Morel Almonte Maria Del Pilar, Castro Jose Guillermo
Jackson Health System, Miami, FL, USA.
University of Miami, Miller School of Medicine, FL, USA.
IDCases. 2025 Apr 4;40:e02208. doi: 10.1016/j.idcr.2025.e02208. eCollection 2025.
Central nervous manifestations of bartonella infection are uncommon and can vary from encephalitis, meningitis, nerve palsy as well as ocular involvement. Most of these manifestations are described in immunocompromised individuals. We report a case of a previously healthy 42-year-old male who presented to the hospital with 4-weeks of fever and headache and found with meningeal signs on physical exam. He reported been scratched by a stray cat at work some days before his symptoms started. He remained febrile in the hospital. Initial work up was unrevealing, but CSF analysis showed pleocytosis, elevated protein and low CSF glucose- plasma glucose ratio consistent with CNS bacterial infection. Blood and CSF cultures were negative. titers in serum were found to be elevated. No other source of infection was identified. Patient was diagnosed with isolated aseptic meningitis secondary to . Treatment with doxycycline and rifampin was started with good response and resolution of symptoms.
巴尔通体感染的中枢神经系统表现并不常见,可表现为脑炎、脑膜炎、神经麻痹以及眼部受累等多种形式。这些表现大多在免疫功能低下的个体中被描述。我们报告一例病例,一名42岁既往健康男性,因发热和头痛4周入院,体格检查发现有脑膜刺激征。他报告在症状出现前几天工作时被一只流浪猫抓伤。他在医院持续发热。初始检查未发现异常,但脑脊液分析显示细胞增多、蛋白升高以及脑脊液葡萄糖与血浆葡萄糖比值降低,符合中枢神经系统细菌感染。血液和脑脊液培养均为阴性。血清滴度升高。未发现其他感染源。患者被诊断为继发于……的孤立性无菌性脑膜炎。开始使用强力霉素和利福平治疗,症状得到良好缓解。