Systemic<i>Bartonella henselae</i>Infection in Immunocompetent Adult Presenting as Fever of Unknown Origin

Zénone, Thierry

doi:10.1155/2011/183937

Cited by 12 publications

(11 citation statements)

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“…31 , 34 Herein, we describe 3 new cases of HS-CSD and review 33 previously reported cases with a focus on clinical descriptions, diagnosis, and therapeutic approaches. 4 , 6 , 9 , 10 , 18 , 23 , 24 , 26 , 27 , 29 , 30 , 33 , 35 , 36 , 38 – 42 , 44 , 45 …”

Section: Introductionmentioning

confidence: 99%

Hepatosplenic Cat Scratch Disease in Immunocompetent Adults

et al. 2014

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Cat-scratch disease (CSD) is the most frequent presentation of Bartonella henselae infection. It has a worldwide distribution and is associated with a previous history of scratch or bite from a cat or dog. CSD affects children and teenagers more often (80%) than adults, and it usually has a self-limiting clinical course. Atypical clinical course or systemic symptoms are described in 5%–20% of patients. Among them, hepatosplenic (HS) forms (abscess) have been described. The majority of published cases have affected children or immunosuppressed patients. Few cases of HS forms of CSD in immunocompetent adult hosts have been reported, and data about the management of this condition are scarce. Herein, we present 3 new cases of HS forms of CSD in immunocompetent adults and review 33 other cases retrieved from the literature. We propose an approach to clinical diagnosis and treatment with oral azithromycin.

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Section: Introductionmentioning

confidence: 99%

Hepatosplenic Cat Scratch Disease in Immunocompetent Adults

et al. 2014

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“…Infection with one or more Bartonella sp. has also been associated with fever of unknown origin [5-9], and arthritic and neurological disorders [10-12]. …”

Section: Introductionmentioning

confidence: 99%

Bartonella henselae bacteremia in a mother and son potentially associated with tick exposure

et al. 2013

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BackgroundBartonella henselae is a zoonotic, alpha Proteobacterium, historically associated with cat scratch disease (CSD), but more recently associated with persistent bacteremia, fever of unknown origin, arthritic and neurological disorders, and bacillary angiomatosis, and peliosis hepatis in immunocompromised patients. A family from the Netherlands contacted our laboratory requesting to be included in a research study (NCSU-IRB#1960), designed to characterize Bartonella spp. bacteremia in people with extensive arthropod or animal exposure. All four family members had been exposed to tick bites in Zeeland, southwestern Netherlands. The mother and son were exhibiting symptoms including fatigue, headaches, memory loss, disorientation, peripheral neuropathic pain, striae (son only), and loss of coordination, whereas the father and daughter were healthy.MethodsEach family member was tested for serological evidence of Bartonella exposure using B. vinsonii subsp. berkhoffii genotypes I-III, B. henselae and B. koehlerae indirect fluorescent antibody assays and for bacteremia using the BAPGM enrichment blood culture platform.ResultsThe mother was seroreactive to multiple Bartonella spp. antigens and bacteremia was confirmed by PCR amplification of B. henselae DNA from blood, and from a BAPGM blood agar plate subculture isolate. The son was not seroreactive to any Bartonella sp. antigen, but B. henselae DNA was amplified from several blood and serum samples, from BAPGM enrichment blood culture, and from a cutaneous striae biopsy. The father and daughter were seronegative to all Bartonella spp. antigens, and negative for Bartonella DNA amplification.ConclusionsHistorically, persistent B. henselae bacteremia was not thought to occur in immunocompetent humans. To our knowledge, this study provides preliminary evidence supporting the possibility of persistent B. henselae bacteremia in immunocompetent persons from Europe. Cat or flea contact was considered an unlikely source of transmission and the mother, a physician, reported that clinical symptoms developed following tick exposure. To our knowledge, this is the first time that a B. henselae organism has been visualized in and amplified from a striae lesion. As the tick bites occurred three years prior to documentation of B. henselae bacteremia, the mode of transmission could not be determined.

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“…For example, splenic rupture and granulomatous splenitis have been associated with Bartonella sp . infection in people . Also, infection with B. henselae was reported in a man with hypergammaglobulinemia, splenomegaly, and polyclonal plasmacytosis who developed fever and other complications postsplenectomy .…”

Section: Discussionmentioning

confidence: 96%

“…In people, fever often accompanies an acute infection with Bartonella spp . In 1 recent human case series, hepatosplenic B. henselae infection was diagnosed in 4 patients with fever of unknown origin . In addition, cat scratch disease is characterized by a classical triad including a history of a cat scratch, fever, and lymphadenopathy.…”

Section: Discussionmentioning

confidence: 99%