Bartonella henselae of the brain; diagnostic challenge

Abstract

A 13 and 35-year-old female patients presented because of fatigability, nocturnal febrile illness,generalized body aches and worsening headache. In the course of the illness both patientsdeveloped worsening headache and attacks of epileptic seizure. Brain MRI imaging showedintraaxial cerebral heterogeneous irregular masseswith focalencephalomalacia,cystic component, glial reaction and dystrophic calcification. Histological results of the resected pathology revealed highly vascular mass with features suggestive of Bartonella henselae. In this report, the initial course of the disease was that of febrile illness, a common problem in a tropical country, furthermore the symptoms were not suggestive of cat scratch disease.