Granulomatous Hepatitis and Necrotizing Splenitis Due to Bartonella henselae in a Patient with Cancer: Case Report and Review of Hepatosplenic Manifestations of Bartonella Infection

Abstract

Bacillary angiomatosis and the related disorders of bacillary peliosis hepatis and bacillary splenitis are manifestations of infection with Bartonella henselae and Bartonella quintana in immunocompromised persons. B. henselae infection, but not B. quintana infection, is linked to contact with cats and is presumed to cause visceral cat-scratch disease. We report a case of visceral infection by B. henselae in an adult patient with cancer who was receiving chemotherapy and had had no contact with a cat or dog. The patient—whose illness was eventually diagnosed on the basis of findings of histologic, polymerase chain reaction, and serological studies—was treated with doxycycline and rifampin, and the infection resolved. In addition, 41 cases of documented or suspected bartonella infection of the liver, spleen, or both in immunocompetent or immunocompromised hosts are reviewed.