associated with peliosis hepatitis, which is characterized by the formation of multiple blood-filled cavities in the liver. As peliosis also affects other parts of the body, for example the spleen.

What are the symptoms?

The manifestation of the disease depends on which anatomical site is affected and the symptoms can be expressed in increased body temperature, lymphadenopathy /swelling of the lymph nodes/ and lesions on the skin.

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Lesions are often dark purple and resemble those of Kaposi’s syndrome. Enlargement of the spleen or liver may be observed.
Sometimes endocarditis is also associated with Bartonella spp infection including B. henselae, B. quintana, B. Elizabethae.

Alcoholism is considered one of the main causes of endocarditis caused by B. Quintana and is also seen in homeless people.

Encephalopathies caused by Bartonella are rare in people with normal immunity, but can develop in HIV-positive patients, especially infection with B. henselae, B. Quintana.

Meningoencephalitis, encephalopathies and neuropsychiatric disorders develop in such cases.

Cases of osteomyelitis caused by B. Henselae have also been reported. A complete picture reveals anemia, and liver function tests show elevated levels of alkaline phosphatase.

Prognosis

• Untreated patients are at high risk of death;
• Immunocompromised patients with bacillary angiomatosis or peliosis hepatitis respond well to antibiotics;
• Relapses are common;

Carrion’s disease and Peruvian wart

Carrion’s disease develops in the acute stage of infection and in the presence of lesions due to Peruvian wart.

What are the symptoms?

Bacteremia in Carrion disease begins 3-12 weeks after the mosquito bite.

It is usually mild in regions where the disease is endemic (Peruvian Andes, Ecuador, Colombia, Chile, Bolivia and Guatemala) but can be very severe in newly infected people who develop severe hemolytic anemia, which is often fatal , if untreated.

When the disease is severe, the patient develops fever, headache, dyspnea, mental changes and seizures.