II. Pathophysiology
- Gram Negative Rod, pleomorphic
- Unlike Rickettsia
- Not obligate intracellular organism (but is facultative intracellular)
- Not anaerobic (Bartonella is obligate aerobe)
III. Associated Conditions
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Cat Scratch Disease (Bartonella Henselae)
- Cats (>50% infected) transmit the infection via biting or clawing humans
- Cats acquire via fleas
- Self limited infection in immunocompetent hosts, for whom Antibiotics are limited to moderate cases
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Bacillary Angiomatosis (Bartonella Henselae, Bartonella Quintana)
- Occurs in AIDS (CD4 Count <100 cells/mm3) and other Immunocompromised patients
- Vascular skin lesions similar to Kaposi's Sarcoma
- Dissemination to bone, CNS, mucous membranes as well as endocarditis and liver (Bacillary Peliosis)
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Bacterial Endocarditis (Bartonella Henselae, Bartonella Quintana)
- Common cause of culture negative endocarditis (esp. in homeless, see Trench Fever below)
- Trench Fever (Bartonella Quintana, previously known as Rickettsia Quintana or Rochalimaea quintana)
- Affected millions in World War I
- Similar to Epidemic Typhus (Rickettsia prowazekii), as spread via Body Lice
- Seen in homeless or Alcoholic patients with Body Lice (which transmit infection)
- Presents with Relapsing Fever (every 5 days), Headaches, back and Leg Pain, Splenomegaly and variably, rash
- Complicated by bacteremia, Bacillary Angiomatosis or endocarditis
- Oroya Fever (Bartonella Bacilliformis)
- Infection endemic to Andes of Peru and Ecuador, transmitted by the sandfly
- Acute phase with Lymphadenopathy and severe Hemolytic Anemia
- Chronic phase (Peruvian Wart, Verruga Peruana) with red-purple Nodules in skin and mucous membranes