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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: led
     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.

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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:

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