A clinical case of prolonged fever associated with hypoechoic formations in the liver and spleen, or the challenges of diagnosing visceral bartonellosis in children

Samoilova N.V., Ismagilova M.I., Ziyatdinova L.M.

1) Kazan State Medical University, Kazan, Russia; 2) Children’s Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan, Kazan, Russia

Visceral (hepatosplenic) bartonellosis in children presents with prolonged fever with the development of multiple lesions in the liver and spleen. The authors present a clinical case of atypical visceral bartonellosis in a 12-year-old girl, demonstrating the complexity of diagnosis in children. The purpose of this demonstration is to draw the attention of not only infectious disease specialists but also pediatricians and general practitioners to the problem of bartonellosis. The article presents the results of an extensive differential diagnostic search, a dynamic study of liver and spleen lesions using imaging techniques, and the effectiveness of long-term antibacterial therapy with doxycycline and rifampin. The availability of laboratory verification for bartonellosis is discussed.

For citations: Samoilova N.V., Ismagilova M.I., Ziyatdinova L.M. A clinical case of prolonged fever associated with hypoechoic formations in the liver and spleen, or the challenges of diagnosing visceral bartonellosis in children. Pharmateca. 2026;33(7):112-118. (In Russ.). DOI: https://dx.doi.org/10.18565/pharmateca.2026.7.112-118

Authors’ contribution: All authors contributed equally to the diagnostic and treatment process presented in this clinical case, as well as to writing, editing, and approving the final version of the article.
Conflicts of interest: The authors confirm that they have no conflicts of interest to declare.
Funding: The study was conducted without any sponsorship.
Patient Consent for Publication: Written, voluntary, informed consent for publication of the examination and treatment results was obtained from the patient’s parents.

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About the Authors

Natalya V. Samoilova, Cand. Sci. (Med.), Associate Professor, Associate Professor at the Department of Hospital Pediatrics, Kazan State Medical University, Kazan, Russia; k169mu@mail.ru, ORCID: https://orcid.org/0000-0002-3591-1301, eLibrary SPIN: 2733-5380 (corresponding author)
Milyausha I. Ismagilova, Pediatrician at the Isolation and Diagnostic Department, Children’s Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan, Kazan, Russia; ism.mila@mail.ru, ORCID: https://orcid.org/0000-0002-6074-4541
Liliya M. Ziyatdinova, Cand. Sci. (Med.), Pediatrician, Head of the Isolation and Diagnostic Department, Children’s Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan, Kazan, Russia; ORCID: https://orcid.org/0009-0009-5592-2110

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