Page 983 - Clinical Small Animal Internal Medicine

96 Bartonellosis 921

Chronic infection in dogs is associated with pyogranu-
Box 96.1 Clinical signs and syndromes potentially
VetBooks.ir associated with Bartonella infection in dogs and cats lomatous disease, which can be located in several sites,
including lymph nodes, liver, and the central nervous
Reported from dogs and cats
Endocarditis system (Figure 96.2). Consequently, clinical signs vary
depending upon the extent of damage caused in one
Fever of unknown origin or more organs. Bartonella infection in humans is asso-
Hepatitis ciated with vasculoproliferative disease (bacillary
Lameness angiomatosis and peliosis hepatis), which has been also
Lymphadenopathy described in dogs (Figure 96.3).
Myocarditis Despite the growing number of reports of sick dogs
Skin lesions infected with Bartonella spp., two recent studies failed to
Uveitis reproduce clinical signs in dogs that were experimentally
Only reported from dogs infected with B. henselae, B. vinsonii subsp. berkhoffii,
Bacillary angiomatosis and B. rochalimae. In addition, another study docu-
Cavitary effusion mented that 18% of asymptomatic dogs carry Bartonella
Chronic erosive polyarthritis DNA in the blood or lymph nodes. In one study, 8% of
Epistaxis Bartonella‐infected dogs were seropositive for at least
Granulomatous hepatitis one other vector‐borne pathogen. Therefore, the patho-
Hyperviscosity syndrome genesis of bartonellosis in dogs is still unclear, and clini-
Meningoradiculoneuritis cians should rule out other relevant differentials before
Peliosis hepatis considering this diagnosis.
Polyarthritis In naturally infected cats, clinical signs are rarely
Systemic pyogranulomatous disease reported. Similarly, experimental infection often causes
Only reported from cats mild and transient clinical signs such as fever, lethargy,
Cholangitis and lymphadenopathy in less than a third of infected
Diaphragmatic myositis cats. However, more severe manifestations have been
Gingivitis reported from experimental studies, including mild neu-
Hepatitis rologic signs (nystagmus, intermittent tremors, and focal
Interstitial nephritis motor seizures), epaxial muscle pain, reproductive fail-
Lower urinary tract disease ure, and severe myocarditis (respiratory distress, cardiac
Neurologic signs (nystagmus, focal motor seizures, murmurs, and arrhythmias). As seen in dogs, Bartonella
behavior changes) infection in cats can be associated with granulomatous
Osteomyelitis lesions in several organs. Osteomyelitis (Figure 96.4),
Reproductive failure (fetal reabsorption, stillbirth) uveitis, hepatitis, gingivitis, and stomatitis, among other
Stomatitis syndromes (Table 96.2), have been associated with natu-
ral Bartonella spp. infection in cats.

(a) (b)

Figure 96.1 Endocarditis caused by Bartonella vinsonii subsp. berkhoffii in a dog. (a) Heart of a dog with mitral valve perforation (black
arrow). (b) Close‐up of the perforation in the supravalvular region of the mitral valve. Source: Chomel et al. (2009). Reproduced with
permission of John Wiley & Sons.