Kucarz Thiago Jessé, Souza Cintia Avila, Hatanaka Simone Aiko, Secamilli Elisa Nunes, Drummond Marina Rovani, Silva Marcos Tadeu Nolasco da, Stelini Rafael Fantelli, Cintra Maria Leticia, Velho Paulo Eduardo Neves Ferreira
Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Clínica Médica, Disciplina de Dermatologia, Campinas, São Paulo, Brazil.
Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Laboratório de Pesquisa Aplicada em Dermatologia e Infecção por Bartonella, Campinas, São Paulo, Brazil.
Rev Inst Med Trop Sao Paulo. 2025 Jul 18;67:e47. doi: 10.1590/S1678-9946202567047. eCollection 2025.
Currently, at least 22 species of Bartonella are known to cause diseases in humans, with Bartonella henselae being the main one. Among the clinical manifestations associated with bartonellosis, cutaneous vasculitis is rare, but it can be severe. We report the case of a 9-year-old child who presented with cervical lymphadenopathy, arthritis, epididymitis, and cutaneous vasculitis as clinical manifestations of systemic bartonellosis, with positive detection of B. henselae in blood and skin fragment using species-specific conventional polymerase chain reaction (PCR) techniques. Vasculitis caused by Bartonella spp. occurs due to the endothelial tropism of the bacteria and can mimic systemic vasculitis with positive anti-neutrophil cytoplasmic antibodies (ANCA). Furthermore, we found just one previous report about epididymitis related to B. henselae infection, and arthritis is also considered an unusual manifestation of the infection. This case emphasizes the need to consider bartonellosis among differential diagnoses when faced with presentations of purpura, cutaneous vasculitis, arthritis, or epididymitis.
目前，已知至少有22种巴尔通体可导致人类发病，其中亨氏巴尔通体是主要病原体。在巴尔通体病的相关临床表现中，皮肤血管炎较为罕见，但可能较为严重。我们报告了一例9岁儿童病例，该患儿出现颈部淋巴结病、关节炎、附睾炎和皮肤血管炎等全身性巴尔通体病的临床表现，采用种特异性常规聚合酶链反应（PCR）技术在血液和皮肤碎片中检测到亨氏巴尔通体呈阳性。巴尔通体属细菌引起的血管炎是由于细菌对内皮细胞的嗜性所致，可模拟抗中性粒细胞胞浆抗体（ANCA）阳性的系统性血管炎。此外，我们仅发现一篇关于与亨氏巴尔通体感染相关附睾炎的既往报道，关节炎也被认为是该感染的一种不寻常表现。该病例强调，当面对紫癜、皮肤血管炎、关节炎或附睾炎等症状时，在鉴别诊断中需要考虑巴尔通体病。
