Bartonellosis in transplant recipients: A retrospective single center experience

Figure 1 Histopathology of liver biopsy from case 1. A: Photomicrograph of liver parenchyma with non-necrotizing granulomas (asterisks) with histiocytes, lymphoplasmacytic inflammatory cells, and neutrophils. (hematoxylin and eosin, 200 ×); B: Bartonella henselae immunohistochemical stain highlights individual and clustered coccobacilli (arrows) (400 ×).

Figure 2 Positron emission tomography-computed tomography scan from case 2. A: Axial view of the abdomen demonstrates diffuse splenic uptake (circle); B: Multiple mildly hypermetabolic < 1 cm retroperitoneal lymph nodes (arrow) and increased signal in the pericecal region and sigmoid colon (circle) are appreciated on axial view of the pelvic region.

Figure 3 Histopathology of splenic biopsy from case 2. A: Photomicrograph of splenic red pulp with necrotizing granuloma showing necrosis (asterisk) surrounded by lymphoplasmacytic inflammatory cells and neutrophils. (hematoxylin and eosin, 200 ×); B: Warthin-Starry stain highlights individual and clustered coccobacilli (interrupted circle) (400 ×).

Figure 4 Chest computed tomography scan from case 2. Bilateral miliary pattern of involvement best appreciated in the posterior portions of the lower lobes.

Figure 5 General approach to considering bartonellosis in transplant recipients. CSD: Cat scratch disease; B. henselae: Bartonella henselae; PCR: Polymerase chain reaction; Ig: Immunoglobulin.