Bartonella

Question 1

Incubation 2-6 wks.

Acute febrile illness w/ severe anemia > chronic cutaneous form

Answer 1

Bartonella Bacilliformis

Question 2

High mortality w/o therapy (10% mortality w/ therapy)

Answer 2

Bacilliformis

Question 3

Spread by sandfly (Lutzomyia). Endemic to Peru, Ecuador, and Columbia

Answer 3

Bacilliformis

Question 4

Bite > bacteria enters blood > penetrates RBCs > fragile RBCs and anemia > myalgias, arthalgias, and headaches

Answer 4

Bacilliformis

Question 5

Sxs > angina, anorexia, mental status changes, seizures, abdominal pain

Answer 5

Bacilliformis

Question 6

Asymptomatic in mildest form and humoral immunity develops

Answer 6

Bacilliformis

Question 7

Chronic stage > verruga peruana. 
Benign nodules (1-2cm) persist months to years. Nodules engorged with blood (angioproliferative) and heal on their own.

Answer 7

Bacilliformis - oroya fever

Question 8

Asymptomatic persistent bacteremia found in 15% survivors. Serves as organism’s reservoir

Answer 8

Bacilliformis - oroya fever

Question 9

Worldwide. Febrile outbreak > trench fever (5 day fever)

Answer 9

Bartonella quintana

Question 10

Common in homeless (associated with poor sanitation). Increased among AIDS pts. Spread by body louse (pediculus humanus).

Answer 10

Quintana

Question 11

Self limiting (low mortality) febrile recurring illness. Headaches, conjunctiva, myalgia

Answer 11

Quintana

Question 12

Self limiting, subacute regional lymphadenitis lasting 1-3 wks

Answer 12

Henselae (CSD)

Question 13

Papules/pustule 3-10 days after contact that can last 1-3 wks > regional ipsilateral LN enlargement 1-7 wks later

Answer 13

CSD

Question 14

Chronic, regional adenopathy of LNs draining site of contact. Spontaneous resolution

Answer 14

CSD

Question 15

Culture negative endocarditis is subacute and cause by

Answer 15

Quintana and henselae

Question 16

Vascular proliferative form of infection due to bartonella organisms

Answer 16

Bacillary angiomatosis

Question 17

Seen in pts with organ transplants OR immuno-competent pts.

Answer 17

Bacillary angiomatosis

Question 18

Raised red/purple lesions that bleed when traumatized

Answer 18

Bacillary angiomatosis

Question 19

Lesions range from 1-1,000. Resemble hemangiomas. Hyperpigmentation hyperkeratotic plaques overlying osseous defects

Answer 19

Bacillary angiomatosis

Question 20

Bone pain in forearms and legs. Jaundice, GI bleeding. Fever, chills, malaise

Answer 20

Bacillary angiomatosis

Question 21

Blood smear for dx of

Answer 21

Bacilliformis

Question 22

Culture not recommended for routine cases of

Answer 22

CSD

Question 23

Culture useful in other manifestations of

Answer 23

CSD

Question 24

Serological testing best way to dx

Answer 24

Henselae and Quintana

Question 25

IgM titer > 1:16

Answer 25

Recent infection

Question 26

IgG titer > 1:256

Answer 26

Current/Past infection

Question 27

Causes Oroya fever and carrion’s disease

Answer 27

Bartonella Bacilliformis