Bats are key hosts in the radiation of mammal-associated Bartonella bacteria.

Bats are notorious reservoirs of several zoonotic diseases and may be uniquely tolerant of infection among mammals. Broad sampling has revealed the importance of bats in the diversification and spread of viruses and eukaryotes to other animal hosts. Vector-borne bacteria of the genus Bartonella are prevalent and diverse in mammals globally and recent surveys have revealed numerous Bartonella lineages in bats. We assembled a sequence database of Bartonella strains, consisting of nine genetic loci from 209 previously characterized Bartonella lineages and 121 new cultured isolates from bats, and used these data to perform a comprehensive phylogenetic analysis of the Bartonella genus. This analysis included estimation of divergence dates using a molecular clock and ancestral reconstruction of host associations and geography. We estimate that Bartonella began infecting mammals 62 million years ago near the Cretaceous-Paleogene boundary. Additionally, the radiation of particular Bartonella clades correlate strongly to the timing of diversification and biogeography of mammalian hosts. Bats were inferred to be the ancestral hosts of all mammal-associated Bartonella and appear to be responsible for the early geographic expansion of the genus. We conclude that bats have had a deep influence on the evolutionary radiation of Bartonella bacteria and their spread to other mammalian orders. These results support a 'bat seeding' hypothesis that could explain similar evolutionary patterns in other mammalian parasite taxa. Application of such phylogenetic tools as we have used to other taxa may reveal the general importance of bats in the ancient diversification of mammalian parasites.

Cutaneous manifestations of bartonellosis.

Bartonellosis are diseases caused by any kind of Bartonella species. The infection manifests as asymptomatic bacteremia to potentially fatal disorders. Many species are pathogenic to humans, but three are responsible for most clinical symptoms: Bartonella bacilliformis, Bartonella quintana, and Bartonella henselae. Peruvian wart, caused by B. bacilliformis, may be indistinguishable from bacillary angiomatosis caused by the other two species. Other cutaneous manifestations include maculo-papular rash in trench fever, papules or nodules in cat scratch disease, and vasculitis (often associated with endocarditis). In addition, febrile morbilliform rash, purpura, urticaria, erythema nodosum, erythema multiforme, erythema marginatus, granuloma annularis, leukocytoclastic vasculitis, granulomatous reactions, and angioproliferative reactions may occur. Considering the broad spectrum of infection and the potential complications associated with Bartonella spp., the infection should be considered by physicians more frequently among the differential diagnoses of idiopathic conditions. Health professionals and researchers often neglected this diseases.

Cutaneous manifestations of bartonellosis

Abstract Bartonellosis are diseases caused by any kind of Bartonella species. The infection manifests as asymptomatic bacteremia to potentially fatal disorders. Many species are pathogenic to humans, but three are responsible for most clinical symptoms: Bartonella bacilliformis, Bartonella quintana, and Bartonella henselae. Peruvian wart, caused by B. bacilliformis, may be indistinguishable from bacillary angiomatosis caused by the other two species. Other cutaneous manifestations include maculo-papular rash in trench fever, papules or nodules in cat scratch disease, and vasculitis (often associated with endocarditis). In addition, febrile morbilliform rash, purpura, urticaria, erythema nodosum, erythema multiforme, erythema marginatus, granuloma annularis, leukocytoclastic vasculitis, granulomatous reactions, and angioproliferative reactions may occur. Considering the broad spectrum of infection and the potential complications associated with Bartonella spp., the infection should be considered by physicians more frequently among the differential diagnoses of idiopathic conditions. Health professionals and researchers often neglected this diseases.

Bartonella infections in cats and dogs including zoonotic aspects.

Bartonellosis is a vector-borne zoonotic disease with worldwide distribution that can infect humans and a large number of mammals including small companion animals (cats and dogs). In recent years, an increasing number of studies from around the world have reported Bartonella infections, although publications have predominantly focused on the North American perspective. Currently, clinico-pathological data from Europe are more limited, suggesting that bartonellosis may be an infrequent or underdiagnosed infectious disease in cats and dogs. Research is needed to confirm or exclude Bartonella infection as a cause of a spectrum of feline and canine diseases. Bartonella spp. can cause acute or chronic infections in cats, dogs and humans. On a comparative medical basis, different clinical manifestations, such as periods of intermittent fever, granulomatous inflammation involving the heart, liver, lymph nodes and other tissues, endocarditis, bacillary angiomatosis, peliosis hepatis, uveitis and vasoproliferative tumors have been reported in cats, dogs and humans. The purpose of this review is to provide an update and European perspective on Bartonella infections in cats and dogs, including clinical, diagnostic, epidemiological, pathological, treatment and zoonotic aspects.

Bartonella henselae infection in diverse clinical conditions in a tertiary care hospital in north India.

BACKGROUND & OBJECTIVES: : Bartonella henselae causes infections which closely resemble febrile illness and chronic diseases such as tuberculosis and haematological malignancies. There are not many studies on Bartonella infections from India. The present study was undertaken to diagnose B. henselae infection in diverse clinical conditions in a tertiary care hospital in north India. METHODS: A total of 145 patients including those with fever and lymphadenopathy, infective endocarditis and neuroretinitis were enrolled in the study. Whole blood, serum and lymph node aspirate and valvular vegetations if available, were obtained. Samples were plated on chocolate agar and brain-heart infusion agar containing five per cent fresh rabbit blood and were incubated at 35°C for at least four weeks in five per cent CO2with high humidity. Immunofluorescent antibody assay (IFA) was done for the detection of IgM antibodies in the serum using a commercial kit. Whole blood was used to perform polymerase chain reaction (PCR) for the citrate synthase gene (gltA). RESULTS: IFA was positive in 11 of 140 (7.85%) patients and PCR was positive in 3 of 140 (2.14%) patients. Culture was negative in all the cases. A higher incidence of Bartonella infection was seen in patients with fever and lymphadenopathy (n=30), seven of whom were children. In ophthalmological conditions, four cases were IFA positive. INTERPRETATION & CONCLUSIONS: The present study shows that the threat of Bartonella infection is a reality in India. It is also an important treatable cause of fever and lymphadenopathy in children. Serology and PCR are useful tests for its diagnosis. Clinicians should consider. BARTONELLA: infection in the differential diagnosis of febrile illnesses and chronic diseases.

Prevalencia de Bartonella henselae en donantes de sangre y riesgo de transmisión sanguínea en Chile / Prevalence of Bartonella henselae in blood donors and risk of blood transmission in Chile

Resumen Introducción: Bartonella henselae es el agente causal de la enfermedad del arañazo del gato en personas inmunocompetentes y de la angiomatosis bacilar y peliosis hepatis en inmunocomprometidos. En Chile la prevalencia de anticuerpos contra B. henselae en niños y adolescentes sanos es de 13,3%, en personas con riesgo ocupacional 60,5% y en gatos 85,6%. No existen datos publicados respecto de la seroprevalencia en donantes de sangre en nuestro país, por lo que determinar si B. henselae se encuentra presente en la sangre de los donantes al momento de la donación es muy importante, ya que este microorganismo puede sobrevivir hasta 35 días en los eritrocitos almacenados en banco de sangre a 4 °C. Objetivo: Determinar la prevalencia de B. henselae en donantes de sangre. Metodología: Se analizaron 140 muestras de sangre de donantes, para detectar la presencia de B. henselae, utilizando la técnica de la reacción de polimerasa en cadena (RPC). Resultados: Se obtuvo 13,6% de los donantes de sangre con RPC positiva para la B. henselae. La secuencia de los fragmentos amplificados presentó una identidad por sobre 98% con respecto a secuencias de B. henselae de referencia. Conclusión: El riesgo de transmisión sanguínea debiera ser considerado en un país con alta seroprevalencia de infección por B. henselae.

Background: Bartonella henselae is the causal agent of cat scratch disease in immunocompetent persons and bacterial angiomatosis in immunocompromised patients. In Chile, the prevalence of antibodies against B. henselae in healthy children and adolescents is 13.3%, in persons with occupational risk 60.5%, and in cats 85.6%. There are no published data regarding the seroprevalence in blood donors in our country, so determining if B. henselae is present in the blood of donors at the time of donation is very important, since this microorganism can survive up to 35 days in the red blood cells stored in a blood bank at 4 °C. Objective: To determine the prevalence of B. henselae in blood donors. Methodology: 140 donor blood samples were analyzed to detect the presence of B. henselae, using the polymerase chain reaction technique. Results: 13.6% of the blood donors with positive polymerase chain reaction for B. henselae were obtained. The sequence of the amplified fragments showed an identity of over 98% with respect to B. henselae reference sequences. Conclusion: The risk of blood transmission is due to a country with high B. henselae infection.

Vectores de la leishmaniasis tegumentaria y la enfermedad de carrión en el Perú: una actualización / Update on tegumentary leishmaniasis and carrion's disease vectors in Peru

RESUMEN De las aproximadamente 190 especies de Lutzomyia en el Perú, solo un reducido número han sido incriminadas como vectores de leishmaniasis tegumentaria en valles occidentales e interandinos: Lutzomyia (Lu.) peruensis, Lu. verrucarum, Lu. tejadai, Lu. ayacuchensis, Lu. pescei; mientras que en la región amazónica Lu. yuilli yuilli, Lu. chagasi, Lu. davisi y Lu. auraensis han sido encontradas infectadas naturalmente con Leishmania del subgénero Viannia. Lutzomyia auraensis constituye un nuevo reporte como vector potencial de leishmaniasis en regiones neotropicales. En relación a los vectores de la bartonellosis humana o enfermedad de Carrión, Lu. verrucarum y Lu. peruensis son los vectores principales y de más amplia distribución en regiones andinas del norte, centro y sur del Perú. Otros potenciales vectores de la enfermedad de Carrión son Lu. serrana en el valle del Monzón, Huamalíes, Huánuco, Lu. pescei en Apurímac y Cusco; Lu. robusta y Lu. maranonensis en las provincias de Jaén, San Ignacio y Utcubamba, selva alta del Perú. Debido a la alta prevalencia de la leishmaniasis y bartonellosis en el Perú y a su dispersión que sobrepasa los límites de las áreas endémicas conocidas, es necesario actualizar tanto la información como los mapas de distribución de los vectores de estas enfermedades, para contribuir con el mejoramiento de las medidas de prevención y control. La información existente sobre flebotomíneos vectores en el Perú ha sido reunida en este artículo.

ABSTRACT Among approximately 190 species of Lutzomyia in Peru, only a small number have been identified as vectors of tegumentary leishmaniasis in Western and inter-Andean valleys. These include L. peruensis, L. verrucarum, L. tejadai, L. ayacuchensis, and L. pescei. In the Amazon region, L. yuilli yuilli, L. chagasi, L. davisi, and L. auraensis are naturally infected, among the subgenera Leishmania and Viannia. L. auraensis is newly reported as a potential vector of leishmaniasis in neotropical regions. Among the primary and most widely distributed vectors of human bartonellosis or Carrión's disease, L. verrucarum and L. peruensis are predominant in the Andean regions of northern, central, and southern Peru. Other potential vectors of Carrion's disease are L. serrana in the Monzon Valley, Huamalies, and Huanuco; L. pescei in Apurímac and Cusco; and L. robusta and L. maranonensis in Jaén, San Ignacio, and Utcubamba provinces, and the high forests of Peru. Because of the high prevalence of leishmaniasis and bartonellosis outside of known endemic areas in Peru, it is necessary to update data and distribution maps of these disease vectors. This may improve both prevention and control measures. Existing information about sandfly vectors in Peru is also provided in this article.

[Prevalence of Bartonella henselae in blood donors and risk of blood transmission in Chile]. / Prevalencia de Bartonella henselae en donantes de sangre y riesgo de transmisión sanguínea en Chile.

BACKGROUND: Bartonella henselae is the causal agent of cat scratch disease in immunocompetent persons and bacterial angiomatosis in immunocompromised patients. In Chile, the prevalence of antibodies against B. henselae in healthy children and adolescents is 13.3%, in persons with occupational risk 60.5%, and in cats 85.6%. There are no published data regarding the seroprevalence in blood donors in our country, so determining if B. henselae is present in the blood of donors at the time of donation is very important, since this microorganism can survive up to 35 days in the red blood cells stored in a blood bank at 4 °C. OBJECTIVE: To determine the prevalence of B. henselae in blood donors. METHODOLOGY: 140 donor blood samples were analyzed to detect the presence of B. henselae, using the polymerase chain reaction technique. RESULTS: 13.6% of the blood donors with positive polymerase chain reaction for B. henselae were obtained. The sequence of the amplified fragments showed an identity of over 98% with respect to B. henselae reference sequences. CONCLUSION: The risk of blood transmission is due to a country with high B. henselae infection.

Rapid and sensitive detection of Bartonella bacilliformis in experimentally infected sand flies by loop-mediated isothermal amplification (LAMP) of the Pap31 gene.

BACKGROUND: Carrion' disease, caused by Bartonella bacilliformis, remains truly neglected due to its focal geographical nature. A wide spectrum of clinical manifestations, including asymptomatic bacteremia, and lack of a sensitive diagnostic test can potentially lead to a spread of the disease into non-endemic regions where competent sand fly vectors may be present. A reliable test capable of detecting B. bacilliformis is urgently needed. Our objective is to develop a loop-mediated isothermal amplification (LAMP) assay targeting the pap31 gene to detect B. bacilliformis. METHODS AND FINDINGS: The sensitivity of the LAMP was evaluated in comparison to qPCR using plasmid DNA containing the target gene and genomic DNA in the absence and presence of human or sand fly DNA. The detection limit of LAMP was 1 to 10 copies/µL, depending on the sample metrics. No cross-reaction was observed when testing against a panel of various closely related bacteria. The utility of the LAMP was further compared to qPCR by the examination of 74 Lutzomyia longipalpis sand flies artificially fed on blood spiked with B. bacilliformis and harvested at days (D) 1, 3, 5, 7 and 9 post feeding. Only 86% of sand flies at D1 and 63% of flies at D3 were positive by qPCR. LAMP was able to detect B. bacilliformis in all those flies confirmed positive by qPCR. However, none of the flies after D3 were positive by either LAMP or qPCR. In addition to demonstrating the sensitivity of the LAMP assay, these results suggest that B. bacilliformis cannot propagate in artificially fed L. longipalpis. CONCLUSIONS: The LAMP assay is as sensitive as qPCR for the detection of B. bacilliformis and could be useful to support diagnosis of patients in low-resource settings and also to identify B. bacilliformis in the sand fly vector.

Soroprevalência de Bartonella sp., Coxiella burnetii e Hantavirus em Pessoas que Injetam Drogas Ilícitas no Estado do Rio de Janeiro nos anos de 1999 a 2001 / Seroprevalence of bartonella sp., coxiella burnetti and hantavirus in intravenous illicit drug users in the state of Rio de Janeiro in the years of 1999-2001

O aumento do consumo de drogas ilícitas na atualidade vem acompanhado não apenas do impacto social e econômico, como também na saúde. As pessoas que injetam drogas apresentam maior susceptibilidade a infecções por diversos agentes, devido ao uso da droga e à subsequente imunossupressão, como também pelo risco de maior exposição a agentes transmitidos por artrópodes e reservatórios vertebrados em ambientes insalubres. São muitos os estudos correlacionando o consumo de drogas à infecção pelo HIV, VHB e VHC, porém raros investigam outros agentes. No presente estudo transversal e retrospectivo, selecionamos aleatoriamente 300 amostras de um estudo multicêntrico da década de 1990 e fizemos a pesquisa sorológica para Bartonella spp., Coxiella burnetii e Hantavirus. O perfil demográfico e social encontrado mostrou-se em concordância com a literatura: homens, jovens, de baixa renda e com histórico de prisão. A maior parte apresentava situações de risco por injetar drogas com dispositivos previamente usados e por injetar em local público. Alguns fatores foram discordantes da literatura internacional e podem ter influenciado os resultados, uma vez que são considerados situações de risco, como escassez de pessoas que injetaram drogas enquanto presas, que residem em instituições, ou sem-tetoA evidência de infecção por C. burnetii foi de 9,3 porcento, praticamente o dobro da observada na população geral brasileira, embora, em comparação com dados internacionais, a prevalência tenha sido menor. Não houve diferença estatística significativa em relação às variáveis demográficas entre os grupos sororeativos e soronegativos para febre Q. A presença de anticorpos anti-Bartonella foi de 1 porcento, bem discrepante dos estudos nacionais e internacionais. Pode ser justificado pela não inclusão no teste sorológico de antígeno de B. elizabethae e de B. quintana e pela reduzida frequência de sem-tetos...

The increased consumption of illicit drugs today is followed not only by a social and economic impact, as well as in health. People who inject drugs are more susceptible to infections by various agents due to drug use and subsequent immunosuppression, as well as the risk of increased exposure to agents transmitted by arthropods and vertebrate reservoirs in unhealthy environments. Many studies link drug use to HIV, HBV and HCV,however only a few investigate other agents. In this retrospective cross-sectional study, we selected randomly 300 samples from a multicenter study from the 1990s and made aserological survey for Bartonella spp., Coxiella burnetii and hantavirus. The demographic and social profile was found in agreement with the literature: men, young age, low incomeand with a history of imprisonment. The majority was exposed to risk situations by injecting drugs with previously used devices and by injecting in a public places. Some factors were disagreeing with the international literature and may have influenced theresults, since they are considered high-risk situations, such as shortage of people whoinjected drugs while imprisoned, residing in institutions, or homeless. Evidence of C.burnetii infection was 9.3 percent, almost double the rate in the general Brazilian population,although in comparison with international data, the prevalence was lower. There was nostatistically significant difference in relation to demographic variables among seroreactiveand seronegative groups for fever Q. The presence of antibodies to Bartonella was 1percent, significantly discrepant from national/international studies. Possibly justified by the noninclusion of antigen B. elizabethae and B. quintana in the serological test, and the reduced frequency of homelessness. There was no correlation between high alcohol consumption with higher seroprevalence of Bartonella spp., probably for the reasons mentioned above...

Aspectos clínicos, epidemiológicos e laboratoriais das bartoneloses em crianças do Rio de Janeiro / Clinical, epidemiological and laboratory aspects of bartonellosis in children in Rio de Janeiro

As bartoneloses são doenças mundialmente dispersas causadas por bactérias gramnegativas do gênero Bartonella. Com mais de 24 espécies reconhecidas, B. bacilliformis, B.henselae e B. quintana são os principais e mais comuns agentes causadores de doença emhumanos. Na literatura existem relatos de casos isolados e alguns estudos de prevalênciasorológica sobre a doença, a maioria realizados em pacientes adultos, com escassainformação sobre a sua apresentação e a epidemiologia nas crianças. A proposta desseestudo retrospectivo foi analisar uma série casos de bartonelose em pacientes abaixo de 16anos, no estado do Rio de Janeiro, durante o período de 2006 a 2012, a partir dos dadossecundßrios obtidos no banco de dados do Laboratório de Referência Nacional paraRickettsioses, Laboratório de Hantavirose e Rickettsioses do Instituto Oswaldo Cruz, Rio deJaneiro. Dos 36 confirmados por anßlise sorológica utilizando teste de imunofluorescênciacomercial, com títulos de corte de 64, e/ ou por reação em cadeia da polimerase, 19 casos(52,7 por cento) foram do sexo feminino, com uma variação por faixa etßria de zero a 16 anos, 19(52,7 por cento) tinham entre 11 e 16 anos de idade. A maioria dos casos - 22 casos (61,1 por cento) -, foiprocedente do município do Rio de Janeiro, com mais cinco (13,8 por cento ) e três (8,3 por cento) empacientes residentes nos municípios de Duque de Caxias e Nova Iguaçu. A informaçãosobre contato com gato estava disponível em apenas sete (19,4 por cento)...

Bartonelloses are globally dispersed diseases caused by gram-negative bacteria fromBartonella genus. With over 24 recognized species, B. bacilliformis, B. henselae and B.Quintana are the main and most common disease-causing agents in humans. In theliterature, there are reports of isolated cases and some seroprevalence studies about thedisease, most performed in adult patients, with limited information about its presentation andepidemiology in children. The purpose of this retrospective study was to analyze a caseseries of bartonellosis in patients aged less than 16 years, in the State of Rio de Janeiro,during the period 2006-2012. We assessed secondary data from the National ReferenceLaboratory for Rickettsiosis, Laboratory of Hantaviroses and Rickettsioses of Oswaldo CruzInstitute, Rio de Janeiro. Nineteen cases (52,7 percent), from 36 confirmed by serological analysisusing commercial immunofluorescence test, with antibody cut off titers of 64 , and / orpolymerase chain reaction, were female, with an age variation from zero to 16 years old, 19(52.7 percent) were between 11 and 16 years old. Most of cases - 22 (61.1 percent) û were found in thecity of Rio de Janeiro, with another five (13.8 percent) and three (8.3 percent) in patients residing in thecities of Duque de Caxias and Nova Iguaçu. Information about contact with cats wasavailable in just seven (19,4 percent). Clinical manifestations observed in this study were similar tothose described in the literature, in which it was possible to identify cat scratch disease(CSD), fever of unknown origin, and hepatosplenic form...

Chronic Bartonellosis in cats: what are the potential implications?

PRACTICAL RELEVANCE: Bartonellae are small, vector-transmitted Gram-negative intracellular bacteria that are well adapted to one or more mammalian reservoir hosts. Cats are the natural reservoir for Bartonella henselae, which is a (re-)emerging bacterial pathogen. It can cause cat scratch disease in humans and, in immunocompromised people, may lead to severe systemic diseases, such as bacillary angiomatosis. Cats bacteraemic with B henselae constitute the main reservoir from which humans become infected. Most cats naturally infected with B henselae show no clinical signs themselves, but other Bartonella species for which cats are accidental hosts appear to have more pathogenicity. GLOBAL IMPORTANCE: Several studies have reported a prevalence of previous or current Bartonella species infection in cats of up to 36%. B henselae is common in cats worldwide, and bacteraemia can be documented by blood culture in about a quarter of healthy cats. The distribution of B henselae to various parts of the world has largely occurred through humans migrating with their pet cats. The pathogen is mainly transmitted from cat to cat by fleas, and the majority of infected cats derive from areas with high flea exposure. No significant difference in B henselae prevalence has been determined between male and female cats. In studies on both naturally and experimentally infected cats, chronic bacteraemia has mainly been found in cats under the age of 2 years, while those over 2 years of age are rarely chronically bacteraemic. EVIDENCE BASE: This article reviews published studies and case reports on bartonellosis to explore the clinical significance of the infection in cats and its impact on humans. The article also discusses possible treatment options for cats and means of minimising the zoonotic potential.

Ecological diversity of Bartonella species infection among dogs and their owner in Virginia.

Bartonella species comprise a genus of gram-negative, fastidious, intracellular bacteria that have been implicated in association with an increasing spectrum of disease manifestations in dogs and human patients. In this study, chronic canine and human disease, for which causation was not diagnostically defined, were reported by the breeder of a kennel of Doberman pinschers. In addition to other diagnostic tests, serology, polymerase chain reaction, and enrichment blood culture were used to assess the prevalence of Bartonella sp. infection in the dogs and their owner. From five dogs, Bartonella vinsonii subsp. berkhoffii genotype I, multiple Bartonella henselae strains, and a species most similar to Candidatus B. volans, a rodent-associated Bartonella sp., were amplified and sequenced from biopsy tissues, cerebrospinal fluid, or blood enrichment cultures. The owner was bacteremic with B. vinsonii subsp. berkhoffii genotype I, the same subsp. and genotype detected in one of her dogs. These results further emphasize the ecological complexity of Bartonella sp. transmission in nature.

[Treatment of human infections caused by Bartonella spp.]. / Tratamiento de las infecciones por Bartonella spp.

Infections by Bartonella spp. include a wide spectrum of emerging and re-emerging infectious diseases. There is not a universal therapy for this infection, therefore treatment should be chosen individually. The aim of this review is to update the therapeutics aspects of this kind of infections.

[Bartonella spp. as a zoonotic pathogens transmitting by blood-feeding arthropods]. / Bartonella spp. jako patogeny odzwierzece przenoszone przez krwiopijne stawonogi.

Prior to 1993, Bartonella bacilliformis was the only member of the Bartonella genus. Now, the genus Bartonella currently contains over 30 species of Gram-negative bacteria that parasitize mammalian erythrocytes and endothelial cells. Bartonella spp. have been isolated from a variety of mammal species, most often from rodents, ruminants and carnivores, and these animals are implicated as reservoirs for the genus Bartonella. The persistent bacteriemia is more readily documented in the primary reservoir species and may occur less frequently or to a much lower lever in accidental hosts. In the natural host, clinical manifestations of the infection may be minimal or unrecognizable. Several insects have been implicated in Bartonella transmission, including flies and ticks. The reservoir host and vector varying depending on the Bartonella species involved, although, neither the reservoir, nor the vector has been identified definitively for many recently described Bartonella species. Humans are natural reservoir hosts for two species: Bartonella bacilliformis and Bartonella quintana, but many animal-associated Bartonella can also cause disease in humans. Members of the genus Bartonella are involved in a variety of human diseases, such as Carrion's disease, cat scratch disease, trench fever, bacillary angiomatosis, endocarditis, pericarditis and neuroretinitis. Most cases of bartonellosis are now diagnosed by tests based on PCR or through serological tests using specific antigens.

Bartonellosis: an emerging infectious disease of zoonotic importance to animals and human beings.

OBJECTIVE: To provide a review of clinically relevant observations related to Bartonella species as emerging pathogens in veterinary and human medicine. DATA SOURCES: Literature as cited in PubMed and as generated by each of the authors who have contributed to various aspects of the clinical understanding of bartonellosis. HUMAN DATA SYNTHESIS: Important historical and recent publications illustrating the evolving role of animal reservoirs as a source of human infection. VETERINARY DATA SYNTHESIS: Comprehensive review of the veterinary literature. CONCLUSIONS: In addition to inducing life-threatening illnesses, such as endocarditis, myocarditis, and meningoencephalitis and contributing to chronic debilitating disease, such as arthritis, osteomyelitis, and granulomatous inflammation in cats, dogs, and potentially other animal species; pets and wildlife species can serve as persistently infected reservoir hosts for the transmission of Bartonella spp. infection to veterinary professionals and others with direct animal contact.

Bartonellosis.

Bartonellosis is a constellation of clinical conditions affecting human beings and a variety of animals. Many Bartonella infections are zoonotic, with some of the most commonly reported zoonotic manifestations of infection including cat scratch disease, bacillary angiomatosis, endocarditis, and neuroretinitis. Companion animals serve as reservoirs for several zoonotic species of Bartonella, and may also serve as sentinels for zoonotic Bartonella species harbored by wildlife. This article provides an overview of bartonellosis of dogs and cats, and discusses public health implications of animal bartonellosis.

Feline bartonellosis and cat scratch disease.

Bartonella species are important emerging zoonotic pathogens. Transmission of these organisms in nature may be much more complex than is currently appreciated. Cats can be infected with five Bartonella species, including, Bartonella henselae, Bartonella clarridgeae, Bartonella bovis, Bartonella koehlerae and Bartonella quintana. In addition to cats, numerous domestic and wild animals, including bovine, canine, human, and rodent species can serve as chronically infected reservoir hosts for various intra-erythrocytic Bartonella species. In addition, an increasing number of arthropod vectors, including biting flies, fleas, keds, lice, sandflys and potentially ticks have been implicated in the transmission of various Bartonella species to animals or human beings. In the reservoir host, Bartonella species cause chronic intra-erythrocytic and vascular endothelial infections, with a relapsing bacteremia documented in experimentally infected cats. Although the immunopathology induced by Bartonella infection requires additional study, the organisms can localize to the heart valve (endocarditis), cause granulomatous inflammation in lymph nodes, liver or spleen, induce central nervous system dysfunction with or without cerebrospinal fluid changes, and may contribute to inflammatory polyarthritis. Hematological abnormalities are infrequent, but thrombocytopenia, lymphocytosis, neutropenia, and eosinophilia have been reported in B. henselae-infected cats. Serology, PCR and culture can be used to support a diagnosis of feline bartonellosis, however, due to the high rate of sub-clinical infections among various cat populations, documenting causation in an individual cat is difficult, if not impossible. Response to treatment can be used in conjunction with serology or organism isolation to support a clinical diagnosis of feline bartonellosis. As fleas are involved in the transmission among cats, the use of acaracide products to eliminate fleas from the environment is of critical importance to decrease the risk of B. henselae transmission among cats and to humans.