Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Jun 18, 2021; 11(6): 244-253
Published online Jun 18, 2021. doi: 10.5500/wjt.v11.i6.244
Bartonellosis in transplant recipients: A retrospective single center experience
Lauren Pischel, Christopher Radcliffe, Gabriel A Vilchez, Ahmad Charifa, Xu-Chen Zhang, Matthew Grant
Lauren Pischel, Christopher Radcliffe, Matthew Grant, Section of Infectious Diseases, Department of Medicine, Yale University School of Medicine, New Haven, CT 06510, United States
Gabriel A Vilchez, Department of Infectious Diseases, University of Kentucky, Lexington, KY 40536, United States
Ahmad Charifa, Department of Pathology, University of California, Irvine, CA 92868, United States
Xu-Chen Zhang, Department of Pathology, Yale University School of Medicine, New Haven, CT 06510, United States
Author contributions: Pischel L decided study design, collected data, and wrote the manuscript; Radcliffe C, Vilchez GA, Charifa A, and Zhang XC collected data and revised the manuscript; Grant M decided study design, conducted study supervision, and revised the manuscript.
Institutional review board statement: Our study protocol (No. 2000023169) was reviewed and approved by the Yale University Institutional Review Board. All work performed during the study period was in accordance with the ethical standards of our institution as well as those detailed by the 1964 Helsinki declaration and its later amendments.
Informed consent statement: Need for informed consent was waived by our institutional review board. No identifying information has been included in this report.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lauren Pischel, MD, Academic Fellow, Section of Infectious Diseases, Department of Medicine, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510, United States. lauren.pischel@yale.edu
Received: April 7, 2021
Peer-review started: April 7, 2021
First decision: May 5, 2021
Revised: May 12, 2021
Accepted: June 1, 2021
Article in press: June 1, 2021
Published online: June 18, 2021
ARTICLE HIGHLIGHTS
Research background

Bartonellosis is a rare but challenging condition to diagnose with a spectrum of clinical presentations in the immunocompromised host.

Research motivation

In order to better understand this rare syndrome, we reviewed our center’s experience with bartonellosis in transplant recipients.

Research objectives

We aimed to characterize the presenting symptoms and detail the diagnostic methods required to establish the diagnosis of bartonellosis in this population.

Research methods

We conducted a retrospective study of all Bartonella henselae (B. henselae) testing for 5012 transplant recipients who received their care at our institution between 2011 and 2018.

Research results

We identified 38 patients who underwent testing for B. henselae, and three of 38 were found to have bartonellosis. Two of the patients were renal transplant recipients and presented with symptoms concerning for post-transplant lymphoproliferative disorder (PTLD). One autologous stem cell transplant recipient presented with cat scratch disease.

Research conclusions

We report three cases of bartonellosis treated at our institution which reinforce the notion that B. henselae infection should be considered when transplant recipients present with symptoms overlapping those of PTLD.

Research perspectives

Overall, bartonellosis should be considered in the differential diagnosis of solid organ transplant or hematopoietic stem cell transplant recipients with persistent fever, known cat exposures, lymphadenopathy, and/or hepatosplenomegaly.