Chronic Vasculitis and Polyneuropathy due to Infection with Bartonella henselae.

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Infection. 2007 Apr;35(2):107-9.

 

Chronic Vasculitis and Polyneuropathy due to Infection with Bartonella

henselae.

 

Stockmeyer B, Schoerner C, Frangou P, Moriabadi T, Heuss D, Harrer T.

 

Dept. of Medicine III, University Hospital Erlangen, Krankenhausstr. 12,

91054, Erlangen, Germany, _Thomas.Harrer_

(Thomas.Harrer) .

 

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.

 

PMID: 17401716 [PubMed - in process]