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Malattia da graffio di gatto (bartonellosi)

Table of Contents

Descrizione

La malattia da graffio di gatto è causata da Bartonella henselae ed esordisce nel 90% dei casi con una papula o pustola cutanea in corrispondenza di un graffio o morso di un gatto, di solito avvenuto circa 7 giorni prima, il gatto è l’ospite naturale dell’infezione (fino al 50% di esemplari sieropositivi, di solito asintomatici), che sembra trasmessa da un insetto vettore (pulce, Ctenocephalides felis) specifico dei felini che assicura la perpetuazione dell’ infezione per via orizzontale tra i felini. L’infezione è più diffusa nell’infanzia ed è spesso asintomatica; sono possibili piccoli focolai epidemici a livello familiare.



Quali sono i sintomi della malattia da graffio di gatto?

Il graffio del gatto diventa la sede, dopo un periodo di incubazione da 2 a 7 giorni, di un’ulcera indolore, a volte di una papula, di una vescicola o di una pustola. L’adenite satellitare compare dopo alcuni giorni o anche diverse settimane; viene individuata spesso nella regione ascellare, cervicale o inguinale. I linfonodi spesso sono ingrossati; regrediscono spontaneamente o suppurano e si formano fistole che lasciano fuoriuscire un pus sterile.  La regressione dell’adenopatia è lenta e i linfonodi sono palpabili per mesi. I sintomi generali sono lievi:  stato febbrile o subfebbrile, astenia e cefalea. Nei soggetti con infezione da virus dell’immunodeficienza umana (HIV), AIDS o altre condizioni che indeboliscono il sistema immunitario, l’infezione può diffondersi a tutto il corpo e, in assenza di trattamento, può essere fatale.



Come viene diagnostica la malattia da graffio di gatto

  • Esami del sangue
  • A volte emocolture
  • Talvolta aspirazione del fluido linfonodale o biopsia

Ricerca del bacillo dell’essudato delle lesioni; l’intradermoreazione con antigene specifico,  preparato da una linfoghiandola con soggetto infetto, è  positiva dopo 48 ore e rimane positiva in media per  4 anni.

Terapia

Normalmente non è richiesta terapia. Se necessario si possono utilizzare doxiciclina, ciprofloxacina, azitromicina (o eritromicina). Il drenaggio chirurgico dei linfonodi  è raramente necessario.

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