{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:31:22Z","timestamp":1791217882012,"version":"4.1.0"},"reference-count":11,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T00:00:00Z","timestamp":1749513600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2025,8]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n \n Cat scratch disease (\n \n Bartonella henselae<\/jats:italic>\n <\/jats:styled-content>\n ) typically presents with fever and granulomatous lymphadenopathy. Immunocompromised individuals, particularly organ transplant recipients, are at increased risk of severe infections with potential multisystem involvement. In renal transplant recipients, the optimal duration of treatment and antibiotic selection remain uncertain due to drug interactions and nephrotoxicity concerns.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We present a 13\u2010year\u2010old male renal transplant recipient who was diagnosed with hepatosplenic Bartonella infection after presenting to the pediatric infectious diseases department with right mandibular lymphadenopathy. The patient underwent a 1\u2010year treatment course and was followed for 2\u2009years, during which no relapse or graft rejection was observed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The patient initially presented with right submandibular swelling and tender lymphadenopathy. Despite empirical antibiotic therapy, persistent fever and progressive lymphadenopathy led to further investigation. Serologic testing confirmed\n \n Bartonella henselae<\/jats:italic>\n <\/jats:styled-content>\n infection, prompting systemic imaging. Although abdominal ultrasound was normal, abdominal MRI revealed focal hepatic and splenic lesions, leading to a diagnosis of invasive Bartonella infection. Due to drug interactions, the patient was treated with trimethoprim\u2010sulfamethoxazole and doxycycline, with a reduction in immunosuppressive therapy. By 6\u2009months, lymphadenopathy and liver lesions had regressed; however, splenic lesions persisted, requiring prolonged treatment. Therapy was completed after 1\u2009year, and no recurrence was observed during 2\u2009years of follow\u2010up. The patient remained stable with no graft rejection.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Hepatosplenic\n Bartonella<\/jats:italic>\n infection in renal transplant recipients may require prolonged antimicrobial therapy. Given the risk of relapse and the need to balance immunosuppressive therapy, an individualized treatment duration should be considered. Imaging modalities play a crucial role in monitoring treatment response. Further studies are needed to establish optimal treatment strategies in immunocompromised patients.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/petr.70113","type":"journal-article","created":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T00:15:52Z","timestamp":1749600952000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Can Lymphadenopathy Guide the Diagnosis of Hepatosplenic\n Bartonella<\/i>\n Infection in Pediatric Renal Transplant Recipients? What Is the Optimal Treatment and Follow\u2010Up Duration?"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2662-5039","authenticated-orcid":false,"given":"\u015eilem \u00d6zdem","family":"Alata\u015f","sequence":"first","affiliation":[{"name":"Department of Pediatric Infectious Disease, Faculty of Medicine Dokuz Eyl\u00fcl University Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0130rem Ceren","family":"Erba\u015f","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Disease, Faculty of Medicine Dokuz Eyl\u00fcl University Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0023-4758","authenticated-orcid":false,"given":"Ay\u015fe \u00c7ak\u0131l","family":"G\u00fczin","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Disease, Faculty of Medicine Dokuz Eyl\u00fcl University Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meral Torun","family":"Bayram","sequence":"additional","affiliation":[{"name":"Department of Pediatric Nephrology Faculty of Medicine Dokuz Eyl\u00fcl University Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nur\u015fen","family":"Belet","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Disease, Faculty of Medicine Dokuz Eyl\u00fcl University Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,10]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11908-000-0026-8"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-3046.2002.01091.x"},{"key":"e_1_2_6_4_1","first-page":"103","volume-title":"Mycoplasma, and Ureaplasma, Dulek, Daniel MD and Statler, Victoria A. MD, MSc in Pediatric Transplant and Oncology Infectious Diseases","author":"Bartonella L.","year":"2020"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-1897"},{"key":"e_1_2_6_6_1","first-page":"9","article-title":"Serious and Atypical Presentations of Bartonella henselae Infection in Kidney Transplant Recipients","volume":"5","author":"Bos F.","year":"2022","journal-title":"Open Forum Infectious Diseases"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3046.2006.00581.x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.13823"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.5500\/wjt.v11.i6.244"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0b013e31824dc07a"},{"key":"e_1_2_6_11_1","first-page":"52","article-title":"Systemic Bartonella henselae Infection With Hepato\u2010Splenic Involvement","volume":"29","author":"Ventura A.","year":"1999","journal-title":"Journal of Pediatric Gastroenterology and Nutrition"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3062.2012.00774.x"}],"container-title":["Pediatric Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.70113","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T12:37:26Z","timestamp":1764679046000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/petr.70113"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,10]]},"references-count":11,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1111\/petr.70113"],"URL":"https:\/\/doi.org\/10.1111\/petr.70113","archive":["Portico"],"relation":{},"ISSN":["1397-3142","1399-3046"],"issn-type":[{"value":"1397-3142","type":"print"},{"value":"1399-3046","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,10]]},"assertion":[{"value":"2025-03-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70113"}}