You are here

Article Text

Article menu
Download PDFPDF
Case Reports: Rare disease
Severe Bartonella henselae bone infection in a kidney transplanted young man
  1. Heidi Dahl Christensen1,
  2. Ann Brinch Madelung2,
  3. Anne Lerberg Nielsen3 and
  4. Fredrikke Christie Knudtzen4
  1. 1Department of Nephrology, Odense University Hospital, Odense, Denmark
  2. 2Department of Clinical Pathology, Odense University Hospital, Odense, Denmark
  3. 3Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark
  4. 4Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
  1. Correspondence to Dr Heidi Dahl Christensen; Heidi.dahl.christensen{at}rsyd.dk

Abstract

We present a case of a young kidney transplanted man. He was admitted with lymphadenopathy, fluctuating fever and night sweats 2 months after a cat bite. After admission, he developed severe pain around his right hip. An 18F-fluorodeoxyglucose (FDG)-positron emission tomography/CT revealed intense FDG-uptake in lymph nodes, spleen and bone, suggestive of lymphoma. An extracted lymph node showed confluent granulomas, microabscesses with neutrophils and scattered multinucleated giant cells histologically. The patient had history of latent tuberculosis and proteinase 3 -anti-neutrophil cytoplasmic antibodies associated (PR3-ANCA) vasculitis, making differential diagnostic considerations complicated. Bartonella henselae antibodies was detected in blood and B. henselae DNA in a lymph node. He was started on doxycycline and rifampicin. Due to severe drug interactions with both tacrolimus and increasing morphine doses, rifampicin was changed to azithromycin. He received 12 days of relevant antibiotic treatment and responded well. He was discharged after 16 days with close follow-up and was still in habitual condition 12 months later.

  • Drug interactions
  • Bone and joint infections
  • Drugs: infectious diseases
  • Renal transplantation
  • Renal medicine

https://doi.org/10.1136/bcr-2021-247805

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Contributors HDC: Main author of this paper and corresponding author. Clinical investigation of this case. Planning, conduct, reporting, conception and design, acquisition of data or analysis and interpretation of data. ABM: Creator of pathology images as well as primary interpreter of these. In addition, participation in the overall process of reporting and analysing data. ALN: Creator of PET-CT images as well as primary interpreter of these. In addition, participation in the overall process of reporting and analysing data. FCK: Planning, conduct, reporting, conception and design, acquisition of data or analysis and interpretation of data.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.