Hepatitis colestásica y microabscesos esplénicos por Bartonella henselae en una paciente inmunocompetente: Reporte de caso

Abstract

Cat-scratch disease, caused by Bartonella henselae, typically presents as self-limited regional lymphadenopathy, although systemic involvement may occasionally occur. We report the case of an immunocompetent 18-year-old woman with close contact with multiple cats who was admitted with fever, jaundice, and abdominal pain. Laboratory tests revealed elevated transaminases, conjugated bilirubin, and alkaline phosphatase levels. Imaging studies demonstrated hepatomegaly, splenomegaly, and multiple splenic microabscesses. After other infectious causes of acute hepatitis and jaundice had been excluded, an indirect immunofluorescence assay for immunoglobulin M (IgM) and immunoglobulin G (IgG) confirmed disseminated B. henselae infection. The patient was treated with intravenous ceftriaxone and ciprofloxacin, followed by oral doxycycline and ciprofloxacin, with a favorable clinical course and progressive improvement in biochemical parameters. This case highlights the importance of considering this etiology in immunocompetent patients exposed to cats who present with fever, cholestatic hepatitis, and focal splenic lesions, thereby facilitating timely diagnosis and appropriate treatment and preventing delays in initial therapeutic management.