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Results for “CAT SCRATCH DISEASE”

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PubMed1998

Cat scratch disease presenting with peripheral facial nerve paralysis.

Acquired peripheral facial nerve paralysis is a relatively common disorder that affects both children and adults. The most frequent nontrauma-related etiologies in otherwise neurologically intact patients are idiopathic (Bell's palsy) and infectious, which includes otitis media, herpes zoster, Lyme disease, herpes simplex virus, Epstein-Barr virus, and Mycoplasma pneumoniae. Cat scratch disease (CSD) is typically a subacute, regional lymphadenitis caused by Bartonella henselae that is seen in children and young adults. CSD most often has a benign, self-limited course. However, 11% of CSD patients may present atypically, most commonly with Perinaud's oculoglandular syndrome or acute encephalopathy. We present a child with the first reported case of acute facial nerve paralysis in serologically proven CSD with typical lymphadenitis.

Cat-Scratch Disease↗
PubMed2001

Chronic active myocarditis following acute Bartonella henselae infection (cat scratch disease).

An association between Bartonella infection and myocardial inflammation has not been previously reported. We document a case of a healthy young man who developed chronic active myocarditis after infection with Bartonella henselae (cat scratch disease). He progressed to severe heart failure and underwent orthotopic heart transplantation. Bartonella henselae, therefore, should be included among the list of infectious agents associated with chronic active myocarditis.

Acute Disease↗
PubMed1994

Cat-scratch disease in Italy: a serological approach.

The results of studies on the serologic responses to Afipia felis and Rochalimaea henselae in suspected patients for Cat Scratch Disease (CSD) are illustrated. This preliminary study performed using Indirect Immunofluorescence Assay, proved negative for A. felis and R. henselae in some patients and positive in others; in a few instances the test was positive for both organisms. Additional microbiological and serological studies are needed to clarify the exact role of these microorganisms in causing CSD.

Adolescent↗
PubMedDate not supplied

Gray-scale sonographic evaluation of cervical lymphadenopathy in cat-scratch disease.

PURPOSE: The aim of this study was to characterize the gray-scale sonographic findings in the lymph nodes of patients with cat-scratch disease (CSD). METHODS: We analyzed the sonograms of cervical lymph nodes in 41 patients with proven CSD between January 1997 and October 1999. RESULTS: A total of 222 involved lymph nodes were detected. Involved nodes were most commonly found in the middle cervical (58%), parotid (37%), upper cervical (37%), and submandibular (17%) regions. We found acute, chronic, or abscessed lymphadenopathy in 63%, 12%, and 24% of patients, respectively. The size of involved lymph nodes ranged from 12 x 4 mm to 35 x 26 mm. The largest involved node had a short axis/long axis ratio of 0.5 or more in 61% of patients. Useful features for the differential diagnosis included markedly decreased echogenicity (100%), normal surrounding tissues (100%), and the presence of an echogenic hilum (76%). Posterior sound enhancement was significantly associated with larger and abscessed lymph nodes. CONCLUSIONS: Despite the absence of a specific sonographic finding for CSD, gray-scale sonography can provide clues to the diagnosis of CSD in the proper clinical setting.

Adolescent↗
PubMed1998

IgM to Bartonella henselae in cat-scratch disease and during acute Epstein-Barr virus infection.

The diagnostic value of IgM to Bartonella henselae was evaluated in 20 children with cat-scratch disease (CSD) and controls consisting of 20 blood donors and 20 children with enlarged lymph nodes without CSD by two indirect immunofluorescence assays (IFA). One was based on B. henselae cocultivated with Vero cells (host cell-associated IFA), and the other on B. henselae grown on agar (host cell-free IFA). With the host cell-associated IFA, 18 of 20 children with CSD revealed IgM, whereas only 14 did so with the host cell-free IFA. Sera of two blood donors as well as sera from three children with enlarged lymph nodes without CSD showed also positive IgM to cell-associated B. henselae. This study reveals that the IFA applied had sensitivities of 70-90% and specificities of 87.5-100% for detecting IgM to B. henselae. Additionally, 20 patients with IgM to Epstein-Barr virus (EBV) capsid antigen were tested for IgM to B. henselae. Sera of 16 and 9 of these patients revealed IgM to B. henselae with the host cell-associated and the host cell-free IFA, respectively. Using Western blot these sera were demonstrated to react against linearized proteins of Vero cells and of B. henselae. Thus, since acute EBV infection may substantially reduce the specificity of B. henselae-specific IgM tests, we conclude that diagnosis of CSD should be confirmed by a significant IgG titer to B. henselae or by detection of this pathogen.

Animals↗
PubMed2001

Serodiagnosis of cat scratch disease: response to Bartonella henselae in children and a review of diagnostic methods.

In this study, sera from 116 children without clinical evidence of cat scratch disease (CSD) and sera from 19 children with CSD were investigated by two different immunofluorescent assays (test A and test B) to evaluate the seroprevalence of Bartonella henselae antibodies in this population. Antibodies against Bartonella henselae were found in noninfected children only in low titers: 13% and 3.5% of serum samples were positive by test A and test B, respectively. IgG titers as determined by test A ranged from 1:64 to 1:256, whereas test B did not yield titers >1:64. Of the 19 children with CSD, 7 (37%) and 5 (26%) had low antibody titers (1:64-1:256) on admission by test A and test B, respectively. In such cases, IgM antibodies against Bartonella henselae and/or a titer increase in the following weeks are required to prove suspected CSD. The results indicate that the seroprevalence of Bartonella henselae antibodies in children without evidence of CSD is low, and that the results may differ depending on the tests being used. Low antibody titers, however, were found not only in healthy children but also among patients with CSD, which could be indicative of the beginning or of the end of an illness. Currently, only few data are available concerning the seroprevalence of antibodies to Bartonella spp. among children. Although children are often affected by CSD, the specificity of most tests has been evaluated by investigating blood donors, who are usually adults. Several different serological tests are used for the diagnosis of CSD, including the immunofluorescence assay, the enzyme-linked immunosorbent assay, and Western blot (WB) analysis. The sensitivities of different IFAs range from 14 to 100%, depending on the antigen used, the cut-off chosen, and the test procedures. The current diagnostic value of different serological tests for diagnosis of CSD is reviewed.

Adolescent↗
PubMed1999

Serologic response to Bartonella henselae in patients with cat scratch disease and in sick and healthy children.

Indirect fluorescent antibody assay (IFA) is the most reliable test for detecting antibody to Bartonella henselae in the diagnosis of cat scratch disease (CSD). Recently, an ELISA test has been proposed, but conflicting results are reported. We compared IgG-IFA and IgG-IgM ELISA methods in CSD patients and in healthy children. We also tested ELISA specificity in a large group of healthy controls and in children with lymphoma-associated lymphadenopathy and with pyogenic lymphadenitis. The ELISA procedure was positive in 69/78 patients with CSD (sensitivity 89.6%), in 5/100 healthy children (specificity 95%), in 2/51 patients with non-Hodgkin's lymphoma or pyogenic lymphadenitis (specificity 96%) and in 27/296 blood donors (specificity 91.6%). In 34 patients with CSD, ELISA IgM and IgG responses decreased significantly between time of diagnosis of the disease and recovery. We found significantly higher IgG-ELISA titres in cat-owners, whether blood donors or healthy children, than in non-cat-owners. The IgG-IFA test gave positive results in 69/78 patients with CSD (sensitivity 89.6%) and in 5/62 healthy controls (specificity 92.5%). The ELISA method is a cheap, sensitive method for determining antibody response to Bartonella henselae infection and is also important for evaluating the clinical course of the disease and the efficacy of antibiotic therapy. The high specificity of ELISA in patients with non-Hodgkin's lymphoma will help the clinician to exclude a potentially life-threatening disease associated with lymphadenopathy.

Adolescent↗
PubMedDate not supplied

[Cat-scratch disease. Comments on a clinical case].

The authors present a clinical case of cat's scratch disease, with lymphadenitis and inoculation pustule. A series of observations are made on the importance of anamnesis, histopathologic examination, elimination of other clinical entities with lymphadenopathic manifestations, for determining the diagnosis. The recent investigations are aimed at identifying the etiologic agent. The treatment of the disease is symptomatic.

Adult↗
PubMedDate not supplied

[Bartonella henselae as the causative agent in cat-scratch disease: case report].

In this article we reported typical clinical, primary skin lesion and regional lymphadenitis, and atypical, protracted fever and algic syndrome, characteristics of cat scratch disease (CSD) in a 21-year-old man (a student) from Zadar, Croatia. Laboratory parameters were in normal range. The histopathologic findings of affected lymph nodes included stellate caseating granulomas. By using IFA method a seroconversion of specific IgG antibodies (neg/1:512) and rise of IgM antibodies (1:160/ > 1:320) to B. henselae were detected in paired sera, and these serologic findings indicate on conclusion that B. henselae is probably etiologic agent of CSD in our patient.

Adult↗