Infection

, 35:107

Chronic Vasculitis and Polyneuropathy due to Infection with Bartonella henselae

Authors

  • B. Stockmeyer
    • Dept. of Medicine IIIUniversity Hospital Erlangen
  • C. Schoerner
    • Institute of Clinical Microbiology, Immunology and HygieneUniversity of Erlangen-Nuremberg
  • P. Frangou
    • Institute for PathologyUniversity of Erlangen-Nuremberg
  • T. Moriabadi
    • Dept. of NeurologyUniversity Hospital Erlangen
  • D. Heuss
    • Dept. of NeurologyUniversity Hospital Erlangen
    • Dept. of Medicine IIIUniversity Hospital Erlangen
Case Report

DOI: 10.1007/s15010-007-6021-3

Cite this article as:
Stockmeyer, B., Schoerner, C., Frangou, P. et al. Infection (2007) 35: 107. doi:10.1007/s15010-007-6021-3

Abstract

Bartonella henselae, the causative agent of cat scratch disease and bacillary angiomatosis, is associated with an expanding spectrum of diseases. Here, we report on a 40-year-old patient suffering from chronic recurrent painful ulcers of the toes, distal axonal sensomotor polyneuropathy and Raynaud's phenomenon. Biopsy of the sural nerve demonstrated an axonal neuropathy with a neurogenic muscular atrophy. Treatment with high dose corticosteroids had no beneficial effect. A biopsy taken from a recurring ulcer 7 years after the beginning of the disease revealed superficial ulcerated hyperkeratosis with subepithelial proliferation of small vessels compatible with a diagnosis of verruca peruana, however, without detection of microorganism. Serologic analysis revealed an elevated IFT titer of 1:1,024 against B. henselae. Treatment with erythromycin induced healing of the ulcer, remission of the vasculitis and the polyneuropathy, and a decline of the IFT titer. This case illustrates that B. henselae infection should be considered in patients with vasculitis and polyneuropathic syndromes.

Copyright information

© Urban & Vogel München 2007