Pathophysiology
In mammals, each Bartonella species is highly adapted to its reservoir host as the result of intracellular parasitism and can persist in the bloodstream of the host. Intraerythrocytic parasitism is only observed in the acute phase of Carrión´s disease. Bartonella also have a tropism for endothelial cells, observed in the chronic phase of Carrión´s disease (also known as Verruga Peruana) and bacillary angiomatosis. Pathological response can vary with the immune status of the host. Infection with Bartonella henselae can result in a focal suppurative reaction (CSD in immunocompetent patients), a multifocal angioproliferative response (bacillary angiomatosis in immunocompromised patients), endocarditis or meningitis.
Some of the diseases can resolve spontaneously without treatment.
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