Pleural and pericardial effusions with fever and altered mental status: an atypical presentation of bartonellosis.
BMJ Case Rep
; 17(1)2024 Jan 29.
Article
in En
| MEDLINE
| ID: mdl-38286581
ABSTRACT
A male in his 60s presented to the emergency department (ED) with a 3-week history of fever and progressive confusion. Initial laboratory and radiographic workup was largely unremarkable except for moderate bilateral pleural effusions. The patient was admitted on broad-spectrum antibiotics and further workup for fever of unknown aetiology. The differential diagnosis was broadened to different zoonotic infections, and subsequent laboratory testing showed a markedly elevated Bartonella henselae IgG and Bartonella quintana IgG (14096 and 1512, respectively) in addition to positive B. henselae IgM titre (>120). During hospitalisation, the patient became more hypoxic and was found to have enlarging pleural effusions as well as a new pericardial effusion. The patient was treated with intravenous then oral doxycycline 100 mg two times per day and oral rifampin 300 mg two times per day for 4 weeks with subsequent improvement in clinical status as well as both effusions. This case highlights a unique presentation of Bartonella and its rare manifestation of pleural and pericardial effusions.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pericardial Effusion
/
Pleural Effusion
/
Bartonella Infections
Type of study:
Diagnostic_studies
/
Etiology_studies
Limits:
Aged
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
BMJ Case Rep
Year:
2024
Document type:
Article
Affiliation country:
Country of publication: