A Case of Atypical Bartonellosis in a 4-Year-Old Immunocompetent Child
In most cases, infection due to <i>Bartonella henselae</i> causes a mild disease presenting with a regional lymphadenopathy frequently associated with a low-grade fever, headache, poor appetite and exhaustion that spontaneously resolves itself in a few weeks. As the infection is generall...
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doaj-341f2cf7246a47d99b97a623b2958b762021-04-28T23:02:42ZengMDPI AGMicroorganisms2076-26072021-04-01995095010.3390/microorganisms9050950A Case of Atypical Bartonellosis in a 4-Year-Old Immunocompetent ChildChiara Sodini0Elena Mariotti Zani1Francesco Pecora2Cristiano Conte3Viviana Dora Patianna4Giovanni Prezioso5Nicola Principi6Susanna Esposito7Pediatric Clinic, Pietro Barilla Children’s Hospital, University of Parma, Via Gramsci 14, 43126 Parma, ItalyPediatric Clinic, Pietro Barilla Children’s Hospital, University of Parma, Via Gramsci 14, 43126 Parma, ItalyPediatric Clinic, Pietro Barilla Children’s Hospital, University of Parma, Via Gramsci 14, 43126 Parma, ItalyPediatric Clinic, Pietro Barilla Children’s Hospital, University of Parma, Via Gramsci 14, 43126 Parma, ItalyPediatric Clinic, Pietro Barilla Children’s Hospital, University of Parma, Via Gramsci 14, 43126 Parma, ItalyPediatric Clinic, Pietro Barilla Children’s Hospital, University of Parma, Via Gramsci 14, 43126 Parma, ItalyUniversità degli Studi di Milano, 20122 Milan, ItalyPediatric Clinic, Pietro Barilla Children’s Hospital, University of Parma, Via Gramsci 14, 43126 Parma, ItalyIn most cases, infection due to <i>Bartonella henselae</i> causes a mild disease presenting with a regional lymphadenopathy frequently associated with a low-grade fever, headache, poor appetite and exhaustion that spontaneously resolves itself in a few weeks. As the infection is generally transmitted by cats through scratching or biting, the disease is named cat scratch disease (CSD). However, in 5–20% of cases, mainly in immunocompromised patients, systemic involvement can occur and CSD may result in major illness. This report describes a case of systemic CSD diagnosed in an immunocompetent 4-year-old child that can be used as an example of the problems that pediatricians must solve to reach a diagnosis of atypical CSD. Despite the child’s lack of history suggesting any contact with cats and the absence of regional lymphadenopathy, the presence of a high fever, deterioration of their general condition, increased inflammatory biomarkers, hepatosplenic lesions (i.e., multiple abscesses), pericardial effusion with mild mitral valve regurgitation and a mild dilatation of the proximal and medial portion of the right coronary artery, seroconversion for <i>B. henselae</i> (IgG 1:256) supported the diagnosis of atypical CSD. Administration of oral azithromycin was initiated (10 mg/kg/die for 3 days) with a progressive normalization of clinical, laboratory and US hepatosplenic and cardiac findings. This case shows that the diagnosis of atypical CSD is challenging. The nonspecific, composite and variable clinical features of this disease require a careful evaluation in order to achieve a precise diagnosis and to avoid both a delayed diagnosis and therapy with a risk of negative evolution.https://www.mdpi.com/2076-2607/9/5/950atypical bartonellosis<i>Bartonella henselae</i>bartonellosiscat scratch diseasehepatosplenic abscesses |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Chiara Sodini Elena Mariotti Zani Francesco Pecora Cristiano Conte Viviana Dora Patianna Giovanni Prezioso Nicola Principi Susanna Esposito |
spellingShingle |
Chiara Sodini Elena Mariotti Zani Francesco Pecora Cristiano Conte Viviana Dora Patianna Giovanni Prezioso Nicola Principi Susanna Esposito A Case of Atypical Bartonellosis in a 4-Year-Old Immunocompetent Child Microorganisms atypical bartonellosis <i>Bartonella henselae</i> bartonellosis cat scratch disease hepatosplenic abscesses |
author_facet |
Chiara Sodini Elena Mariotti Zani Francesco Pecora Cristiano Conte Viviana Dora Patianna Giovanni Prezioso Nicola Principi Susanna Esposito |
author_sort |
Chiara Sodini |
title |
A Case of Atypical Bartonellosis in a 4-Year-Old Immunocompetent Child |
title_short |
A Case of Atypical Bartonellosis in a 4-Year-Old Immunocompetent Child |
title_full |
A Case of Atypical Bartonellosis in a 4-Year-Old Immunocompetent Child |
title_fullStr |
A Case of Atypical Bartonellosis in a 4-Year-Old Immunocompetent Child |
title_full_unstemmed |
A Case of Atypical Bartonellosis in a 4-Year-Old Immunocompetent Child |
title_sort |
case of atypical bartonellosis in a 4-year-old immunocompetent child |
publisher |
MDPI AG |
series |
Microorganisms |
issn |
2076-2607 |
publishDate |
2021-04-01 |
description |
In most cases, infection due to <i>Bartonella henselae</i> causes a mild disease presenting with a regional lymphadenopathy frequently associated with a low-grade fever, headache, poor appetite and exhaustion that spontaneously resolves itself in a few weeks. As the infection is generally transmitted by cats through scratching or biting, the disease is named cat scratch disease (CSD). However, in 5–20% of cases, mainly in immunocompromised patients, systemic involvement can occur and CSD may result in major illness. This report describes a case of systemic CSD diagnosed in an immunocompetent 4-year-old child that can be used as an example of the problems that pediatricians must solve to reach a diagnosis of atypical CSD. Despite the child’s lack of history suggesting any contact with cats and the absence of regional lymphadenopathy, the presence of a high fever, deterioration of their general condition, increased inflammatory biomarkers, hepatosplenic lesions (i.e., multiple abscesses), pericardial effusion with mild mitral valve regurgitation and a mild dilatation of the proximal and medial portion of the right coronary artery, seroconversion for <i>B. henselae</i> (IgG 1:256) supported the diagnosis of atypical CSD. Administration of oral azithromycin was initiated (10 mg/kg/die for 3 days) with a progressive normalization of clinical, laboratory and US hepatosplenic and cardiac findings. This case shows that the diagnosis of atypical CSD is challenging. The nonspecific, composite and variable clinical features of this disease require a careful evaluation in order to achieve a precise diagnosis and to avoid both a delayed diagnosis and therapy with a risk of negative evolution. |
topic |
atypical bartonellosis <i>Bartonella henselae</i> bartonellosis cat scratch disease hepatosplenic abscesses |
url |
https://www.mdpi.com/2076-2607/9/5/950 |
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