Multi systemic compromise due to Bartonella henselae in a child

Abstract

Currently, at least 22 species of Bartonella are known to cause diseases in humans, with Bartonella henselae being the main one. Among the clinical manifestations associated with bartonellosis, cutaneous vasculitis is rare, but it can be severe. We report the case of a 9-year-old child who presented with cervical lymphadenopathy, arthritis, epididymitis, and cutaneous vasculitis as clinical manifestations of systemic bartonellosis, with positive detection of B. henselae in blood and skin fragment using species-specific conventional polymerase chain reaction (PCR) techniques. Vasculitis caused by Bartonella spp. occurs due to the endothelial tropism of the bacteria and can mimic systemic vasculitis with positive anti-neutrophil cytoplasmic antibodies (ANCA). Furthermore, we found just one previous report about epididymitis related to B. henselae infection, and arthritis is also considered an unusual manifestation of the infection. This case emphasizes the need to consider bartonellosis among differential diagnoses when faced with presentations of purpura, cutaneous vasculitis, arthritis, or epididymitis.