Objective – To describe the current understanding of the etiology, pathogenesis, diagnosis, and treatment of feline hemotropic mycoplasmosis (feline infectious anemia).
Data Sources – Manuscripts published on hemotropic mycoplasmosis in cats and other animal species, based on a search of PubMed using the search terms ‘hemoplasmas,’‘haemoplasmas,’‘hemotropic,’‘haemotropic,’ and ‘Haemobartonella,’ as well as references published within manuscripts accessed.
Human Data Synthesis – Although hemotropic bacteria such as Bartonella bacilliformis have been recognized in humans for over 100 years, it has only been in recent years that some of these have been identified as hemotropic mycoplasmas.
Veterinary Data Synthesis – Three species of hemotropic mycoplasmas have been documented in cats worldwide, Mycoplasma haemofelis, ‘Candidatus Mycoplasma turicensis,’ and ‘Candidatus Mycoplasma haemominutum.’ These organisms were previously known as Haemobartonella felis, but are now known to be mycoplasmas. M. haemofelis is the most pathogenic species, and causes anemia in immunocompetent cats. Although ‘Candidatus Mycoplasma turicensis’ and ‘Candidatus Mycoplasma haemominutum’ may be more capable of causing anemia in immunosuppressed cats, their pathogenicity remains controversial. Assays based on polymerase chain reaction technology are the most sensitive and specific diagnostic tests available for these organisms, because they remain uncultivable in the laboratory setting. Blood smears are unreliable for diagnosis of hemoplasmosis because of their lack of sensitivity and specificity.
Conclusions – Cats presenting to emergency/critical care specialists with hemolytic anemia should be tested using polymerase chain reaction assays for hemotropic mycoplasmas before instituting antimicrobial therapy. Positive test results for M. haemofelis suggest involvement of this organism in hemolytic anemia. Other differential diagnoses for hemolytic anemia should be considered in cats testing positive for ‘Candidatus Mycoplasma turicensis’ and ‘Candidatus Mycoplasma haemominutum,’ because the presence of these organisms is not always associated with anemia. Blood from infected cats should be handled with care because of the potential zoonotic nature of this infection.