Year: 2026
Type: article
Study design: Case Report
Abstract: Introduction: infection in immunocompetent adults and may closely mimic haematological malignancy. Case description: A 62-year-old woman with a history of breast cancer presented with an eight-week history of fever, night sweats and weight loss. A fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET/CT) revealed hypermetabolic hepatosplenic lesions, retroperitoneal lymphadenopathy and a focal acetabular bone lesion, strongly suggesting stage IV lymphoma or metastatic disease. Bone marrow biopsy showed no evidence of malignancy; liver biopsy revealed caseous necrotising granulomas. Mycobacterial polymerase chain reaction (PCR) and cultures were negative. Bartonella serology demonstrated a high IgG titre (>1:1.280), while tissue PCR was borderline positive. Treatment with azithromycin and rifampicin for four weeks resulted in clinical improvement and resolution of constitutional symptoms. Conclusion: infection should be considered early in the diagnostic workup. LEARNING POINTS: infection in patients with prolonged fever and visceral lesions, to avoid unnecessary investigations or inappropriate treatments.
DOI: 10.12890/2026_007477
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $323
OpenAlex ID: W7222622985