Disseminated bartonellosis and EBV reactivation in an adolescent treated with upadacitinib

IF 3 4区医学 Q2 INFECTIOUS DISEASES

Brazilian Journal of Infectious Diseases Pub Date : 2025-05-01 DOI:10.1016/j.bjid.2025.104536

Vincent Pargny , Emilie Delugre , Raphael Janela , Soumaya Skalli , Abdeljalil Zeggay , Hortense Petat

{"title":"Disseminated bartonellosis and EBV reactivation in an adolescent treated with upadacitinib","authors":"Vincent Pargny , Emilie Delugre , Raphael Janela , Soumaya Skalli , Abdeljalil Zeggay , Hortense Petat","doi":"10.1016/j.bjid.2025.104536","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div><em>Bartonella henselae</em> is responsible for disseminated infections in immunocompromised patients. Upadacitinib is a JAK inhibitor used since 2021 for the treatment of severe atopic dermatitis in adolescents over 12-years. We report here the case of disseminated Bartonellosis in a 15-year-old male treated with upadacitinib.</div></div><div><h3>Case presentation</h3><div>This patient presented with fever and abdominal pain. Laboratory tests showed inflammation, rhabdomyolysis and acute renal failure. Imaging studies revealed lymphadenopathies, hepatosplenic, renal and pulmonary nodules, pleural and peritoneal effusions and spleen abscesses. <em>Bartonella henselae</em> serology was positive for IgG and IgM. Treatment with doxycycline resolved the symptoms. We detected a concomitant EBV reactivation.</div></div><div><h3>Conclusions</h3><div><em>Bartonella henselae</em> infection should be suspected in immunocompromised patients presenting with fever of unknown origin. Upadacitinib is responsible for rapid immunodepression, which can lead to viral reactivation and severe bacterial infections. Randomized controlled trials are needed to establish a consensus on treatments for the various forms of Bartonellosis.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 3","pages":"Article 104536"},"PeriodicalIF":3.0000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Brazilian Journal of Infectious Diseases","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S141386702500039X","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Bartonella henselae is responsible for disseminated infections in immunocompromised patients. Upadacitinib is a JAK inhibitor used since 2021 for the treatment of severe atopic dermatitis in adolescents over 12-years. We report here the case of disseminated Bartonellosis in a 15-year-old male treated with upadacitinib.

Case presentation

This patient presented with fever and abdominal pain. Laboratory tests showed inflammation, rhabdomyolysis and acute renal failure. Imaging studies revealed lymphadenopathies, hepatosplenic, renal and pulmonary nodules, pleural and peritoneal effusions and spleen abscesses. Bartonella henselae serology was positive for IgG and IgM. Treatment with doxycycline resolved the symptoms. We detected a concomitant EBV reactivation.

Conclusions

Bartonella henselae infection should be suspected in immunocompromised patients presenting with fever of unknown origin. Upadacitinib is responsible for rapid immunodepression, which can lead to viral reactivation and severe bacterial infections. Randomized controlled trials are needed to establish a consensus on treatments for the various forms of Bartonellosis.

查看原文本刊更多论文

用upadacitinib治疗的青少年弥散性巴尔通体病和EBV再激活

背景：亨塞拉巴尔通体是免疫功能低下患者播散性感染的原因。Upadacitinib是一种JAK抑制剂，自2021年起用于治疗12岁以上青少年的严重特应性皮炎。我们在这里报告的病例播散巴尔通体病在一个15岁的男性与upadacitinib治疗。病例表现：患者表现为发热和腹痛。实验室检查显示有炎症、横纹肌溶解和急性肾功能衰竭。影像学检查显示淋巴结病变、肝脾、肾和肺结节、胸膜和腹膜积液和脾脓肿。母鸡巴尔通体血清IgG和IgM阳性。多西环素治疗可缓解症状。我们检测到伴随的EBV再激活。结论出现不明原因发热的免疫功能低下患者应怀疑为亨塞巴尔通体感染。Upadacitinib负责快速免疫抑制，这可能导致病毒再激活和严重的细菌感染。需要进行随机对照试验，以就各种形式巴尔通体病的治疗方法达成共识。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Brazilian Journal of Infectious Diseases 医学-传染病学

CiteScore

5.50

自引率

0.00%

发文量

925

审稿时长

41 days

期刊介绍： The Brazilian Journal of Infectious Diseases is the official publication of the Brazilian Society of Infectious Diseases (SBI). It aims to publish relevant articles in the broadest sense on all aspects of microbiology, infectious diseases and immune response to infectious agents. The BJID is a bimonthly publication and one of the most influential journals in its field in Brazil and Latin America with a high impact factor, since its inception it has garnered a growing share of the publishing market.