Epidemiology and clinical manifestations of Bartonella infections in HIV-infected patients
- David H Spach, MD
David H Spach, MD
- Professor of Medicine
- Division of Infectious Diseases
- University of Washington
Bartonella infections can cause serious morbidity and mortality in HIV-infected patients, particularly those with advanced immunosuppression.
This topic will address the epidemiology, microbiology, and clinical manifestations of Bartonella infections in HIV-infected patients. The diagnosis, treatment, and prevention of these infections are discussed elsewhere. (See "Diagnosis, treatment, and prevention of Bartonella infections in HIV-infected patients".)
Other aspects of Bartonella infection are discussed separately. (See "Microbiology, epidemiology, clinical manifestations, and diagnosis of cat scratch disease" and "Endocarditis caused by Bartonella" and "South American bartonellosis: Oroya fever and verruga peruana".)
Although more than 20 distinct species of Bartonella have been isolated, only two Bartonella species cause a significant number of clinically relevant infections in individuals infected with the human immunodeficiency virus (HIV): Bartonella henselae and Bartonella quintana [1,2].
Transmission — Patients with B. henselae infection usually have a history of cat exposures . The transmission of Bartonella to humans most often results via a cat scratch involving the claw of a cat that is contaminated with Bartonella-infected flea feces. Cat fleas become infected with B. henselae after feeding on the cat. While on the cat, the fleas excrete feces that contain Bartonella. The cat’s claw becomes contaminated with flea feces when the cat scratches its skin in an area infested with fleas.
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- CLINICAL MANIFESTATIONS
- Bacillary angiomatosis
- - Cutaneous lesions
- - Subcutaneous lesions
- - Osseous lesions
- - Mucosal lesions
- - Central nervous system
- Bacillary peliosis and splenitis
- Bacteremia, endocarditis, and unexplained fever
- SUMMARY AND RECOMMENDATIONS