Case Reports
Bartonella quintana and Mycobacterium tuberculosis Coinfection in an HIV-infected Patient with Lymphadenitis

https://doi.org/10.1053/jinf.2002.1040Get rights and content

Abstract

Cat scratch disease (CSD) is usually associated with Bartonella henselae infection in patients with a history of cat exposure, but Bartonella quintana may also be a cause of chronic lympadenopathy in patients with cat or flea contact. The lymph node histopathology of CSD and tuberculosis may be indistinguishable. We report herein the first description of lymph node coinfection with B. quintana and M. tuberculosis in a 32-year HIV-infected woman. Culture of lymph node biopsy material on Columbia agar with sheep blood and on human endothelial cells in shell vial allowed us to isolate not only B. quintana, but also M. tuberculosis hominis.

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    Citation Excerpt :

    It is interesting to discuss, however, that Bartonella infections may have gone undiagnosed in this group of patients, since it was not systematically searched for. Tuberculosis was the most prevalent HIV-associated diagnosis, and previous reports have shown co-infection of Bartonella and mycobacteria (Bernit et al., 2003; Rolain et al., 2006; Rovery et al., 2006), especially in diseased lymph nodes, a frequent site of extrapulmonary tuberculosis in adult AIDS patients in Brazil. Treatment for associated conditions with drugs active against Bartonella such as rifampin, aminoglycosides, quinolones, macrolides, might have at least partially treated this proteobacterium.

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Please address all correspondence to: D. Raoult. Tel.: +(33)49138 5517; Fax: (33)491830390. E-mail address:[email protected]

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Copyright © 2003 The British Infection Society. Published by Elsevier Ltd. All rights reserved.