Bartonella henselae and Aspergillus flavus coinfection in an immunocompromised patient

Abstract

Objective: This clinical study reports a case of atypical cat scratch disease in a patient undergoing immunosuppressive treatment, who contracted COVID-19 during the treatment period. Despite pharmacological and surgical interventions, Bartonella henselae was not completely cleared, leading to the recurrence of symptoms. The study highlights the challenges of management and the need for thorough immune assessment and precise diagnosis.

Methods: A case report provides a detailed description of the treatment process for a young female patient with cat scratch disease (CSD), who had been treated with immunosuppressive agents (adalimumab and baricitinib) for ankylosing spondylitis and developed a concurrent COVID-19 infection during the treatment of CSD.The diagnosis was confirmed through macrogenomic second-generation sequencing. Pharmacological and surgical interventions were administered, and clinical outcomes were monitored.

Results: When a patient is infected with Bartonella henselae and remains in a prolonged immunocompromised state, pharmacological or surgical treatment may still fail to completely clear the pathogen, leading to the recurrence of symptoms.

Conclusion: This case emphasizes the recurrence of symptoms in a patient undergoing long-term immunosuppressive treatment who contracted COVID-19 during Bartonella henselae infection. It suggests a potential interaction between immunosuppression and infection. It highlights the importance of immune assessment, accurate diagnosis, and vigilant management. Appropriate therapeutic strategies should be considered for patients with prolonged illness and impaired self-healing capability. Further research is warranted to clarify the mechanisms behind these interactions and to optimize management strategies for similar cases.