1.Unmasking Bartonella henselae: A forgotten cause of hepatosplenic and marrow involvement
Zainulabid U.A. ; Cheong X.K. ; Kori N. ; Kueh, J.W.T J.W.T ; Mohamed Rose, I. I. ; Ramli R. ; Abdul Muien M.Z. ; Periyasamy P. ; Ramli S.R.
Tropical Biomedicine 2026;43(No. 2):219-222
Bartonella henselae is an uncommon but important cause of prolonged pyrexia of unknown origin
(PUO) and hepatosplenomegaly. Conventional diagnostic tools often fail in disseminated disease,
leading to delayed or missed diagnoses. We report a 60-year-old man with PUO, progressive weight
loss, and hepatosplenomegaly. Clinical suspicion, guided by significant cat exposure, led to molecular
confirmation of B. henselae infection after conventional workup proved inconclusive. Liver biopsy
revealed pleomorphic rod-shaped organisms on Warthin-Starry staining, while real-time PCR targeting
the rpoB gene and conventional PCR targeting the gltA gene performed on bone marrow aspirate
confirmed disseminated bartonellosis. The patient responded well to prolonged doxycycline and
rifampicin therapy, achieving near-complete recovery. This case underscores the importance of clinical
vigilance, histological clues, and molecular diagnostics in identifying rare but treatable infections.
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