Post-COVID reactivation of latent Bartonella henselae infection: a case report and literature review

Abstract

Cat scratch disease (CSD) is caused by Bartonella henselae (B. henselae) and presents as lymphadenopathy following close contact with cats. However, in context of the global COVID-19 pandemic, clinical manifestations of CSD may vary, posing new challenges for healthcare professionals. Here we describe a case of a 54-year-old male with painful left upper arm mass, which gradually resolved until he was infected with COVID-19. The mass then rapidly progressed before admission. Meanwhile, pulmonary symptoms including pleural effusion emerged simultaneously. The cause was undetermined with routine blood culture and pathological test until the next generation sequencing (NGS) confirmed the presence of B. henselae. We believe this case is the first to report localized aggravation of CSD after COVID-19 infection and hopefully, offers treatment experience for clinicians worldwide.

Keywords: Bartonella henselae; COVID-19; Cat scratch disease (CSD); High-throughput sequencing.

Fig. 1

(A): MRI image of the mass on admission; (B): Preoperative view of the mass, the pus head has ruptured; (C): Intra-operative view of the mass, most necrotic or infected tissue have been removed; (D): Post-operative histopathological results showing acute and chronic inflammation of subcutaneous soft tissue with histiocytes infiltration (marked by green triangle and magnification on the upper right corner), regional inflammatory granulation tissue hyperplasia (marked by red star)

Fig. 2

Pulmonary CT scan results with effusion indicated by red arrows. A: Taken 2 days prior to admission, showing interstitial changes, pneumonia with minor amount of pleural effusion; (B): Taken on day 4 of admission, showing progressed pneumonia with increased pleural effusion; (C): Taken on day 8 of admission, showing alleviated pneumonia, and previous pleural effusion absorbed; (D): Taken 2 weeks after discharge with normal result