Important “One Health in Action”... veterinarian, medical microbiologist and physician working collaboratively on zoonotic disease pathogen “Cat Scratch Disease”: *Much More to it than Many Thought! Neurological Manifestations of Bartonellosis in Immunocompetent Patients: A composite of reports from 2005-2012 Please see: http://www.onehealthinitiative.com/publications/BreitschwerdtJNeuroparasitolReview2012.pdf Edward B. Breitschwerdt, DVM, DACVIM1, Sushama Sontakke, PhD1,2, Sarah E. Hopkins, MD3 1Intracellular Pathogens Research Laboratory, Center for Comparative Medicine and Translational Research, North Carolina State University,Raleigh, NC 27607, USA 2Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607, USA 3Department of Neurology, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE 19803, USA Reference Citation (Open-Access): Breitschwerdt EB, Sontakke S, Hopkins S. Neurological Manifestations of Bartonellosis in Immunocompetent Patients: A composite of reports from 2005-2012. J Neuroparasitol . 3: 15 pages, 2012 doi:10.4303/jnp/235640 Abstract: In recent years, an increasing number of Bartonella species have been identified as zoonotic pathogens, transmitted by animal bites, scratches or by arthropods. Although historically the term bartonellosis was attributed to infections with Bartonella bacilliformis, transmitted by sandflies in the Peruvian Andes, a more inclusive medical use of this term now includes infections caused by any Bartonella sp., anywhere in the world. Potentially, because Bartonella spp. can infect erythrocytes, endothelial cells and various macrophage-type cells, including brain derived dendritic cells in vitro, the clinical and pathological manifestations of bartonellosis appear to be very diverse. The purpose of this review is to focus attention on neurological bartonellosis cases reported in immunocompetent patients since 2005. Among these patients, disease course has varied substantially in length and severity, including one fatal case of encephalitis in a child. Based upon the evolving literature, a high clinical index of suspicion is warranted. *Notable Comment from the first author: The genus Bartonella provides an important contemporary example of One Health in action (i.e. physicians, veterinarians and disease ecologists working together). The primary motivations for this review were to emphasize the expanding number of arthropod vectors, wild and domestic animal reservoirs and growing number of named Bartonella species that have induced documented human infections in recent years. In addition, this review will hopefully help physicians, public health officials and veterinarians to stop equating infection with a Bartonella species to historical Cat Scratch Disease, but to start considering the possibility that a much more complex environmental and medical scenario might be contributing to diverse neurological disease presentations in neurobartonellosis patients throughout the world. Footnote: Dr. Breitschwerdt1, a veterinarian, is a prominent vector borne infectious diseases researcher and recognized One Health Supporter/Advocate; Dr. Sontakke1,2 is a medical microbiologist who has previously collaborated with Dr. Breitschwerdt on studies related to bartonellosis; and Dr. Hopkins3, a physician, is a pediatric neurologist, who has managed a patient with neurobartonellosis identified in Dr. Breitschwerdt’s research laboratory.