Bartonellosis also known as “Cat Scratch Fever”, is an increasingly recognized and emerging bacterial zoonotic disease found all over the world. Bartonella species are fastidious haemotropic (blood loving) Gram-negative anaerobic (disliking oxygen) bacteria that are mainly transmitted by biting insects and arthropods such as fleas, sand flies, mosquitoes and ticks or a cat scratch. Species of Bartonella have been found in wild cats, rabbits, sheep, dogs, grey and red foxes, raccoons, coyotes and even sea otters in Alaska.
There are roughly 13 species of pathogenic Bartonella species including B. henselae, B. quintana, B. clarridgeriae, B. rochalimae, B. koehlerae, B. vinsonii berkhoffi, B. washoensis, and B. elizabethae, B. alsatica, B. melophagi, B. tamiae, and four of them have been isolated in cats, especially feral cats, giving rise to the name “Cat Scratch Fever.” Of note, cats appear to be a particular reservoir for Bartonella species however, it has also been found in dogs rendering question as to whether or not dogs are carriers of this bacteria as well. To date, reliable Bartonella serum antibody tests are limited to the species B. henselae and B. quintana. However, newly developed fluorescent in situ hybridization (FISH) testing is now able to detect Bartonella at the species level allowing better laboratory detection of bacterial presence.
Bartonellosis was first isolated in the early 1920’s, and prevalence of the infection varies geographically. Northern climates reportedly have less prevalence of the disease, although this trend is changing in conjunction with global climate change.
In immunocompetent patients, Bartonella infection is characterized by regional lymphadenopathy, low-grade fever, malaise, muscle aches, joint pain, and chronic fatigue. There have also been reported cases of hemolytic anemia, thrombocytopenic purpura, Henoch-Schonlein purpura Syndrome, retinitis, uveitis, neuroretinitis, enlarged spleen, glomerulonephritis, endocarditis, and encephalitis due to infection.
Bartonella infection in immunocompromised patients with low natural killer cells (CD57 cells) low T helper cells (CD4 cells) and/or low T suppressor cells (CD8 cells) often present with “red streaks” resembling cat scratches, and this condition is known as bacillary angiomatosis or peliosis.
Electron microscopy studies of patients infected with Bartonella reveal that this bacteria has a particular affinity for the vascular endothelium (inside the blood vessel walls) where organisms are observed in clumps along the vessel wall. This appears to be an advantageous residence for bacteria that utilize nutrients in the host’s blood for their own benefit.
Clustering of Bartonella cases within families has been observed especially in families that have adopted feral cats. Ocular, neurologic, dermatologic, hematologic, orthopedic, cardiac, renal, and pulmonary presentations are typical for Bartonella infections but symptom presentation may vary among family members.
A combination of herbs, antibiotics, immune support, an alkalized diet, moderate exercise and nutritional support are highly recommended for successful treatment of a Bartonella infection.