Case reports in nephrology · 2026
Disseminated Bartonellosis Masquerading as Autoimmune Glomerulonephritis: A Case Report.
СтатьяНазвание и аннотация: Перевод в очереди
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Debyser Tim, Falter Mattias, Vanhoutte Thomas, Koshy Priyanka, Depypere Melissa, De Vusser Katrien, Henckaerts Liesbet
Аннотация
BACKGROUND: Although Bartonella henselae is primarily known for causing self-limiting cat scratch disease in immunocompetent individuals, it can also lead to severe disseminated infections, particularly in immunocompromised patients.
CASE PRESENTATION: We present a rare case of disseminated B. henselae infection in a 70-year-old man with multiple comorbidities, including a recent aortic valve replacement and pacemaker implantation. The patient initially presented with purpuric skin lesions, progressive renal impairment, and pancytopenia, leading to a preliminary diagnosis of autoimmune glomerulonephritis and treatment with immunosuppressants. Subsequent investigations, including kidney and skin biopsies, revealed C3-dominant glomerulonephritis and leukocytoclastic vasculitis, respectively. Further imaging uncovered a concurrent lung malignancy, treated with radiotherapy. Five months later, the patient presented with blood culture-negative endocarditis complicated by septic embolic strokes, persisting pancytopenia, and hepatosplenomegaly. Serology and B. henselae PCR of bone marrow confirmed disseminated Bartonella henselae infection.
CONCLUSIONS: This case highlights the diagnostic challenges of disseminated Bartonella infections, which can mimic autoimmune diseases and delay appropriate treatment. Clinicians should maintain a high index of suspicion to ensure timely diagnosis and management.
CASE PRESENTATION: We present a rare case of disseminated B. henselae infection in a 70-year-old man with multiple comorbidities, including a recent aortic valve replacement and pacemaker implantation. The patient initially presented with purpuric skin lesions, progressive renal impairment, and pancytopenia, leading to a preliminary diagnosis of autoimmune glomerulonephritis and treatment with immunosuppressants. Subsequent investigations, including kidney and skin biopsies, revealed C3-dominant glomerulonephritis and leukocytoclastic vasculitis, respectively. Further imaging uncovered a concurrent lung malignancy, treated with radiotherapy. Five months later, the patient presented with blood culture-negative endocarditis complicated by septic embolic strokes, persisting pancytopenia, and hepatosplenomegaly. Serology and B. henselae PCR of bone marrow confirmed disseminated Bartonella henselae infection.
CONCLUSIONS: This case highlights the diagnostic challenges of disseminated Bartonella infections, which can mimic autoimmune diseases and delay appropriate treatment. Clinicians should maintain a high index of suspicion to ensure timely diagnosis and management.