Hemophagocytic lymphohistiocytosis secondary to unrecognized Bartonella henselae infection: a case report

Tropical Diseases, Travel Medicine and Vaccines

Case Report

Fizza Manzoor¹  Amanda Hempel¹  Dan Petrescu² 

[1] Department of Medicine, University of Toronto, RM 13EN, 300 Elizabeth Street, M5G 2C4, Toronto, ON, Canada;Division of Infectious Diseases, University Health Network, Toronto, ON, Canada;

关键词: Bartonella;    Bartonellosis;    Cat-scratch disease;    Hemophagocytic lymphohistiocytosis;    HLH;    Immunocompetent;    Dog;   

DOI  :  10.1186/s40794-023-00200-1

 received in 2023-04-06, accepted in 2023-06-28,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundBartonella henselae is a species of intracellular bacteria transmitted to humans through animal bites and scratches contaminated with the feces of arthropod vectors, and are most commonly associated with cat exposure although transmission from other mammals has been reported. Bartonella henselae infection has a spectrum of clinical manifestations and has rarely been reported as cause of hemophagocytic lymphohistiocytosis (HLH) in immunocompromised hosts.Case presentationWe present a report of Bartonella henselae infection progressing to HLH in an immunocompetent patient. The patient initially presented with regional lymphadenopathy but the diagnosis was not suspected as the patient reported no exposure to cats. On further history, he did report a scratch from a dog prior to development of symptoms. The patient was treated with methylprednisolone, intravenous immunoglobulin and anakinra for the HLH and three months of Doxycycline for Bartonella infection, with complete resolution of symptoms.ConclusionsAlthough commonly associated with cat exposure, Bartonella henselae transmission can occur after exposure to other animals and vectors including dogs and clinicians need to maintain an index of suspicion for timely diagnosis. Bartonella henselae is associated with a spectrum of clinical manifestations which can include disseminated infection with severe complications such as hemophagocytic lymphohistiocytosis. Prompt initiation of Bartonella treatment is essential when thought to be the trigger for hemophagocytic lymphohistiocytosis although the optimal treatment regimen is unclear.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

Fig. 2