Zoonosis and Us

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For those who have been diagnosed with bartonella (an often seen co-infection in Lyme patients), have you been told which type you have? Or are our doctors simply saying "positive" and nothing else?

Cats are the main reservoir for Bartonella henselae, B. clarridgeiae, and B. koehlerae. Dogs can be infected with B. vinsonii subsp. berkhoffii, B. henselae, B. clarridgeiae, B. washoensis, B. elizabethae, and B. quintana.

Traditionally, cats were linked to the zoonosis (transmission to humans from animals) of this bacteria (Cat-scratch fever), but updated research indicates that dogs and other pets should also be considered as possible sources. Additionally, multiple reports of this finding seem to indicate that Bartonella is not only a tick borne but a tick-transmitted pathogen.

Classic cat scratch disease presents as tender and swollen regional lymph nodes, a condition referred to as regional lymphadenopathy. There may be a papule (a small raised area) at the site of initial infection. While some patients have fever and other systemic symptoms, many do not. Other associated complaints include headache, chills, backache and abdominal pain. It may take 7 to 14 days, or as long as two months, before symptoms appear. Most cases are benign and self-limiting, but lymphadenopathy may persist for several months after other symptoms disappear.

The prognosis is generally favorable. In temperate climates, most cases occur in fall and winter. The disease usually resolves spontaneously, with or without treatment, in one month. In immunocompromised patients more severe complications sometimes occur (myocarditis, endocarditis, optic neuritis, etc. (see Wikipedia at http://en.wikipedia.org/wiki/Cat-scratch_Disease)

While Bartonella species are susceptible (vulnerable) to a number of standard antibiotics in vitro (as in a petrie dish) macrolides and tetracycline, for example, the efficacy of antibiotic treatment in immunocompetent (healthy) individuals is uncertain. Immunocompromised (the immune system is not able to fight off diseases) patients should be treated with antibiotics because they are particularly susceptible to systemic (affecting the entire body) disease and bacteremia.

Drugs of particular effectiveness include trimethoprim-sulfamethoxazole (Gantanol), gentamicin, ciprofloxacin (Cipro), and rifampin (Rifadin), B. henselae is generally resistant to penicillin, amoxicillin, and nafcillin.

Although I seem to have no symptoms, since I have both cats and dogs and we just went through a flea infestation, I'm thinking I should be tested.

What do you think? Please leave your comments.

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• Emerging infectious threats to the blood supply (slideshare.net)
• Clues about Bartonella infections (seattletimes.nwsource.com)
• What are Antibiotics? (brainz.org)

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