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Harrison's Principles of Internal Medicine, 18e
| Part 8. Infectious Diseases > Section 6. Diseases Caused by Gram-Negative Bacteria > |
Chapter 160. Bartonella Infections, Including Cat-Scratch Disease
Sections: Bartonella Infections, Including Cat-Scratch Disease: Introduction, Cat-Scratch Disease, Trench Fever and Chronic Bacteremia, Bartonella Endocarditis, Bacillary Angiomatosis and Peliosis, Bartonellosis (Carrión's Disease), Further Readings.
Topics Discussed: bartonella; bartonellosis.
Excerpt:"Bartonella species are fastidious, facultative intracellular, slow-growing, gram-negative bacteria that cause a broad spectrum of diseases in humans. This genus includes at least 27 distinct species or subspecies, of which at least 13 have been recognized as confirmed or potential human pathogens; B. bacilliformis, B. quintana, and B. henselae are most commonly identified (Table 160-1). Most Bartonella species have successfully adapted to survival in specific domestic or wild mammals. Prolonged intraerythrocytic infection in these animals creates a reservoir for human infections. B. bacilliformis and B. quintana, which are not zoonotic, are exceptions to this rule. Arthropod vectors are often involved. Isolation and characterization of Bartonella species are difficult and require special techniques. Clinical presentation generally depends on both the infecting Bartonella species and the immune status of the infected individual. Bartonella species are susceptible to many antibiotics in vitro; however, clinical responses to therapy and studies in animal models suggest that the minimal inhibitory concentrations of many antimicrobial agents correlate poorly with the drugs' in vivo efficacies in patients with Bartonella..."
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