Disseminated Bartonella infection following liver transplantation

Hugo Bonatti, Julio Mendez, Ivan Guerrero, Murli Krishna, Jaime Ananda-Michel, Joseph Yao, Jeffery L. Steers, Walter Hellinger, Rolland C. Dickson, Salvador Alvarez

Research output: Contribution to journalArticle

32 Scopus citations

Abstract

Bartonella henselae has not only been identified as the causative agent of cat scratch disease, but it is also associated with other significant infectious syndromes in the immunocompromized population. We describe two cases of B. henselae associated diseases in liver transplant recipients who both had contact with cats. The first recipient developed localized skin manifestation of bacillary angiomatosis in association with granulomatous hepatitis. He tested positive for Immunoglubulin G (IgG) antibodies against B. henselae. The second patient developed axillary lymphadenopathy, with biopsy showing necrotizing granulomatous inflammation and polymerase chain reaction studies were positive for B. henselae DNA. Her serology for bartonellosis showed a fourfold rise in antibody titers during her hospitalization. Both patients responded to treatment with Azithromycin in combination with Doxycycline. These were the only cases within a series of 467 consecutive liver transplants performed in 402 patients performed during a 4-year period. Although bartonellosis is a rare infection in liver transplantation recipients, it should always be included in the differential diagnosis of patients presenting with fever, central nervous system (CNS) symptoms, skin lesions, lymphadenopathy, and hepatitis especially if prior contact with cats is reported.

Original languageEnglish (US)
Pages (from-to)683-687
Number of pages5
JournalTransplant International
Volume19
Issue number8
DOIs
StatePublished - Aug 1 2006

Keywords

  • Azithromycin
  • Bartonelliosis
  • Cat scratch disease
  • Liver transplantation

ASJC Scopus subject areas

  • Transplantation

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    Bonatti, H., Mendez, J., Guerrero, I., Krishna, M., Ananda-Michel, J., Yao, J., Steers, J. L., Hellinger, W., Dickson, R. C., & Alvarez, S. (2006). Disseminated Bartonella infection following liver transplantation. Transplant International, 19(8), 683-687. https://doi.org/10.1111/j.1432-2277.2006.00336.x