Lymphadenopathies associated with Cat-Scratch Disease in Turkiye

Öz

Aim: Bartonella henselae is the etiologic agent of cat-scratch disease. The disease affects children and young adults. The objective of this study is to analyze the epidemiology, clinical features, and course of this disease in Turkiye. Materials and Methods: Children without immunodeficiency, with relevant clinical signs and symptoms, and positive serology were included in the study. Clinical, demographic and laboratory data of patients diagnosed with cat-scratch disease between October 2018 and February 2021 were evaluated retrospectively. Results: A total of 46 patients were included. The mean age was 132 months (IQR 90- 153 months), and 69.6% (n = 32) were male. There was a history of cat contact in 73.9% of the patients and 43.5% of these were with household cats. Most of the lymphadenopathies were axillary (73.9%), and generalized lymphadenopathy was not observed. The median duration of symptoms before admission was 4 weeks. The median ultrasonographic lymphadenopathy size was 4 cm. The median clinical improvement time was 6.5 weeks. Azithromycin was given in 18 patients and intravenous and/or oral beta-lactamase inhibitor combination therapy in 18 patients while no treatment was necessary in 10 patients. Conclusion: The typical presentation is a solitary, enlarged lymph node, mostly in the axillary region. Bartonella henselae IgG level should be studied prior to invasive procedures. It should be known that cat scratch disease can develop without a history of cat contact. Meanwhile, it should be known that contact with a house cat may cause disease more often than contact with street cats.

Anahtar Kelimeler

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

Türkiye’de Kedi Tırmığı Hastalığı ile İlişkili Lenfadenopatiler

Öz

Amaç: Bartonella henselae, kedi tırmığı hastalığı etyolojik etkenidir. Hastalık çocukları ve genç yetişkinleri etkiler. Bu çalışmanın amacı, Türkiye’de bu hastalığın epidemiyolojisini, klinik özelliklerini ve seyrini analiz etmektir. Gereç ve Yöntemler: İmmün yetmezliği olmayan, ilgili klinik belirti ve semptomlara sahip ve pozitif serolojisi olan çocuklar çalışmaya dahil edildi. Ekim 2018 ile Şubat 2021 arasında kedi tırmığı hastalığı tanısı alan hastaların klinik, demografik ve laboratuvar verileri retrospektif olarak değerlendirildi. Bulgular: Toplam 46 hasta çalışmaya dahil edildi. Ortalama yaş 132 ay (IQR 90-153 ay) ve %69,6'sı (n=32) erkekti. Hastaların %73,9'unda kedi teması öyküsü mevcuttu ve bunların %43,5'i evcil kediydi. Lenfadenopatilerin çoğu aksiller (%73,9) idi ve jeneralize lenfadenopati izlenmedi. Başvurudan önceki medyan semptom süresi 4 haftaydı. Medyan lenfadenopati boyutu 4 cm idi. Medyan klinik iyileşme süresi 6.5 haftaydı. 18 hastaya azitromisin, 18 hastaya intravenöz ve/veya oral beta-laktamaz inhibitör kombinasyon tedavisi verilirken, 10 hastaya tedavi gerekmedi. Sonuç: Tipik prezentasyon, çoğunlukla aksiller bölgede soliter, büyümüş bir lenf nodudur. Bartonella henselae IgG düzeyi, invaziv prosedürlerden önce çalışılmalıdır. Kedi tırmığı hastalığının kedi teması öyküsü olmadan da gelişebileceği bilinmelidir. Aynı zamanda ev kedisi ile temasın sokak kedileriyle temastan daha sık hastalığa neden olabileceği bilinmelidir.

Anahtar Kelimeler

• Bartonella henselae
• kedi tırmığı hastalığı
• çocuklar
• lenfadenopati

Kaynakça

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