Former genus name: Rochalimaea
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Species
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Exposure Risk
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B. henselae
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cats (scratch, bite, fleas)
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B. quintana
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poor living conditions
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Risk factors (Mohle-Boetani et al):
(1) CD4+ lymphocyte count < 200 per µL
(2) anemia (hematocrit < 36%)
(3) elevated serum alkaline phosphatase
Clinical findings:
(1) tender, violaceous or erythematous skin lesions
(2) tender lymphadenopathy
(3) peliosis in liver and/or spleen
(4) bone lesions
(5) brain lesions
(6) bronchial lesions
(7) persistent bacteremia
Histologic findings:
(1) vascular proliferation with areas of necrosis
(2) mixed inflammatory response
(3) bacteria present (by Warthin-Starry stain or immunoperoxidase)
Confirmation of diagnosis:
(1) demonstration of organism (PCR is quickest method, also culture or serology)
(2) positive response to antibiotic therapy (erythromycin, other)
Differential diagnosis: Kaposi’s sarcoma (both may affect the same patient)
