what-are-bartonella-hensela : Symptoms, Causes, Treatment & Prevention

Bartonella bacteria cause several diseases in humans. The three most common are cat scratch disease, caused by B. henselae; trench fever, caused by B. quintana; and Carrión’s disease, caused by B. bacilliformis.

What are the symptoms of Bartonella henselae?

Cat scratch disease (CSD), Bartonella henselae

• Low-grade fever may be present
• Enlarged, tender lymph nodes that develop 1–3 weeks after exposure
• A papule or pustule at the inoculation site

  Rarely, unusual manifestations such as eye infections, severe muscle pain, or encephalitis may occur.

Trench fever, Bartonella quintana

• Fever (may present as a single bout of fever or bouts of recurrent fever)
• Headache
• Rash
• Bone pain, mainly in the shins, neck, and back

Carrión’s disease, Bartonella bacilliformis

This disease has 2 distinct phases:

• Oroya fever: During this phase, patients may present with fever, headache, muscle aches, abdominal pain, and severe anemia.
• Verruga peruana: During this later phase, lesions appear under the skin as nodular growths, then emerge from the skin as red-to-purple vascular lesions that are prone to ulceration and bleeding.

How Bartonella henselae diagnosed?

• CSD may be diagnosed presumptively in patients with typical signs and symptoms and a compatible exposure history. Serology can confirm the diagnosis, although cross-reactivity may limit interpretation in some circumstances. In general, lymph node aspiration is not recommended except to relieve severe pain and swelling or in cases where the diagnosis is unclear.
• B. henselae DNA may be detected by PCR or culture of lymph node aspirates or blood, though sensitivity of these methods is not optimal for blood samples.
• Since B. henselae is a fastidious, slow-growing bacterium, cultures should be held for a minimum of 21 days.
• Trench fever can be diagnosed by isolation of B. quintana from blood cultured on blood or chocolate agar under 5% CO₂. Microcolonies can be seen after 21 days of incubation at 37°C.
• Trench fever can also be diagnosed by serology.
• Carrión’s disease is typically diagnosed via blood culture or direct observation of the bacilli in peripheral blood smears during the acute phase of infection (Oroya fever).
• Endocarditis due to Bartoellna species can be diagnosed by serology and by PCR or culture of excised heart valve tissue.

How Bartonella henselae diagnosed?

• CSD may be diagnosed presumptively in patients with typical signs and symptoms and a compatible exposure history. Serology can confirm the diagnosis, although cross-reactivity may limit interpretation in some circumstances. In general, lymph node aspiration is not recommended except to relieve severe pain and swelling or in cases where the diagnosis is unclear.
• B. henselae DNA may be detected by PCR or culture of lymph node aspirates or blood, though sensitivity of these methods is not optimal for blood samples.
• Since B. henselae is a fastidious, slow-growing bacterium, cultures should be held for a minimum of 21 days.
• Trench fever can be diagnosed by isolation of B. quintana from blood cultured on blood or chocolate agar under 5% CO₂. Microcolonies can be seen after 21 days of incubation at 37°C.
• Trench fever can also be diagnosed by serology.
• Carrión’s disease is typically diagnosed via blood culture or direct observation of the bacilli in peripheral blood smears during the acute phase of infection (Oroya fever).
• Endocarditis due to Bartoellna species can be diagnosed by serology and by PCR or culture of excised heart valve tissue.