Possible donor-recipient bartonellosis transmission in a pediatric liver transplant

Transpl Infect Dis. 2008 Dec;10(6):431-3. doi: 10.1111/j.1399-3062.2008.00326.x. Epub 2008 Jul 22.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Amikacin / therapeutic use
  • Anti-Infective Agents / therapeutic use
  • Antibodies, Bacterial / blood
  • Azithromycin / therapeutic use
  • Bartonella henselae / isolation & purification*
  • Cat-Scratch Disease / diagnosis*
  • Cat-Scratch Disease / drug therapy
  • Cat-Scratch Disease / etiology
  • Cat-Scratch Disease / transmission
  • Child
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Liver / diagnostic imaging
  • Liver / microbiology
  • Liver / pathology
  • Liver Neoplasms / diagnosis*
  • Liver Neoplasms / drug therapy
  • Liver Neoplasms / etiology
  • Liver Neoplasms / microbiology
  • Liver Transplantation / adverse effects*
  • Lymph Nodes / diagnostic imaging
  • Lymph Nodes / microbiology
  • Lymph Nodes / pathology
  • Lymphomatoid Granulomatosis / diagnosis*
  • Lymphomatoid Granulomatosis / drug therapy
  • Lymphomatoid Granulomatosis / etiology
  • Lymphomatoid Granulomatosis / microbiology
  • Male
  • Postoperative Complications / diagnosis*
  • Postoperative Complications / etiology
  • Postoperative Complications / microbiology
  • RNA, Bacterial / analysis
  • RNA, Ribosomal, 16S / analysis
  • RNA, Ribosomal, 23S / analysis
  • Tacrolimus / administration & dosage
  • Tissue Donors
  • Transplants / microbiology
  • Treatment Outcome
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use
  • Ultrasonography

Substances

  • Anti-Infective Agents
  • Antibodies, Bacterial
  • Immunosuppressive Agents
  • RNA, Bacterial
  • RNA, Ribosomal, 16S
  • RNA, Ribosomal, 23S
  • Trimethoprim, Sulfamethoxazole Drug Combination
  • Azithromycin
  • Amikacin
  • Tacrolimus