Bartonella Species

Bartonella species

Background:

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Other (Gram Negative Bacilli)
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>Aeromonas species:
     1] Aeromonas hydrophila
     2] Aeromonas veronii
     3] Aeromonas shubertii
>Bartonella species:

     1] Bartonella bacilliformis
     2] Bartonella henselae (organism responsible for cat scratch disease)
     3] Bartonella Quintana
     4] Other
>Campylobacter:
     1] Campylobacter fetus
     2] Campylobacter jejuni
>Capnocytophaga species:
     1] Capnocytophaga canimorsus
     2] Capnocytophaga ochracea
>Francisella tularensis
>Helicobacter pylori
>Legionella species: ( L. pneumophila)
>Plesiomonas shigelloides
>Vibrio species:
     1] Vibrio cholera
     2] Vibrio parahaemolyticus
     3] Vibrio damsela
     4] Other

Bartonella:

(formerly known as ochalimaea).
Facultative intracellular parasites.
Can infect healthy people but are considered especially important as opportunistic pathogens.
Bartonella are transmitted by insect vectors such as ticks, fleas, sand flies, and mosquitoes.
Bartonella henselae is the organism responsible for cat scratch disease, a self-limited disease except in immunocompromised hosts.

Therapy:

Important considerations: The choice of an agent should be based on local antimicrobial sensitivities, site of infection, cost, and comorbid conditions. Generally, the most common agents/regimens are listed first. Listed dosages may need to be adjusted for renal dysfunction.

Bartonella henselae: cat source. Cat scratch disease.
Bartonella quintana: Louse-born. Poor personal hygiene (homeless). Urban trench feve.

Several others – 19 known species.

Because of the large number of possible isolates, definitive therapy does not exist. Some infections are self-limited and will not require treatment, however, complicated cases may respond to one of the listed regimens listed below, Several weeks of therapy may be needed in some cases:

Doxycycline 100mg orally twice daily [Range: 100-200mg in 1-2 divided doses]
Erythromycin 500mg orally four times daily
Azithromycin 500mg orally once daily.
Clarithromycin 500mg po q12h
[Doxycycline 100mg orally twice daily or Erythromycin 500mg orally four times daily] PLUS Rifampin 300-450 mg orally q12h
Doxycycline 100mg orally twice daily + Gentamicin 3mg/kg/day IV