Bartonellosis a Rare Cause of a Splenic Cyst

Background: Bartonellosis comprises infections caused by the emerging pathogens in the genus Bartonella. B henselae is the causeof cat scratch disease. Most of the cases present with the typical self-limited regional lymphadenitis. Isolated splenic involvementis very rare. Here we present a case of splenic cyst which was found to be due to Bartonella Henselae.The case: A 30 years old, previously healthy female presented with non-specific poorly localized abdominal pain for 2 months.Her condition was not associated with any gastrointestinal symptoms or fever. She had close contact with pets (dogs and cats).Physical examination was only positive for a palpable spleen of about 6 cm below the costal margin.Abdominal U/S and CT showed a loculated splenic cyst in the lower pole with wall calcification. Blood tests were unremarkable.A provisional diagnosis of Hydatid cyst was made and the patient received albendazole tabs and planned for splenectomy.Splenectomy was done and histopathological examination of the spleen revealed collection of black small filaments that stainpositive for Bartonella Henselae, associated with marked vascularity. Patient run an uneventful postoperative course and wasprescribed oral erythromycin for 3 weeks.Conclusion: Bartonellosis is rare in immunocompetent patients and isolated splenic involvement is even extremely rare. The casepresented here represents this atypical presentation of this rare disease.