BARTONELLA HENSELAE - ETIOLOGY OF PULMONARY NODULES IN A PATIENT WITHDEPRESSED CELL-MEDIATED-IMMUNITY

We describe an immunocompromised renal transplantation patient with op portunistic lung infection due to Bartonella henselae (formerly Rochal imaea henselae) and provide evidence suggesting transmission from a pe t cat. Computed tomographic scans of the chest and lung biopsies provi ded material for diagnosis. The etiology was established by polymerase chain reaction and sequencing of a 16S ribosomal DNA segment from inf ected lung tissue. Histopathologic and serological evidence supported the molecular data. B. henselae was isolated from the blood of eight o f the patient's many cats. The patient responded to prolonged therapy with doxycycline, and relapse did not occur during a 1-year follow-up. B. henselae joins a long list of pathogens that can cause lung infect ions in association with cell-mediated immunodeficiency states. Molecu lar methods are useful in diagnosis of this infection in light of the bacterium's fastidious growth characteristics. If an immunocompromised patient has lung nodules and a history of exposure to cats, B. hensel ae should be sought in biopsy specimens.