Bartonellosis in transplant recipients: A retrospective single center experience

Abstract

BACKGROUND Bartonellosis is a rare but challenging condition to diagnose with a spectrum of clinical presentations in the immunocompromised host. AIM To further characterize the presentation of Bartonella henselae ( B. henselae ) infections in solid organ and hematopoietic stem cell transplant recipients. METHODS We conducted a single-center retrospective study of all B. henselae testing for 5012 transplant recipients receiving care at a single institution between 2011 and 2018. RESULTS We identified 38 patients who underwent testing for B. henselae , and three of 38 were found to have bartonellosis. Two of the patients were renal transplant recipients who presented with visceral bartonellosis and symptoms concerning for post-transplant lymphoproliferative disorder. One autologous stem cell transplant recipient presented with cat scratch disease. We detail the clinical courses of these three cases and review the literature concerning the clinical presentations, differential diagnosis, and limitations of diagnostic tests for B. henselae infections in transplant recipients. CONCLUSION Although the incidence of B. henselae infection in transplant recipients is unknown, it merits inclusion in the differential diagnosis for fever of unknown origin in this population.

Parinaud's oculo-glandular syndrome secondary to sporotrichosis

“…PCOS is a syndrome marked by the presence of nodular lesions in the bulbar and tarsal conjunctiva with a granulomatous appearance. Conjunctivitis can present as mild to severe, with ulcers or necrosis [3,6,8,9,11]. When present, adenopathy may or may not be painful, and its size and consistency are also variable.…”

“…PCOS can be caused by several types of pathogens. Among them, the most common is the gram-negative bacillus Bartonella henselae, responsible for catscratch disease [6,[13][14][15]. Other bacteria such as Chlamydia trachomatis, Listeria monocytogenes, Treponema pallidum, and Myco-bacterium tuberculosis can also cause the disease.…”

“…Lesions are usually restricted to the skin, subcutaneous tissue, and adjacent lymphatic vessels. Spread to other organs exists, but is rare [2,4,5,6]. The clinical forms of sporotrichosis are classified as fixed or localized cutaneous, cutaneous-lymphatic, disseminated cutaneous, mucosal and extracutaneous or systemic.…”

“…The clinical forms of sporotrichosis are classified as fixed or localized cutaneous, cutaneous-lymphatic, disseminated cutaneous, mucosal and extracutaneous or systemic. The latter develops when there is inhalation of spores [3,4,6,7]. Cats play an important epidemiological role in the transmission and propagation of the disease, because in their skin lesions there is a large amount of infecting fungal cells.…”

Serious and Atypical Presentations of Bartonella henselae Infection in Kidney Transplant Recipients

“…Bartonella in immunocompromised patients is generally described as bacillary angiomatosis and hepatic and splenic peliosis. In solid organ transplant patients, disseminated forms account for two-thirds of cases [ 4 , 5 ].…”