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Article History

Received: 5 March 2026

Accepted: 17 June 2026

First Online: 27 July 2026

Declarations

Ethics approval and consent to participate: As the subjects had died prior to sample collection obtaining signed Institutional Review Board consent for research testing was not possible. On behalf of the Institutional Review Board Committee, the Director of the North Carolina State University Institutional Review Board provided a written determination stating testing of specimens from deceased individuals is NOT Research with Human Subjects as outlined in the (United States) Code of Federal Regulations 45 CFR 46.101 and 45 CFR 46.102. This project does not require IRB review or approval. The corresponding author obtained signed permission (BioMed Central Consent Form) to publish from a parent of each of the six individuals in this study.

Consent for publication: All parents reviewed the case report information for their child who was included in this manuscript.

Competing interests: In conjunction with Dr. S. Sontakke and North Carolina State University, E. B. Breitschwerdt holds US Patent No. 7,115,385 Media and Methods for Cultivation of Microorganisms, which was issued on October 3rd, 2006. He is a co-founder, shareholder and Chief Scientific Officer for Galaxy Diagnostics, a company that provides advanced diagnostic testing for the detection of Bartonella spp. infections. Dr. Ricardo Maggi is a co-founder and the Chief Technical Officer for Galaxy Diagnostics Inc. Dr. Henry H. Lindner is a relative of one of the individuals in this study. All other authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.