Possible donor-recipient bartonellosis transmission in a pediatric liver transplant.
Bartonella henselae is the causative agent of cat-scratch disease and other disorders, including hepatosplenic granulomatosis. This infection has only rarely been reported after solid organ transplantation, where it can mimic the more common post-transplant lymphoproliferative disease. Here we present a case of asymptomatic B. henselae hepatic and lymph nodal granulomatosis in a pediatric patient who had received orthotopic liver transplant 2 months before; we hypothesize that the causative agent was transmitted from the donor. This infection developed early in the post-transplant period; the disease involved only the graft liver and the regional lymph nodes, and the patient did not have a cat or any history of contact, scratches, or bites by a cat. In our patient this infection resolved successfully with a combination of 2 associated antibiotics and reduction of immunosuppressive therapy.
Scolfaro
C
C
Divisione di Malattie Infettive e Immuno-Reumatologia, Dipartimento di Pediatria, Universitá di Torino, Torino, Italy. carlo.scolfaro@unito.it
Mignone
F
F
Gennari
F
F
Alfarano
A
A
Veltri
A
A
Romagnoli
R
R
Salizzoni
M
M
D000583:Amikacin / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood; D017963:Azithromycin / Q000627:therapeutic use; D018416:Bartonella henselae / Q000302:isolation & purification*; D002372:Cat-Scratch Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology / Q000635:transmission; D002648:Child; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008099:Liver / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology; D016031:Liver Transplantation / Q000009:adverse effects*; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D008230:Lymphomatoid Granulomatosis / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology / Q000382:microbiology; D012329:RNA, Bacterial / Q000032:analysis; D012336:RNA, Ribosomal, 16S / Q000032:analysis; D012338:RNA, Ribosomal, 23S / Q000032:analysis; D016559:Tacrolimus / Q000008:administration & dosage; D014019:Tissue Donors; D019737:Transplants / Q000382:microbiology; D016896:Treatment Outcome; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D014463:Ultrasonography
D000890:Anti-Infective Agents; D000907:Antibodies, Bacterial; D007166:Immunosuppressive Agents; D012329:RNA, Bacterial; D012336:RNA, Ribosomal, 16S; D012338:RNA, Ribosomal, 23S; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D017963:Azithromycin; D000583:Amikacin; D016559:Tacrolimus