Infection with Bartonella (Formerly Rochalimaea)
Prevention of Exposure
HIV-infected persons, particularly those who are severely immunosuppressed,
are at unusually high risk of developing relatively severe disease due to
Bartonella species. These persons should consider the potential
risks of cat ownership. Those who elect to acquire a cat should adopt
or purchase an older animal (aged >1 year) that is in good health.
Although declawing is not generally advised, HIV-infected persons should avoid rough play with cats and situations in which scratches are likely. Any cat-associated wound should be washed promptly. HIV-infected persons should not allow cats to lick open cuts or wounds.
Care of cats should include flea control.
There is no evidence of benefit to cat or owner from routine culture or serologic testing of the pet for Bartonella infection.
Prevention of Disease
No data currently support chemoprophylaxis for Bartonella
-associated disease.
Prevention of Recurrence
Relapse or reinfection with Bartonella has sometimes followed
a course of primary treatment. Although no firm recommendation can be made
regarding prophylaxis in this situation, long-term suppression of infection
with erythromycin or doxycycline should be considered.
Note:
Pediatric Note
The risks of cat ownership for HIV-infected children who are severely
immunocompromised should be discussed with parents/caretakers.
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