The expanded spectrum of bartonellosis in children

Bartonella spp cause various clinical syndromes in immunocompetent and immunocompromised hosts. Domestic cats are the natural reservoir and vectors of B henselae. B henselae infection usually occurs early in childhood, is generally asymptomatic, and in most cases revolves spontaneously. It may, however, produce a wide spectrum of clinical symptoms, the most frequent feature being cat-scratch disease. Disseminated atypical B henselae infection may follow cat-scratch disease after a symptom-free period or may present de novo mimicking a wide range of clinical disorders. A careful clinical history researching an intimate contact with a kitten associated with a specific serology and an abdominal ultrasound for typical hepatosplenic involvement may allow a rapid and accurate diagnosis.