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Bartonella

Bartonella henselae Bloodstream Infection in a Boy With Pediatric Acute-Onset Neuropsychiatric Syndrome
Breitschwerdt EB, Greenberg R, Maggi RG, Mozayeni BR, Lewis A, Bradley JM. Bartonella henselae Bloodstream Infection in a Boy With Pediatric Acute-Onset Neuropsychiatric Syndrome. J Cent Nerv Syst Dis. 2019 Mar 18;11:1179573519832014. doi: 10.1177/1179573519832014. PMID: 30911227; PMCID: PMC6423671.

Methods: Evaluation of a 14-year-old boy with sudden-onset psychotic behavior. Bartonella spp. serology, PCR, DNA sequencing, and blood culture used for assessment. PCR assays for other vector-borne infections performed.

Results:

  • 18 months of psychosis despite multiple hospitalizations, psychiatric medications, and autoimmune encephalitis treatment.
  • Neurobartonellosis diagnosed after cutaneous lesions appeared. Bartonella henselae DNA found in blood despite doxycycline treatment. Negative B. henselae serology.
  • Combination antimicrobial chemotherapy led to symptom improvement, drug cessation, lesion resolution, and return to normal activities.

Conclusions: B. henselae bloodstream infection may contribute to persistent neuropsychiatric symptoms in a subset of PANS patients.