Unmasking Bartonella henselae infection in the shadows of long COVID thanks to clinical metagenomics

Aurélien Aubry; Emilie Corvilain; Théo Ghelfenstein-Ferreira; François Camelena; Véronique Meignin; Béatrice Berçot; Jérôme Le Goff; Maud Salmona

doi:10.1007/s10096-024-04801-2

Unmasking Bartonella henselae infection in the shadows of long COVID thanks to clinical metagenomics

Eur J Clin Microbiol Infect Dis. 2024 Mar 12. doi: 10.1007/s10096-024-04801-2. Online ahead of print.

Authors

Aurélien Aubry^{1

2}, Emilie Corvilain³, Théo Ghelfenstein-Ferreira⁴, François Camelena^{5

6}, Véronique Meignin⁷, Béatrice Berçot^{5

6}, Jérôme Le Goff^{8

9}, Maud Salmona^{8

9}

Affiliations

¹ Virology Department, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France. aubry.aurelien@chu-amiens.fr.
² Resistant Infectious Agents and Chemotherapy Research Unit, AGIR UR4294, Jules Verne University of Picardie, Amiens, 80000, France. aubry.aurelien@chu-amiens.fr.
³ Clinical Immunology Department, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France.
⁴ Parasitology-Mycology Department, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France.
⁵ Bacteriology Department, Saint Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
⁶ University Paris Cité, INSERM 1137, IAME, Paris, France.
⁷ Pathology Department, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France.
⁸ Virology Department, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France.
⁹ University Paris Cité, Inserm U976, INSIGHT Team, Paris, France.

PMID: 38472519
DOI: 10.1007/s10096-024-04801-2

Abstract

The diagnosis of long COVID often relies on symptoms post-COVID-19, occasionally lacking biological evidence. This case study illustrates how investigating long COVID uncovered an underlying bartonellosis through clinical metagenomics. Following mild COVID-19, a 26-year-old woman experienced persistent symptoms during 5 months, including axillary adenopathy. Pathological examination, 16 S rRNA PCR, and clinical metagenomic analysis were done on an adenopathy biopsy. The latter revealed Bartonella henselae DNA and RNA. Treatment with clarithromycin improved symptoms. This case underscores the relevance of clinical metagenomics in diagnosing hidden infections. Post-COVID symptoms warrant thorough investigation, and bartonellosis should be considered in polyadenopathy cases, regardless of a recent history of cat or flea exposures.

Keywords: Bartonellosis; Cat scratch disease; Long COVID; Metagenomics.