Skip to main content

Advertisement

Log in

Unmasking Bartonella henselae infection in the shadows of long COVID thanks to clinical metagenomics

  • Brief Report
  • Published:
European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

The diagnosis of long COVID often relies on symptoms post-COVID-19, occasionally lacking biological evidence. This case study illustrates how investigating long COVID uncovered an underlying bartonellosis through clinical metagenomics. Following mild COVID-19, a 26-year-old woman experienced persistent symptoms during 5 months, including axillary adenopathy. Pathological examination, 16 S rRNA PCR, and clinical metagenomic analysis were done on an adenopathy biopsy. The latter revealed Bartonella henselae DNA and RNA. Treatment with clarithromycin improved symptoms. This case underscores the relevance of clinical metagenomics in diagnosing hidden infections. Post-COVID symptoms warrant thorough investigation, and bartonellosis should be considered in polyadenopathy cases, regardless of a recent history of cat or flea exposures.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

Data availability

Raw metagenomic data may contain human genome information and are therefore not available. The other relevant data is provided in the manuscript.

References

  1. Jacquier H, Fihman V, Amarsy R et al (2019) Benefits of polymerase chain reaction combined with culture for the diagnosis of bone and joint infections: a prospective test performance study. Open Forum Infect Dis 6:ofz511

    Article  PubMed  PubMed Central  Google Scholar 

  2. Garzaro M, Zhao L-P, De Castro N et al (2022) Metagenomic next-generation sequencing restores the diagnosis of a rare infectious complication of B cell depletion. Eur J Clin Microbiol Infect Dis 41:1269–1273

    Article  PubMed  Google Scholar 

  3. Sivan M, Taylor S (2020) NICE guideline on long covid. BMJ 371:m4938

    Article  PubMed  Google Scholar 

  4. Sudre CH, Murray B, Varsavsky T et al (2021) Attributes and predictors of long COVID. Nat Med 27:626–631

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Raveendran AV, Jayadevan R, Sashidharan S, Long COVID (2021) An overview. Diabetes Metab Syndr 15:869–875

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Lopez-Leon S, Wegman-Ostrosky T, Del Ayuzo NC et al (2022) Long-COVID in children and adolescents: a systematic review and meta-analyses. Sci Rep 12:9950

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Carithers HA (1985) Cat-scratch disease. An overview based on a study of 1,200 patients. Am J Dis Child 139:1124–1133

    Article  CAS  PubMed  Google Scholar 

  8. Chomel BB, Kasten RW, Floyd-Hawkins K et al (1996) Experimental transmission of Bartonella henselae by the cat flea. J Clin Microbiol 34:1952–1956

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Florin TA, Zaoutis TE, Zaoutis LB (2008) Beyond cat scratch disease: widening spectrum of Bartonella henselae infection. Pediatrics 121:e1413–1425

    Article  PubMed  Google Scholar 

  10. Gómez-Alonso B, Montesdeoca A, Arroyo LA et al (2012) [Prolonged febrile syndrome and abdominal pain in a paediatric patient]. Enferm Infecc Microbiol Clin 30:101–103

    Article  PubMed  Google Scholar 

  11. Dunn MW, Berkowitz FE, Miller JJ et al (1997) Hepatosplenic cat-scratch disease and abdominal pain. Pediatr Infect Dis J 16:269–272

    Article  CAS  PubMed  Google Scholar 

  12. Antar AAR, Goyal A, Murphy K et al (June 2017) Disseminated cat-scratch disease presenting as nausea, diarrhea, and weight loss without fever in a heart transplant recipient. Transpl Infect Dis 19 Epub ahead of print. https://doi.org/10.1111/tid.12678

  13. Balakrishnan N, Pritchard J, Ericson M et al (2014) Prostatitis, steatitis, and diarrhea in a dog following presumptive flea-borne transmission of Bartonella henselae. J Clin Microbiol 52:3447–3452

    Article  PubMed  PubMed Central  Google Scholar 

  14. Kaufman DL, Kogelnik AM, Mozayeni RB et al (2017) Neurological and immunological dysfunction in two patients with Bartonella henselae bacteremia. Clin Case Rep 5:931–935

    Article  PubMed  PubMed Central  Google Scholar 

  15. Bradley JM, Mascarelli PE, Trull CL et al (2014) Bartonella henselae infections in an owner and two papillon dogs exposed to tropical rat mites (Ornithonyssus bacoti). Vector Borne Zoonotic Dis 14:703–709

    Article  PubMed  Google Scholar 

  16. Ericson ME, Mozayeni BR, Radovsky L et al (2024) Bartonella- and Borrelia-related Disease presenting as a neurological Condition revealing the need for Better Diagnostics. Microorganisms 12:209

    Article  PubMed  PubMed Central  Google Scholar 

  17. Mascarelli PE, Maggi RG, Hopkins S et al (2013) Bartonella henselae infection in a family experiencing neurological and neurocognitive abnormalities after woodlouse hunter spider bites. Parasit Vectors 6:98

    Article  PubMed  PubMed Central  Google Scholar 

  18. Breitschwerdt EB, Bartonellosis (2017) One health and all creatures great and small. Vet Dermatol 28:96–e21

    Article  PubMed  Google Scholar 

  19. Rolain JM, Brouqui P, Koehler JE et al (2004) Recommendations for treatment of human infections caused by Bartonella species. Antimicrob Agents Chemother 48:1921–1933

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Pizzuti M, Bailey P, Derrick C et al Epidemiology and treatment of invasive Bartonella spp. infections in the United States. Infection. Epub ahead of print 1 February 2024. https://doi.org/10.1007/s15010-024-02177-1

  21. Klotz SA, Ianas V, Elliott SP (2011) Cat-scratch disease. Am Fam Physician 83:152–155

    PubMed  Google Scholar 

  22. Hansmann Y, DeMartino S, Piémont Y et al (2005) Diagnosis of cat scratch disease with detection of Bartonella henselae by PCR: a study of patients with lymph node enlargement. J Clin Microbiol 43:3800–3806

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Edouard S, Nabet C, Lepidi H et al (2015) Bartonella, a common cause of endocarditis: a report on 106 cases and review. J Clin Microbiol 53:824–829

    Article  PubMed  PubMed Central  Google Scholar 

  24. Ruffier D’Epenoux L, Fayoux E, Guillouzouic A et al (2023) The brief case: a mixed cutibacterium species positive Valve Culture hiding a Bartonella Infective Endocarditis. J Clin Microbiol 61:e0076822

    Article  PubMed  Google Scholar 

  25. Liu BM, Mulkey SB, Campos JM et al (2024) Laboratory diagnosis of CNS infections in children due to emerging and re-emerging neurotropic viruses. Pediatr Res 95:543–550

    Article  PubMed  Google Scholar 

  26. Li M, Yan K, Jia P et al (2022) Metagenomic next-generation sequencing may assist diagnosis of cat-scratch disease. Front Cell Infect Microbiol 12:946849

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

This work did not receive any grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

Authors

Contributions

AA : Data analysis, writing - original draft ; EC : Conceptualization, data analysis, writing – review & editing ; TGF : Data analysis, writing – review & editing ; FC : Data analysis, writing – review & editing ; VM : Data analysis, writing – review & editing ; BB : Data analysis, writing – review & editing ;JLG : Data analysis, writing – review & editing ; MS : Conceptualization, data analysis, writing – review & editing, supervision.

Corresponding author

Correspondence to Aurélien Aubry.

Ethics declarations

Ethical approval statement

An informed consent from the patient included in the article was obtained and this report does not contain any personal information that could lead to her identification.

Conflict of interest

There are no competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary Material 1

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Aubry, A., Corvilain, E., Ghelfenstein-Ferreira, T. et al. Unmasking Bartonella henselae infection in the shadows of long COVID thanks to clinical metagenomics. Eur J Clin Microbiol Infect Dis 43, 1025–1029 (2024). https://doi.org/10.1007/s10096-024-04801-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-024-04801-2

Keywords

Navigation