Medical Microbiology

334 4 BacteriaasHumanPathogens

BartonellaandAfipia

Bartonella

Classification.ThegenusBartonellaincludes,amongothers,thespecies

B.bacilliformis,B.quintana,B.henselae,andB.clarridgeia.

Morphologyandculture.Bartonellabacteriaaresmall(0.6– 1 lm),Gram-

negative,frequentlypleomorphicrods.Bartonellaecanbegrownonculture

mediumsenrichedwithbloodorserum.

Table4. 15 PathogensandClinicalPicturesofBartonelloses

Pathogen Transmission/

host

Disease Clinicalpicture

Bartonella

bacilliformis

Sandfly/

humans

Oroyafever

(Carrion’sdisease)

Incubation: 1 5–40days;high

fever;lymphadenitis;spleno-

hepatomegaly;hemolyticane-

miaduetolysisoferythrocytes

invadedbyB.bacilliformis

Verrugaperuana

phaseofOroya

fever

Multiple,wartlikeskinlesionson

extremities,face,mucosa;onset

eithermonthsafterabatingof

Oroyafeverorwithoutanacute

precedinginfection

B.quintana Lice/humans Five-dayfever

(Wolhynianfever,

trenchfever)

Periodicrelapsesoffever(3–8)

every 5 days,sepsis;bacillary

angiomatosis(seebelow);also

endocarditis

B.henselae Catsto

humans/cats

Catscratch

disease

Lymphadenopathy;fever;

cutaneouslesion(notalways

present)

Sepsis,bacillary

angiomatosis

Inpatientswithimmunedefi-

ciencies(HIV);vascularprolifera-

tioninskinandmucosa(similar

toverrugaperuana)

Bacterialpeliosis

hepatis/splenica

Cystic,blood-filledlesionsin

liverandspleen

B.clarridgeia CatscratchdiseaseSeeabove

4

Kayser, Medical Microbiology © 2005 Thieme