Pleural and extradural spinal involvement in a patient with systemic bartonellosis

Bartonella henselae is a gram-negative pleomorphic fastidious bacillus that predominantly affects the pediatric population. Its best-known clinical manifestation is cat scratch disease (CSD), which is initiated by inoculation of the bacterium through feline saliva, its main reservoir. The clinical spectrum of Bartonella henselae infections is broad; fever with lymphadenopathy is the most frequent presentation, usually self-limited. Despite the availability of specific serological tests, a delay in diagnosis is common, especially in cases with unusual manifestations. This paper aims to describe an atypical form of systemic bartonellosis with lymph node, pleural and extradural spinal involvement in a pediatric patient.