Enlarged lymph node from cat scratch disease

Enlarged lymph node resulting from cat scratch disease. Used with permission of NEJM.

Cat scratch disease (CSD), Bartonella henselae

  • Low-grade fever
  • Enlarged, tender lymph nodes that develop 1–3 weeks after exposure
  • A papule or pustule at the site of the scratch

Rarely, eye infections, severe muscle pain, or encephalitis (swelling of the brain) may occur.

Trench fever, Bartonella quintana

  • Fever (may occur once or repeatedly)
  • Headache
  • Rash
  • Bone pain, mainly in the shins, neck, and back

Carrión’s disease, Bartonella bacilliformis

Verruga peruana, mular form

Verruga peruana, mular form. Used with permission of NEJM.

This disease has two distinct phases:

  • Oroya fever: During this phase, fever, headache, muscle aches, abdominal pain, and severe anemia may occur.
  • Verruga peruana (Peruvian warts): During this later phase, growths form under the skin and develop into red-to-purple vascular sores that can become raw or bleed.

Other complications

Bacillary angiomatosis

Bacillary angiomatosis (caused by B. henselae or B. quintana) and bacillary peliosis (caused by B. henselae) occur primarily in people with weakened immune systems, such as those with advanced HIV infection. Bacillary angiomatosis may result in lesions in the skin, under the skin, in bone, or in other organs. Bacillary peliosis causes sores in the liver and spleen.

Bacillary angiomatosis

Bacillary angiomatosis. Used with permission of NEJM.

Subacute endocarditis

Many Bartonella species can cause infection of the heart valves (subacute endocarditis), which is often culture negative.