Prolonged Bartonella bacteremia in cats associated with cat-scratch disease patients

Abstract

Recent evidence supports a causal relationship between Bartonella (Rochalimaea) henselae, cat-scratch disease (CSD), and bacillary angiomatosis. Cats appear to be the primary reservoir. Blood from 19 cats owned by 14 patients diagnosed with CSD was cultured. Blood samples from cats owned by veterinary students (n ‫؍‬ 25) having no association with CSD or bacillary angiomatosis were cultured as controls. Eighty-nine percent (17 of 19) of cats associated with CSD patients and 28% (7 of 25) of controls were bacteremic with Bartonella species (chi-square ‫؍‬ 16.47; P < 0.001). Twenty-three isolates were characterized as B. henselae, while one isolate from the cat of a CSD patient appeared to be a new Bartonella species. Thirteen cats remained culture positive during the ensuing 12-month period. Our results support the conclusion that B. henselae is the predominant species involved in CSD and is transmitted by cats. The incidence of Bartonella bacteremia in control cats suggests that B. henselae bacteremia is prevalent among the domestic cat population in the United States. Cat-scratch disease (CSD), cat-scratch fever, or benign nonbacterial lymphadenitis was recognized by Robert Debré in 1931, but it was first reported in 1950 (5). A presumptive diagnosis of CSD is made when a patient has an inoculation wound at the site of a cat bite or scratch, regional lymphadenopathy, a positive CSD skin test, and negative test results for brucellosis, infectious mononucleosis, mycobacteria, syphilis, and tularemia. The search for the etiologic agent was intensified after Wear et al. (40) described the presence of small, silver-staining bacilli in lymph nodes from 28 CSD patients. In 1990, Relman et al. (29) used PCR to amplify Bartonella DNA from bacillary angiomatosis (BA) lesions of four immunocompromised individuals, including one woman who had recently experienced a severe cat scratch. The causative agent eluded isolation attempts until concurrent reports by Welch et al. (42) and Regnery et al. (26) described the recovery of small gram-negative rods from both immunocompetent and immunocompromised patients by the lysis-centrifugation blood culture technique. The organisms were determined to be closely related to Bartonella quintana and were subsequently named Bartonella henselae. The molecular characterization and cultivation of B. henselae facilitated development of an indirect fluorescentantibody (IFA) test which was used by Regnery et al. (27, 28) to identify a seropositive B. henselae bacteremic cat. Soon thereafter, Koehler et al. (16) reported the isolation of Bartonella species from the BA lesions of four immunocompromised patients. B. quintana was found in three patients denying cat or arthropod contact, while B. henselae was cultured from the blood of the fourth patient who had obtained several scratches from his flea-infested cat and kitten. In 1993, Dolan et al. (7) described two immunocompetent patients with B.

Does Coinfection ofBartonella henselaeand FIV Induce Clinical Disorders in Cats?

“…The results of the present study suggest that neither FIV nor FeLV infection influences the prevalence of B. henselae infection in cats. Disease manifestation has not been reported in cats naturally infected with B. henselae, even in prolonged bacteremic cats (14,16). However, in some cases of feline lymphadenopathies of unknown cause, organisms microscopically resembling those associated with human CSD (19) were found in a silver-stained section of the mandibular, parotid and popliteal lymph nodes of cats (11,12).…”

BartonellaSpecies Antibodies and Hyperglobulinemia in Privately Owned Cats

“…antibody prevalence rates in cats. 5,19,[35][36][37] The majority of the studies reported to date have had small sample numbers or have varied widely in age distribution, which could have affected the results. Based on careful evaluation of prevalence data by age for the other reported studies, it appears that seroprevalence increases with age until cats reach 1-3 years of age, after which it plateaus or declines.…”

“…are recognized as primary pathogens in human diseases, including cat scratch disease, bacillary angiomatosis, endocarditis, and bacillary peliosis. [1][2][3] Bartonella infection has been associated with extended, often asymptomatic, intraerythrocytic bacteremia in domestic cats, [4][5][6][7][8] the primary mammalian reservoir host for Bartonella henselae. In addition, Bartonella spp.…”

Investigation of Bartonella acquisition and transmission in Xenopsylla ramesis fleas (Siphonaptera: Pulicidae)

“…Prolonged periods of bacteremia have been documented in naturally infected cats for at least 15 months (Kordick et al 1995) and in experimentally infected cats for at least 454 days (Kordick et al 1999). In a study where female C57BL ⁄ 6 mice were infected with B. henselae, B. henselae-DNA could be detected for 94 days (Regnath et al 1998).…”