Medical Microbiology

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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

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Kayser, Medical Microbiology © 2005 Thieme
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