Bartonellosis (Bartonella Infection) Differential Diagnoses

Updated: Mar 09, 2022
  • Author: Kassem A Hammoud, MD; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Diagnostic Considerations


Cat scratch disease: Consider other causes of enlarged lymph nodes, such as localized infections with regional node swelling and systemic diseases. Examples include lymphoma, leukemia, other neoplasms, fungal infection, tularemia, tuberculosis, plague, lymphogranuloma venereum (LGV), AIDS, toxoplasmosis, and viral infection such as Ebstein-Barr virus infection and syphilis.

Bacteremia and systemic illnesses: Culture-negative endocarditis is always difficult to diagnose. Consider this diagnosis when the Duke criteria for endocarditis are present with negative findings on routine blood cultures. If bartonellosis is suspected, obtain antibody titers for B henselae and B quintana. Other causes of culture-negative endocarditis that merit consideration include Q fever, HACEK group infections (Haemophilus parainfluenzae, Aggregatibacter actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens,Kingella kingae), brucellosis, Tropheryma whipplei and Granulicatella spp (formerly known as nutritionally variant streptococci).

Bacillary angiomatosis: These lesions are often dark purple and resemble Kaposi sarcoma, pyogenic granuloma, or verruga peruana.

Oroya fever and verruga peruana: Febrile patients who have returned from travel to a developing country mandate consideration of a rather large number of possible illnesses depending on the itinerary, activities, and potential for exposures. Serious illnesses to consider include dengue fever, malaria, tuberculosis, and babesiosis.

Differential Diagnoses