In recent years, an increasing number of Bartonella species have been identified as zoonotic pathogens, transmitted by animal bites, scratches or by arthropods. Although historically the term bartonellosis was attributed to infections with Bartonella bacilliformis, transmitted by sandflies in the Peruvian Andes, a more inclusive medical use of this term now includes infections caused by any Bartonella sp., anywhere in the world. Potentially, because Bartonella spp. can infect erythrocytes, endothelial cells, and various macrophage-type cells, including brain-derived dendritic cells in vitro, the clinical and pathological manifestations of bartonellosis appear to be very diverse. The purpose of this review is to focus attention on neurological bartonellosis cases reported in immunocompetent patients since 2005. Among these patients, disease course has varied substantially in length and severity, including one fatal case of encephalitis in a child. Based upon the evolving literature, a high clinical index of suspicion is warranted.
Journal of Neuroinfectious Diseases
Journal of neuroparasitology 3:1-15, January 2012