Was There an Increase in Cat-scratch Disease in Children During the COVID-19 Pandemic?

Öz

Background: Cat-scratch disease (CSD) is a zoonotic infection caused by Bartonella henselae that presents as usually local lymphadenopathy and is classified as localized, dissemine (hepatosplenic) or atypical syndrome according to clinical presentation. In this study, we present the cases of CSD that occurred during the COVID-19 pandemic. Methods: This retrospective single-center study was performed between January 2014 and December 2022 and included 23 patients aged <18 years diagnosed with CSD. Results: Among the 23 patients, 86% (n=20) were admitted between 2020 and 2022, had a mean age of 143.82±47.5 months, and 47.8% (n=11) were female. The most common symptoms were lymphadenopathy (87%), fever (8.7%), stomach aches (8.7%), and weight loss (13%). According to the clinical classification of CSD, 82% of the patients had localized CSD, 15% had disseminated CSD, and 0.04% had atypical (uveitis) CSD. Azithromycin therapy was preferred for localized CSD, combination therapy (rifampin or gentamycin) for disseminated CSD, and steroids for uveitis. Overall, the treatment outcomes were favorable, and a curing was achieved in the localized group. Notably, splenic lesions persisted for over 2 years in one patient. Conclusions: Our study highlights the significant emergence of CSD during the COVID-19 pandemic and emphasizes its importance in children. The increase in cases may be attributed to alterations in pet acquisition practices and a surge in outdoor activities after lockdown restrictions were lifted.

Anahtar Kelimeler

• Bartonella henselae
• cat-scratch disease
• children
• COVID-19
• lymphadenopathy

COVID-19 Pandemisi Sırasında Çocuklarda Kedi Tırmığı Hastalığı’nda Artış Oldu Mu?

Öz

Giriş: Kedi tırmığı hastalığı (KTH), Bartonella henselae'nın etken olduğu, genellikle lokal lenfadenopati şeklinde ortaya çıkan ve klinik tabloya göre lokalize, yaygın (hepatosplenik) veya atipik sendrom olarak sınıflandırılan zoonotik bir enfeksiyondur. Bu çalışmada, COVID-19 pandemisi sırasında ortaya çıkan CSD vakalarını sunulmuştur. Yöntemler: Bu retrospektif tek merkezli çalışma Ocak 2014 ile Aralık 2022 tarihleri arasında yürütülmüş olup KTH tanısı alan 18 yaş altı 23 hastay dahil edildi. Bulgular: Hastanın %86'sı (n=20) 2020 ile 2022 yılları arasında başvurmuş olup, ortalama yaşları 143,82±47,5 ay ve hastaların %47,8'i (n=11) kadındı. En sık görülen semptomlar lenfadenopati (%87), ateş (%8,7), mide ağrısı (%8,7) ve kilo kaybı (%13) idi. Klinik sınıflandırmasına göre hastaların %82'sinde lokalize, %15'inde yaygın ve %0,04'ünde atipik KTH vardı. Lokalize KTH için azitromisin tedavisi, yaygın KTH için kombinasyon tedavisi (rifampin veya gentamisin) ve üveit için steroidler tercih edildi. Genel olarak, tedavi sonuçları olumlu ve lokalize grupta kür sağlandığı görülse de bir hastada dalak lezyonları 2 yıldan uzun süre devam etti. Sonuçlar: Çalışmamız, KTH’nın çocuklarda önemini ve COVID-19 pandemisi sırasındaki artışına dikkat çekmektedir. Bu durum evcil hayvan edinme davranışlarındaki değişikliklere ve karantina kısıtlamalarının kaldırılmasından sonra açık hava aktivitelerindeki artışa bağlanabilir.

Anahtar Kelimeler

• Bartonella henselae
• kedi tırmığı hastalığı
• çocuklar
• COVID-19
• lenfadenopati.

Kaynakça

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