Bartonella henselae causes granulomatous and indolent infection in the immune competent human, and angioproliferation in the context of persistent
infection and impaired immunity. This bacterium is found in up to 40% of household cats, from which humans acquire it by either
a cat scratch or a bite (hence the name, cat-scratch disease). Approximately 5% of Australian and US blood donors have serological
evidence of past infection, but most associated illnesses are mild or subclinical. A number of lines of evidence prompted
us to consider a relationship between rheumatoid arthritis (RA) and
Bartonella infection. These include epidemiological associations with household pet exposure; apparent responsiveness of some RA cases
to tetracycline therapy; the granulomatous and angioproliferative nature of
Bartonella lesions; the insidiousness and high seroprevalence of this infection in the community; and even reported
Bartonella infection mimicking juvenile RA. In a small group of patients with chronic arthritides, we found no direct evidence of humoral
antibodies to, nor of persistent infection with,
Bartonella henselae in synovial fluid. While larger and more invasive studies are likely to provide more confident exclusions of this hypothesis,
this suggests that persistent
Bartonella infection is unlikely to play a major role in RA.
Key words Rheumatoid arthritis - Aetiology - Bartonella henselae - Infection - Persistence
Received: 19 March 2000 / Accepted: 16 June 2000