CAUSES:
β’ B. bacilliformis : CarriΓ³n disease (limited to the
Andes mountains)
β’ B. quintana : Trench fever, BA/BP( BACILLARY ANGIOMATOSIS/PELIOSIS), endocarditis
β’ B. henselae : Acute and persistent bacteremia, BA/BP complex, non-neovascular infl ammation including endocarditis and CSD( CAT SCRATCH DISEASE), neurologic manifestations
β’ B. elizabethae : Bacteremia with endocarditis
β’ B. clarridgeiae : CSD
β’ B. vinsonii : bacteremia
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DIFFERENTIAL DIAGNOSIS
. Typical CSD: other causes of unilateral lymphadenopathy : Sporothrix schenckii , Pasteurella species, Yersinia pestis , Francisella tularensis , Mycobacteria , Erysipelothrix rhusiopathiae , Staphylococci , Streptococci , other agents associated with injection drug use, lymphoma, metastatic malignancy
. Atypical CSD: other agents causing similar syndromes
. Non-bacilliformis Bartonella species bacteremia syndromes
. In immunocompromised, especially HIV-infected:
Cryptococcus neoformans , Histoplasma
capsulatum , Coccidioides immitis , Mycobacterium avium-complex
. After recent arthropod exposure: rickettsial infections, tularemia, plague, babesiosis, borreliosis (locationdependent).
. After cat/dog scratch/bite: Pasteurella species infection
. Viral illnesses: influenza, infectious mononucleosis, acute hepatitis, etc.
. Endocarditis: other fastidious/slow-growing bacteria associated with endocarditis, e.g. species of Haemophilus, Actinobacillus , Cardiobacterium , Eikenella , Kingella , Coxiella
. BA/BP: Kaposi sarcoma; pyogenic granuloma
. Neurologic in HIV-infected : other causes of encephalopathy, e.g., primary HIV-related, tertiary syphilis, cryptococcal meningitis, toxoplasmosis of brain, progressive multifocal leukoencephalopathy, alcohol or drug abuse
* FOR Non-bacilliformis Bartonella spp:
. Blood cultures: lysis-centrifugation (Isolator) cultures plated on blood or chocolate agar, incubated at 35-37 C in 5% CO2 > 2 weeks; enriched broth media, e.g. BACTER, incubated at 35-37ΒβΉC in 5% CO2 >2 weeks and subculture to agar if bacilli detected by periodic acridine orange staining.
. Tissue cultures: recovery from tissue homogenate plated on blood or chocolate agar may require >4 weeks