Bartonella henselae
Darla Severin

For many years Bartonella henselae was known to cause trench fever. However, recent research has shown that B. henselae is the cause of many diseases such as bacillary angiomatosis, visceral peliosis, septicemia, endocarditis, and cat scratch disease (CSD).1

Bartonella henselae is a fastidious Gram-negative bacterium. Warthin-Starry staining is used to identify it histologicaly.2 Two different strains of B. henselae have been cultured from Europe one of which has the ability to ferment lactose.3 Some Bartonella are flagellated. The size of B. henselae ranges from 0.3 to 0.6 by 0.3 to 1.0 nm and its optimum temperature is greater than 38 degrees celsius.4 In vivo B. henselae grows intracellularly, but it can also grow on nonliving culture media.5 B. henselae is a slow growing organism so when it is cultured from blood, lymph nodes, or other tissue it takes nine to forty days for colonies to appear.3 Refer to figure 1.

Figure 1.

Colonies of B. henselae grown on chocolate blood agar from 3-month old kitten.3

B_h1.jpg - 157911 Bytes

For many years cat scratch disease(CSD) was thought to be caused by A. felis. However, research of retrospective CSD patients has cast doubt on this hypothesis.3 When cultures were taken from CSD infected tissue B. henselae kept being isolated. Analysis of the tissue was done either by culture, serologic studies, or molecular biology techniques.4 Refer to figure 2.

Figure 2. DNA band pattern of B. henselae on electrophoresis on panel c. Other panels show pus specimens from patents taken from the neck region.6 B_h2.jpg - 32175 Bytes
Cat scratch disease was first discovered in 1931 in Paris. The first case reported here in the United States was in 1951.3 There are estimated 24,000 cases annually in the United States while only 2000 are admitted into the hospital.7

The symptoms of CSD vary greatly among people who acquire the disease. The most common symptoms are fever lasting seven to fifty-six days, abdominal pain, and lesions.2 Refer to figure 3.

Figure 3. Infected lymph node region by B. henselae.3 B_h3.jpg - 56356 Bytes

Lesions are usually found above lymph nodes near the site of the scratch. This occurs since B. henselae in many cases causes lymphadenopathy which is disease of the lymph nodes.8 Lesions have also been found on the liver and spleen of infected patients.9 In atypical cases B. henselae causes endocaritis which is vegetation of bacteria on the surface of the endocardium or in the endocardium itself.10 A wide variety of antibiotics are used to kill B. henselae.

In culture B. henselae is susceptible to many antibiotics.11 Aminoglycosides are considered to be bactericidal while beta-lactams are clearly ineffective.3 In vivo B. henselae is much more difficult to kill which could be do to its intracellular growth. Rifampin used orally or invasively over a six week period is considered the most effective antibiotic.11 The combination of erythromycin plus rifampin is used when relapsing fever and B. henselae in the blood occur.3

Reference:

Bouchard, Bosseray, Leclecq, and Micoud, Presse Medicale, 25, 199-201(1196).

Edward, and Hill, The Journal of Thoracic & Cardiovascular Surgery, 119, 171-172(2000).

Bass, Wincent, and Person, The Pediatric Infectious Disease Journal, 16, 163-179(1997).

Raoult, Fournier, Pierre, Drancourt, Marrie, Etienne, Cosserat, Cacoub, Poinsingnon, Leclercq, and Sefton, Annals of Internal Medicine, 125, 646-652(1996).

Balows, Truper, Dworkin, Harder, and Schleifer, The Prokaryotes Second Edition; Arcata Graphics/Halliday: West Hanover, MA, 1981, 3994-3996.

Giladi, and Avidor, The New England Journal of Medicine, 340, 108(1999).

Numazaki, Chiba, and Hiroshi, The New England Journal of Medicine, 340, 1841-1842(1999).

Zangwill, Hamilton, Perkins, Regnery, Plikaytis, Hadler, Cartter, and Wenger, The New England Journal of Medicine, 329, 8-13(1993).

Ventura, Massei, Not, Massimetti, Bussani, and Maggiore, Journal of Pediatric Gastro and Nutrition, 29, 52-56(1999).

W. B. Saunders Company, Miller-Keane Encyclopedia & Dictionary of Medicine, Nursing, & Allied Health Fifth Edition, Harcourt Brace Jovanovich, Inc.: 1992, 868.

Steele, Clinical Pediatrics, 39, 126(2000).

 

*Disclaimer - This report was written by a student participaring in a microbiology course at the Missouri University of Science and Technology. The accuracy of the contents of this report is not guaranteed and it is recommended that you seek additional sources of information to verify the contents.

 

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