A Case Report of Bartonella henselae -Related New-Onset Refractory Status Epilepticus / Febrile Infection–Related Epilepsy Syndrome Complicated With Stimulus-Induced Rhythmic,Periodic,or Ictal Discharges

Febrile infection-related epilepsy syndrome (FIRES) is a subtype of new-onset refractory status epilepticus (NORSE) characterized by the prodrome of fever. Bartonella henselae (B henselae), known to cause various neurological complications, has been implicated in new-onset refractory status epilepticus/febrile infection-related epilepsy syndrome in some cases. We report a case of a 7-year-old male with autism spectrum disorder who developed new-onset refractory status epilepticus/febrile infection-related epilepsy syndrome. Initial treatments included antiseizure medications and anesthetics for refractory status epilepticus. Despite these measures, seizure control remained suboptimal, necessitating immunotherapy with methylprednisolone and intravenous immunoglobulin, as well as rifampin and doxycycline after serologic confirmation of B henselae. The hospital course was complicated by stimulus-induced rhythmic, periodic, or ictal discharges but did not negatively impact the overall outcome. We present a patient with suspected Bartonella-related new-onset refractory status epilepticus/febrile infection-related epilepsy syndrome with remarkable outcomes after immunotherapy and antibiotics.