Feline Bartonellosis

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Cause

Bartonella are small, fastidious, vector-transmitted gram-negative bacteria in the family Bartonellaceae of the α-2 subgroup of the Proteobacteria.1 These bacteria are highly adapted to mammalian reservoir hosts, in which a long-term asymptomatic bacteremia often occurs. The type species is B bacilliformis, an intracellular parasite of human erythrocytes and endothelial cells that causes severe hemolytic anemia and cutaneous angioproliferative lesions in human beings. It is endemic to some

Epidemiology

Feline B henselae infection was first reported in 1992.35 Since then, natural infection of cats with 5 Bartonella species (B henselae, B clarridgeiae, B koehlerae, B quintana, and B bovis [formerly B weissii])21, 23, 30, 36, 37, 38 has been reported, although feline infections with species other than B henselae or B clarridgeiae are rarely reported.21, 23, 36, 38 Seroepidemiologic studies of cats indicate that exposure to Bartonella species, most frequently B henselae, occurs worldwide.

Pathogenesis

B henselae is naturally transmitted among cats by cat fleas (Ctenocephalides felis felis). B henselae was transmitted among cats by transferring fleas fed on infected cats to specific pathogen-free cats, and by intradermal inoculation of excrement from infected fleas.68, 69 B henselae survives for at least 3 days in flea feces, suggesting that flea feces are an important source of environmental contamination.70 Cats did not become infected with B henselae when fed on by Bartonella-infected

Experimental Studies

Most cats experimentally infected with Bartonella exhibited no clinical signs. Clinical signs that did occur were generally mild, and varied with the strain of B henselae used for inoculation.55, 81, 94 Cats inoculated intradermally developed areas of induration and/or abscess at inoculation sites between approximately 2 and 21 days after inoculation.55, 81, 83, 95 Pure cultures of B henselae were obtained from these lesions in some cats.81 Other transient clinical findings included generalized

Diagnosis

Diagnosis of Bartonella infection is not straightforward. Clinical signs, when present, are transient and variable, and determining which sick animals are most likely to have Bartonella infection is difficult. Because bartonellosis is zoonotic, veterinarians may be asked to test healthy pets belonging to clients with Bartonella-related illnesses, or to screen healthy cats that are being considered as pets for immunocompromised people (see section on public health).

Treatment

Documenting clearance of feline Bartonella infections through antibiotic treatment is difficult because of the relapsing nature of the bacteremia. Treatment of Bartonella infections seems to require long-term (at least 4–6 weeks) antibiotic administration. No regimen of antibiotic treatment has been proved effective for definitively eliminating Bartonella infections in cats.45, 95, 122 Enrofloxacin (3.5–11.4 mg/kg given by mouth every 12 hours) treatment for 28 days appeared to clear B henselae

Prevention

Prevention of Bartonella infections is best accomplished by avoiding exposure to infected animals, fleas, and other arthropod vectors. Because B henselae and B clarridgeiae have been transmitted through inoculation of infected cat blood,55 cats that are seropositive for Bartonella should not be used as blood donors. B henselae was reported to survive in stored human red blood cells for up to 35 days.138 No vaccine is available to prevent Bartonella infection in cats.

Public health

Bartonella spp cause many clinical syndromes in human beings, some of which include CSD (typical and atypical forms, including encephalopathies in children and other neurologic abnormalities), bacillary angiomatosis, parenchymal bacillary peliosis, relapsing fever with bacteremia, endocarditis, optic neuritis, pulmonary, hepatic, or splenic granulomas, and osteomyelitis.14, 17, 31, 72, 100, 139, 140, 141, 142, 143, 144 Immunocompetent individuals may have more localized infections, whereas

Summary

The role of Bartonella species as feline pathogens is still an active area of investigation. Diagnosis and treatment of Bartonella infections remain challenging. It is recommended that the best practice for making a diagnosis of Bartonella-associated disease in cats is a combination of blood culture and/or PCR testing with serology and a careful evaluation for the presence of other potential causes for the clinical signs observed in a feline patient. Antibiotic treatment is recommended only if

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