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A case of isolated meningitis caused by Bartonella henselae

Maria Del Pilar Morel Almonte1, Jose Guillermo Castro2

  • 1Jackson Health System, Miami, FL, USA.

Idcases
|April 21, 2025
PubMed

Insights

Central nervous system infections from Bartonella henselae are rare, especially in healthy individuals. This case highlights aseptic meningitis as a potential manifestation in an immunocompetent patient.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Microbiology

Background:

  • Central nervous system (CNS) involvement in Bartonella infections is uncommon, typically observed in immunocompromised patients.
  • Manifestations can include encephalitis, meningitis, nerve palsy, and ocular issues.

Observation:

  • A previously healthy 42-year-old male presented with a 4-week history of fever and headache, exhibiting meningeal signs.
  • The patient reported a recent stray cat scratch preceding symptom onset.
  • Cerebrospinal fluid (CSF) analysis revealed pleocytosis, elevated protein, and low glucose, suggestive of bacterial meningitis, though blood and CSF cultures were negative.

Findings:

  • Elevated serum titers confirmed *Bartonella henselae* infection.
  • The patient was diagnosed with isolated aseptic meningitis secondary to *Bartonella henselae*.
  • Treatment with doxycycline and rifampin resulted in symptom resolution.

Implications:

  • This case underscores the possibility of Bartonella henselae causing aseptic meningitis in immunocompetent individuals.
  • Highlights the importance of considering Bartonella infection in unexplained meningitis, even without typical risk factors.
  • Suggests specific antibiotic regimens for effective treatment of neurobartonellosis.
Keywords:
Bartonella henselaeCat scratch disease (CSD)Fever of unkown origin (FUO)Meningitis

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