Disseminated cat-scratch disease presenting as nausea, diarrhea, and weight loss without fever in a heart transplant recipient
Annukka A. R. Antar
Division of Infectious Diseases, Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, MD, USA
Search for more papers by this authorAmit Goyal
Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, MD, USA
Search for more papers by this authorKarly Murphy
Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, MD, USA
Search for more papers by this authorMatthew Schimmel
Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, MD, USA
Search for more papers by this authorNisha A. Gilotra
Division of Cardiology, Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, MD, USA
Search for more papers by this authorIsabella Martin
Department of Pathology, The Johns Hopkins Hospital, Baltimore, MD, USA
Search for more papers by this authorGenevieve Marie Crane
Department of Pathology, The Johns Hopkins Hospital, Baltimore, MD, USA
Search for more papers by this authorChristopher Sciortino
Division of Cardiac Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA
Search for more papers by this authorRobin K. Avery
Division of Infectious Diseases, Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, MD, USA
Search for more papers by this authorCorresponding Author
Brian A. Houston
Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA
Correspondence
Brian A. Houston, MD, Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA.
Email: [email protected]
Search for more papers by this authorAnnukka A. R. Antar
Division of Infectious Diseases, Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, MD, USA
Search for more papers by this authorAmit Goyal
Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, MD, USA
Search for more papers by this authorKarly Murphy
Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, MD, USA
Search for more papers by this authorMatthew Schimmel
Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, MD, USA
Search for more papers by this authorNisha A. Gilotra
Division of Cardiology, Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, MD, USA
Search for more papers by this authorIsabella Martin
Department of Pathology, The Johns Hopkins Hospital, Baltimore, MD, USA
Search for more papers by this authorGenevieve Marie Crane
Department of Pathology, The Johns Hopkins Hospital, Baltimore, MD, USA
Search for more papers by this authorChristopher Sciortino
Division of Cardiac Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA
Search for more papers by this authorRobin K. Avery
Division of Infectious Diseases, Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, MD, USA
Search for more papers by this authorCorresponding Author
Brian A. Houston
Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA
Correspondence
Brian A. Houston, MD, Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA.
Email: [email protected]
Search for more papers by this authorAbstract
We report the case of an afebrile 59-year-old heart transplant recipient presenting with nausea, vomiting, diarrhea, weight loss, and diffuse lymphadenopathy. Lymph node biopsies revealed non-caseating granulomatous inflammation. Cat-scratch disease was confirmed by serologic studies, Warthin-Starry staining, and polymerase chain reaction testing of lymph node tissue. The patient's symptoms resolved with 3 months of doxycycline. We review clinical presentations of Bartonella henselae infection and review diagnostic approaches for B. henselae in this patient population.
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