Abstract: Two siblings presented with fever and gastrointestinal symptoms, including abdominal pain. Imaging studies of the liver and spleen revealed hypoechoic lesions. Liver biopsy demonstrated granulomatous lesions DNA polymerase chain reaction positive for Bartonella henselae. Bartonella immunoglobulin M and immunoglobulin G antibody testing were positive. Both patients responded to antibiotics active against Bartonella henselae.