A case of Bartonellosis presenting as a puzzling multisystem disorder complicated by nosocomial COVID-19 infection

Garland, Huw; Stoll, Sarah; Patel, Shalinee; Mogal, Rahul

The most commonly considered infection with a Bartonella species is cat-scratch disease caused by Bartonella henselae. Here, we discuss a unique case of a 60-year-old man who presented with Bartonella infection complicated by nosocomial COVID-19. He was admitted with a history of chest pain, persistent fever, rash and influenza-like symptoms. Positive Bartonella serology confirmed diagnosis and the patient developed complications of pericardial effusion in addition to COVID-19 infection, requiring non-invasive ventilation and admission to the intensive care unit. We discuss his symptoms, investigations, treatment and outcomes, while also highlighting the challenges of assessing patients presenting with fever of unknown origin during the COVID-19 pandemic.