Disseminated Bartonella infection following liver transplantation*.

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Transpl Int. 2006 Aug;19(8):683-7.

 

Disseminated Bartonella infection following liver transplantation*.

 

Bonatti H, Mendez J, Guerrero I, Krishna M, Ananda-Michel J, Yao J,

Steers JL, Hellinger W, Dickson RC, Alvarez S.

 

Transplant Center, Mayo Clinic, Jacksonville, FL, USA.

 

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.

 

PMID: 16827686 [PubMed - in process]