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Bartonella infection

Última revisão: 20 Aug 2025
Última atualização: 13 Jun 2023

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)
Todos los datos

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
Todos los datos

Factores de riesgo

  • cat scratches and bites
  • exposure to arthropod vectors
  • homelessness or poor living conditions
  • history of cardiac valvular disease
  • immunosuppression
Todos los datos

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
Todos los datos

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
Todos los datos

Algoritmo de tratamiento

Inicial

suspected Bartonella endocarditis

Agudo

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
Janak Koirala

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

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

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

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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