Bartonella henselae (Classical Cat Scratch Disease)    •
Considered a relatively benign, self-limiting disease in people.
Frequently, an inoculation papule, which can persist for months,
is located at the site of a bite or scratch. Intermittent fever,
lymphadenopathy and lethargy may be the only clinical
manifestations of B. henselae. Approximately 10% of currently
recognized B. henselae cases are accompanied by atypical
manifestations, including tonsillitis, encephalitis,
endocarditis, cerebral arteriosis, transverse myelitis,
granulomatous hepatitis and/or splenitis, osteolysis, pneumonia,
pleural effusion, and thrombocytopenic purura. Until recently,
physicians would not have considered bartonella infection in the
differential diagnosis of patients with atypical B. henselae
manifestations, particularly if a history of lymphadenopathy or
animal contact was not obtained. Infection with B. henselae can
produce distinct clinical entities in immunocompromised people,
including acute febrile illness with bactere