Microbiology
A proteobacteria, includes R. elizabethae, R. henselae, R. quintana.
Epidemiologic Risks
Rochalimaea quintana: human body louse.
Rochalimaea henselae: found in cats, spread by fleas.
Syndromes
Rochalimaea quintana: Trench fever (a febrile illness often in the filthy homeless) occasionally endocarditis and encephalitis.
Rochalimaea henselae: Bacillary angiomatosis (red bumps) in HIV, Cat Scratch Fever (aka Ted Nugents disease), Bacillary peliosis (lesions in the liver in HIV), occasionally endocarditis and encephalitis.
Rochalimaea elizabethae: endocarditis.
Treatment
Erthythromycin OR doxycycline sometimes combined with rifampin are preferred. Cases also treated with azithromycin OR quinolones. BA is treated for months, endocarditis for 4 to 6 weeks.
Notes
The encephalitis is late in CSD and often starts with combativeness. One patient of mine, after he woke up from his coma, he had all three cats of his girls friends "put down." I doubt they are still together.