Resumo
定义
Anamnesis y examen
Principales factores de diagnóstico
- fever
- skin manifestations (cat-scratch disease [CSD])
- lymphadenopathy (CSD, Oroya fever)
- episodic abdominal pain (CSD)
- headache, post-orbital (trench fever)
- maculopapular rash (trench fever)
- nodular skin lesions (verruga peruana, Peruvian wart)
Otros factores de diagnóstico
- gastrointestinal symptoms
- bone and joint pain (trench fever)
- severe pallor (Oroya fever)
- hepatosplenomegaly (Oroya fever)
- dyspnea, heart murmur, and signs of cardiac failure (CSD, trench fever)
- mental state changes (CSD, Oroya fever)
- nuchal rigidity (CSD)
- red eye (CSD, trench fever)
- painless visual loss, with unilateral, abrupt onset (CSD)
- bone pain (CSD)
- mastoiditis (CSD)
- Janeway lesions, Osler nodes, or splinter hemorrhages (CSD, trench fever)
- chest pain
- photophobia
- gastrointestinal bleeding
Factores de riesgo
- cat scratches and bites
- exposure to arthropod vectors
- homelessness or poor living conditions
- history of cardiac valvular disease
- immunosuppression
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- serology: Bartonella henselae (cat-scratch disease [CSD])
- culture: B henselae (CSD)
- aspiration or biopsy of lymph nodes (CSD)
- serology: B quintana (trench fever)
- culture: Bartonella quintana (trench fever)
- blood smear (Carrion disease)
- culture: Bartonella bacilliformis (Carrion disease)
- serology: B bacilliformis (Carrion disease)
- culture: B vinsonii
- immunofluorescence antibody (IFA) assay: B vinsonii
- polymerase chain reaction (PCR) assay: B vinsonii
Pruebas diagnósticas que deben considerarse
- PCR: B henselae (CSD)
- tuberculin skin testing (TST)
- interferon-gamma release assays (IGRA)
- PCR: B quintana (trench fever)
- tissue biopsy (trench fever)
- tissue biopsy (Carrion disease)
- echocardiogram
- CT abdomen
- lumbar puncture with cerebrospinal fluid (CSF) analysis
- bone scan
Algoritmo de tratamiento
suspected Bartonella endocarditis
cat-scratch disease: no endocarditis, hepatic involvement or bacillary angiomatosis
trench fever: no endocarditis or bacillary angiomatosis
bacillary angiomatosis
peliosis hepatis or hepatosplenic microabscesses
confirmed Bartonella endocarditis
Carrion disease: Oroya fever
Carrion disease: verruga peruana
Bartonella vinsonii infection
Colaboradores
Autores
Janak Koirala, MD, MPH, FACP, FIDSA

Professor Emeritus of Medicine
Division of Infectious Diseases
Southern Illinois University School of Medicine
Springfield
IL
Divulgaciones
JK declares that he has no competing interests.
Vidya Sunadareshan, MD, MPH
Professor of Medicine
Chair, Division of Infectious Diseases
Southern Illinois University School of Medicine
Springfield
IL
Divulgaciones
VS declares that she has no competing interests.
Sangita Basnet, MD, FAAP
Professor of Pediatrics
Department of Pediatrics
Southern Illinois University School of Medicine
Springfield
IL
利益声明
SB declares that she has no competing interests.
同行评议者
Russell Wesley Steele, MD
Professor of Pediatrics and Infectious Diseases
Tulane University School of Medicine
New Orleans
LA
利益声明
RWS declares that he has no competing interests.
Miguel G. Madariaga, MD, MSc
Infectious Diseases Consultant
Naples Community Hospital
Naples
FL
利益声明
MGM declares that he has no competing interests.
Katarina Westling, MD, PhD
Division of Infectious Diseases
Karolinska University Hospital
Huddinge
Stockholm
Sweden
利益声明
KW declares that she has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
Maguina C, Gotuzzo E. Bartonellosis. New and old. Infect Dis Clin North Am. 2000 Mar;14(1):1-22;vii. 摘要
Rolain JM, Brouqui P, Koehler JE, et al. Recommendations for treatment of human infections caused by Bartonella species. Antimicrob Agents Chemother. 2004 Jun;48(6):1921-33.全文 摘要
Florin TA, Zaoutis TE, Zaoutis LB. Beyond cat scratch disease: widening spectrum of Bartonella henselae infection. Pediatrics. 2008 May;121(5):e1413-25. 摘要
Centers for Disease Control and Prevention. Bartonella infection. Jan 2022 [internet publication].全文
Prutsky G, Domecq JP, Mori L, et al. Treatment outcomes of human bartonellosis: a systematic review and meta-analysis. Int J Infect Dis. 2013 Oct;17(10):e811-9.全文 摘要
参考文献
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