Cat scratch disease: An unusual presentation

Year 2015, Volume: 7 , - , 27.04.2015

Anas Gremida , Rochelle Remus Arjun Sarin

Abstract

Cat-scratch disease (CSD) is a zoonotic infection caused by Bartonella henselae occurring in about 24000 patients annually in the United States. It typically presents with fever and regional lymphadenopathy and is considered as one of the most common causes of chronic lymphadenitis in pediatric population. It generally has a benign and self-limited course, though this is not always the case. Rare forms of extra-nodal involvement, and fatalities in immunocompetent patients have been reported. We report a case of cat scratch disease presented with encephalitis without the usual prodromal symptoms. Cat-scratch encephalopathy should always be considered in patients with an altered mental status of unknown etiology.

Keywords

Cat scratch, Bartonella henselae, lymphadenitis, encephalopathy

References

• Anderson BE, Neuman MA. Bartonella spp. as emerging human pathogens. Clin Microbiol Rev. 1997; 10: 203-19.
• Debre R, Lamy M, Jamment ML, Costil L, Mozziconacci P. Cat scratch disease. Sem Hop. 1950; 26: 1895-1904.
• Jackson LA, Perkins BA, Wenger JD. Cat scratch disease in the United States: an analysis of three national databases. Am J Public Health. 1993; 83: 1707-11.
• Carithers HA. Cat-scratch disease: an overview based on a study of 1,200 patients. Am J Dis Child. 1985; 139: 1124-33.
• Lamps LW, Scott MA. Cat-scratch disease: historic, clinical, and pathologic perspectives. Am J Clin Pathol. 2004; 121 Suppl: S71-80.
• Carithers HA, Margileth AM: Cat-scratch disease—acute
• neurological manifestations. Am J Dis Child. 1991; 144: :98-101. and
• other Noah DL, Bresee JS, Gorensek MJ, et al. Cluster of five children with acute encephalopathy associated with cat-scratch disease in south Florida. Pediatr Infect Dis J. 1995; 14: 866-9
• 8- Lewis DW, Tucker SH. Central nervous system involvement in cat scratch disease. Pediatrics. 1986; 77: 714-21.
• 9- Revol A, Vighetto A, Jouvet A, Aimard G, Trillet M. Encephalitis in cat scratch disease with persistent dementia. J Neurol Neurosurg Psychiatry. 1992; 55: 133-5.
• 10- Lyon LW. Neurologic manifestations of cat- scratch disease: report of a case and review of the literature. Arch Neurol. 1971; 25: 23-7.
• 11- Conrad, D.A. Treatment of cat-scratch disease. Curr Opin Pediatr. 2001; 13: 56-9.
• 12- Liao H, Huang F, Wang N, Chen B. Systemic Cat Scratch Disease. J Formos Med Assoc. 2006; 105: 674-9.
• 13- Maman E1, Bickels J, Ephros M, et al. Musculoskeletal Manifestations of Cat Scratch Disease. Clin Infect Dis. 2007; 45: 1535-40.
• 14- Fouch B, Coventry S. A case of fatal disseminated bartonella henselea infection (cat-scrath disease) with encephalitis. Arch Pathol Lab Med. 2007; 131: 1591-4.
• 15- Dyachenko P, Ziv M, Raz R, Chazan B, Lev A, Rozenman D. Cat scratch disease encephalopathy in an immunocompetent patient. Eur J Intern Med. 2005; 16: 610-1.
• 16- Gerber JE, Johnson JE, Scott MA, Madhusudhan KT. Fatal meningitis and encephalitis due to Bartonella henselae bacteria. J Forensic Sci. 2002; 47: 640-4.
• 17- Selby, G. and G. L. Walker . Cerebral arteritis in cat-scratch disease. Neurology. 1979; 29: 1413-8.
• 18- Massei F, Gori L, Taddeucci G, Macchia P, Maggiore G. Bartonella henselae infection associated with Guillain-Barre´ syndrome. Pediatr Infect Dis J. 2006; 25: 90-1.
• 19- Wheeler SW, Wolf SM, Steinberg EA. Cat- scratch encephalopathy. Neurology. 1997; 49: 876-8. 20- Bass JW, Freitas BC, Freitas AD, et al. Prospective randomized double blind placebo- controlled evaluation of azithromycin for treatment of cat-scratch disease. Pediatr Infect Dis J. 1998; 17: 447-52.
• 21- Margileth AM. Antibiotic therapy for cat-scratch disease: clinical study of therapeutic outcome in 268 patients and a review of the literature. Pediatr Infect Dis J. 1992; 11: 474-8.
• Weston KD, Tran T, Kimmel KN, Maria BL. Possible Role of High-Dose Corticosteroids in the Treatment of Cat-Scratch Disease Encephalopathy. J Child Neurol. 2001; 16: 762-3.
• 23- Dharnidharka VR, Richard GA, Neiberger RE, Fennell RS 3rd. Cat scratch disease and acute rejection after pediatric renal transplantation. Pediatr Transplant. 2002; 6: 327-31.