Concomitant cat scratch disease and squamous cell carcinoma in a cardiac transplant

Abstract

Cat scratch disease has been reported very rarely in cardiac transplant recipients. In a review of 1073 episodes of infection in 620 heart transplant patients over a 16 year period, only one case of infection secondary to Bartonella henselae was documented. Another case of hepatosplenic bacillary angiomatosis from B. henselae was reported 2 decades ago in a heart transplant recipient who had presented with fevers of unknown origin. Although the typical clinical manifestation is that of a skin lesion accompanied with lymphadenopathy, cat scratch disease may present with persistent fevers without a clinically overt infective focus in immunosuppressed individuals. Moreover, more than one disease process may coexist in immunocompromised hosts. While the lymphadenopathy in our patient was secondary to Cat scratch disease, interestingly, the adjacent skin lesion that was thought to represent unhealed site of inoculation of Bartonella was diagnosed as squamous cell carcinoma.

Bartonella henselae infection‐associated vasculitis and crescentic glomerulonephritis leading to renal allograft loss

“…Liver transplant recipients were more prone to develop disease earlier and had more severe clinical presentations in this study (35). Additional cases involving heart and lung transplant recipients have also been reported (33,57).…”

“…A comprehensive literature search identified 37 reported cases of solid organ transplant recipients who developed Bartonella infections with clinical pictures ranging from typical granulomatous suppurative lymphoid involvement to unusual presentations such as chorioretinitis . In the analysis of 29 cases by Psarros et al.…”

“…Furthermore, an increasing number of putatively immune para‐infectious or post‐infectious disorders have been reported in association with Bartonella infections affecting the central nervous system and other organs (see Table ; ). Specifically, a case of post‐infectious chronic active myocarditis has been reported , as well as renal involvement in the form of immune‐complex mediated or pauci‐immune acute glomerulonephritis .…”