Bartonellosis

Overview

Bartonellosis is a group of infections caused by Bartonella bacteria. These bacteria can get into your body through a scratch, bite, or an insect bite. Depending on the type, it can cause fever, swollen lymph nodes, and sometimes more serious problems.

It is not very common overall, but cat scratch disease is the most familiar form and is seen around the world.

Anyone can get bartonellosis, but it is most often seen in children, people who live with cats, and those who spend time outdoors in areas where the bacteria are present.

Symptoms

Common symptoms

• Fever
• Feeling very tired or weak
• Headache
• A small bump or blister at the site of a scratch or bite
• Swollen lymph nodes, often near the scratch or bite

Symptoms in children

• Children may have the same symptoms as adults, but they are more likely to develop a high fever.
• Swollen lymph nodes in the neck, armpit, or groin are common in children.

Symptoms in older adults

• Older adults may not have typical symptoms and might only feel generally unwell.
• If they have a weakened immune system, infection can be more severe and spread to organs.

Causes

Main causes

• Bartonella bacteria, which can be passed through a scratch or bite from an infected animal, especially a cat.
• Flea or tick bites that carry the bacteria.
• Lice bites, which can spread a form called trench fever.

Risk factors

• Living with or handling cats, especially kittens.
• Being around fleas or ticks.
• Weakened immune system due to illness, medication, or other health conditions.

When to see a doctor

See a doctor urgently if:

• You have a high fever that is not getting better.
• You have a swollen lymph node that is painful or growing quickly.
• You have symptoms like chest pain, confusion, or trouble breathing.

Book a routine appointment if:

• You have been scratched or bitten by an animal and feel unwell.
• You have a fever or swollen glands that last more than a few days.
• You have a bite or scratch that looks infected or is not healing.

Diagnosis

Your healthcare provider will ask about your symptoms and whether you have been around cats, fleas, or other animals. They may also examine you for a bite or scratch and feel for swollen lymph nodes.

Tests that may be done

• Blood tests to look for signs of the bacteria or your body's immune response.
• A swab or tissue sample from a swollen lymph node in rare cases.
• An ultrasound or other imaging test if your provider wants to look more closely at an affected organ.

What to expect at your appointment

Diagnosis is usually straightforward. You may need a blood test, and results can take a few days. Your provider will explain what they mean and what to do next.

Treatment

Treatment depends on how severe your illness is and your overall health. Many people with mild cat scratch disease feel better in a few weeks without medicine. For more serious cases, antibiotics can help your body get rid of the infection.

Self-care at home

• Rest until your fever goes down and you feel stronger.
• Drink plenty of fluids to stay hydrated.
• Ask your pharmacist about safe over-the-counter pain or fever relief.
• Clean any scratches or bites with soap and water.

Medical treatments

Your doctor may prescribe antibiotics for certain forms of bartonellosis, especially if you have a weakened immune system or the infection has spread. They may also drain a swollen lymph node if it is causing pain. Always take any prescribed medicine exactly as directed.

When is surgery considered?

Surgery is rarely needed. Sometimes a very large or painful swollen lymph node may be drained, but this is done in a doctor's office or clinic and is not a major operation.

Living with this condition

Take any prescribed treatment as directed and give yourself time to recover. If you feel tired, don't push too hard. Follow up with your doctor if symptoms don't improve or return.

Lifestyle tips

• Avoid rough play with cats, especially kittens, to prevent scratches and bites.
• Wash hands after handling pets and clean any wounds right away.
• Use flea control for pets and avoid stray animals.

Diet and exercise

Keep a balanced diet and drink enough water. As you feel better, slowly return to normal activities and exercise. Listen to your body and don't rush.

Mental health and emotional wellbeing

A long infection can feel frustrating or worrying. It is normal to feel anxious if you are unwell. Talk to your healthcare provider about how you are feeling. If you are in emotional distress, reach out to a mental health support line in your area.

Prevention

You can reduce your risk by avoiding scratches and bites from animals, keeping cats indoors if possible, washing wounds right away, and using flea control. When you are outdoors, try to protect yourself from insect bites.

Vaccines

There is currently no vaccine for bartonellosis.

Screening programmes

There is no routine screening for the general public. If you have symptoms or have been in close contact with an infected animal, your doctor can test you.

Complications

If left untreated

• In rare cases, the infection can spread to the heart and cause endocarditis.
• The nervous system can be affected, leading to complications like meningitis or seizures.
• People with weakened immune systems are more at risk for serious illness if the infection is not treated.

Long-term outlook

Most people with bartonellosis recover fully, even without treatment. When treatment is needed, antibiotics usually work well. With the right care, the outlook is very good, and most people return to their normal lives without long-term problems.

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