Journal of Clinical Research & Bioethics

Treatment and Management of Bartonella bacilliformis Disease

Abidi Hussain^* Department of Advanced Sciences, Aga Khan University, Karachi, Pakistan
^*Correspondence: Abidi Hussain, Department of Advanced Sciences, Aga Khan University, Karachi, Pakistan, Email:

Received: 01-Sep-2022, Manuscript No. JCRB-22-18886; Editor assigned: 05-Sep-2022, Pre QC No. JCRB-22-18886 (PQ); Reviewed: 19-Sep-2022, QC No. JCRB-22-18886; Revised: 26-Sep-2022, Manuscript No. JCRB-22-18886 (R); Published: 03-Oct-2022, DOI: 10.35248/2155-9627.22.13.441

Description

Carrion's disease (Bartonella bacilliformis), trench fever have all been linked to one of the Bartonella spp bacteria. A number of studies have found clinically healthy people who have tested positive for Bartonella but have no history of typical Bartonella symptoms. Those who do become ill usually have mild disease that resolves on its own (self-limiting). Bartonella, on the other hand, can cause severe infection in some of the people. Immunocompromised patients, such as those receiving immunosuppressive cancer treatments, organ transplant recipients, and HIV/AIDS patients, are more likely to develop severe, life-threatening disease.

Bartonella bacteria colonise red blood cells (erythrocytes) and the lining of blood vessels endothelial cells where they multiply. It is protected from the host's primary and secondary immune responses inside the erythrocytes, which explains bacterial persistence in some cases.

Treatment and Management

The clinical presentation of cat scratch disease determines how the disease is managed. Because the disease is self-limiting, patients who present with milder symptoms such as lymphadenopathy and fever are usually not put on an antimicrobial regimen. However, studies have shown that using a single antimicrobial regimen significantly reduces the duration of the symptoms. The most commonly used antimicrobial agents are azithromycin, ciprofloxacin, gentamicin, trimethoprimsulfamethoxazole, and rifampin.

Oral azithromycin at 500 mg on day one and 250 mg on days two through five for patients with extensive lymphadenopathy. Oral Doxycycline 100 mg twice daily for 4 to 6 weeks and oral rifampin 300 mg twice daily for 4 to 6 weeks for retinitis. Trench fever can be treated with Doxycycline 200 mg once daily for 4 weeks and gentamicin 3 mg/kg intravenously for 2 weeks.

Bacillary angiomatosis and peliosis hepatis were treated for 3 to 4 months with oral erythromycin 500 mg four times daily. Endocarditis caused by Bartonella should be treated with oral Doxycycline 100 mg for 6 weeks and intravenous gentamicin at 3 mg/kg/day for 14 days.

A combination of oral doxycycline 100 mg twice daily and rifampin 300mg twice daily is recommended for neuroretinitis and CNS involvement. There are no controlled clinical trials comparing those who do not receive antibiotics to those who do.

Retrospective case series, on the other hand, consistently linked antibiotics to faster visual recovery and better visual outcomes. The use of corticosteroids in CSD with eye involvement has yielded mixed results. Ciprofloxacin is one of the first-line treatments for Oroya fever, followed by chloramphenicol and ceftriaxone, both of which are very effective.

Verruga peruana is primarily treated with azithromycin, with rifampin, ciprofloxacin, and chloramphenicol as preferred alternatives. Ciprofloxacin is the first line of defence in the treatment of Oroya fever, followed by chloramphenicol and ceftriaxone as effective alternatives. Azithromycin and rifampicin are the most commonly used treatments for Verruga peruana. Ciprofloxacin and chloramphenicol are both preferable alternatives. Because of its lower risk of side effects, azithromycin is preferred. Patients with severe anemia, on the other hand, may require blood transfusions, and pericardial effusions may necessitate drainage. Doxycycline can be taken orally to treat trench fever or chronic bacteremia. The use of appropriate in vitro and in vivo infection models, in conjunction with molecular strategies employing bacterial mutants (e.g., generated by random and targeted mutagenesis) and recombinant protein expression strategies (e.g., via heterologous expression libraries), could aid in gaining deeper insights into the infection biology of this difficult-to-manage pathogen and could serve as the foundation for the development of a potential vaccine.