Bartonella & Osteomyelitis

Bartonella Henselae

• Bartonella henselae are aerobic, rod-shaped bacteria found mainly in the saliva of cats. According to the Centers for Disease Control, about 40 percent of cats carry B. henselae at some time in their lives, with kittens being the most likely to be infected. Cats carrying B. henselae do not get sick, so there is no way to know which cats are carriers. Humans catch B. henselae when they are bitten or scratched by a cat. The bacteria is transferred to a cat's claws when the cat licks its paws.

Cat-Scratch Disease

• According to a synopsis published in the Emerging Infectious Diseases Journal, "CSD is typically a benign and self-limited illness lasting 6 to 12 weeks in the absence of antibiotic therapy." Symptoms are usually mild. Within about 10 days, a sore or blister may appear around the bite or scratch. Lymph nodes close to the point of injury may become swollen. Some patients may experience a fever, malaise, headache, nausea, sore throat and tenderness in the spleen.

Complications of Cat-Scratch Disease

• The European Bioinformatics Institute report on Bartonella henselae states, "People with immunocompromised conditions, such as those undergoing immunosuppressive treatments for cancer, organ transplant patients, and people with HIV/AIDS, are more likely than others to have complications of CSD."

  The synopsis in the Emerging Infectious Diseases Journal states, "Unusual manifestations of CSD, which occur in up to 14% of patients, include Perinaud's oculoglandular syndrome (6%), encephalopathy (2%), hepatic granulomas (0.3%), osteomyelitis (0.3%), and pulmonary disease (0.2%)."

CSD and Osteomyelitis

• After an extensive review of literature, researchers publishing in the Journal of Infection concluded that osteomyelitis caused by cat-scratch disease, "... is rare but should be considered when bone pain and fever are present in a patient with nodal CSD." Patients with this complication of cat-scratch disease are treated with antibiotics, and the review states that, "The prognosis is good, whatever treatment is given."

When to Call a Doctor

• Though cat-scratch disease will clear up without treatment for most people, antibiotics may be needed when symptoms persist for extended periods of time. A Family Doctor information page recommends that you call a physician if you are scratched or bitten by a cat and the wound does not seem to heal. Also watch for fevers that last for several days and painful lymph nodes or joint pain that lasts for more than two weeks.