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PubMed2000

[Familial parinaud oculo-glandular syndrome in cat-scratch disease].

Cat-scratch disease is manifested by subacute, regional lymphadenitis and occurs mainly in children. The causative agent is a pleomorphic, gram-negative bacillus, Bartonella henselae carried by asymptomatic cats. Parinaud oculoglandular syndrome is the most common ocular manifestation of this disease. It is characterized by unilateral conjunctivitis with polypoid granuloma, usually of the palpebral conjunctiva, and preauricular lymphadenopathy. The diagnosis is supported by a history of exposure to cats and is confirmed by positive serologic tests or positive PCR assay. The occurrence of more than 1 case of Parinaud syndrome in a family is rare. We describe 2 sisters with Parinaud oculoglandular syndrome, proven by serologic tests. They reported that they used to cuddle with their cats, among them a kitten. Because of the refractory conjunctivitis and signs of imminent periorbital cellulitis, they were treated with oral tetracycline with apparently good responses. We recommend asking about contacts with cats in any atypical conjunctivitis accompanied by regional lymphadenopathy, especially in young patients. Systemic antibiotics should be given when there is any suspicion of significant ocular involvement, if the patient is immunosuppressed, or if there are systemic manifestations of cat-scratch disease.

Adolescent↗
PubMed2006

Systemic cat scratch disease.

Systemic cat scratch disease (CSD) is often associated with prolonged fever and microabscesses in the liver and/or spleen. We report a case of systemic CSD with hepatic, splenic and renal involvement in an aboriginal child in Taiwan. A previously healthy 9-year-old girl had an intermittent fever for about 17 days, and complained of abdominal pain, headache and weight loss. Abdominal computed tomography showed multiple tiny hypodense nodular lesions in the spleen and both kidneys. Laparotomy revealed multiple soft, whitish-tan lesions on the surface of the liver and spleen. Histopathologic examination of a biopsy specimen of the spleen showed necrotizing granulomatous inflammation with central necrosis surrounded by epithelioid cells and occasional Langhans' giant cells, strongly suggestive of Bartonella henselae infection. History revealed close contact with a cat. B. henselae DNA was detected by polymerase chain reaction in the tissue specimen, and the single antibody titer against B. henselae was greater than 1:2048. These results confirmed the diagnosis of visceral CSD caused by B. henselae. The patient's symptoms resolved after treatment with rifampin and tetracycline. This case illustrates the need for inclusion of systemic CSD in patients with fever of unknown origin and abdominal pain.

Animals↗
PubMed1986

Cat-scratch disease.

Cat-scratch disease has been reported with increasing frequency since its initial description in 1931. It is now recognized as being so prevalent that it probably represents the most common cause of unilateral lymphadenopathy in children, once nonspecific viral diseases and cutaneous infections have been excluded. The cardinal feature of the disease is a subacute regional granulomatous lymphadenitis. Because of its relatively mild natural course, most cases are treated on an outpatient basis. Forty-four children, representing the more seriously ill portion of the disease spectrum, were treated at Texas Children's Hospital from 1972 to 1984 and constitute the data base for this article. Most patients were symptomatic for nearly 1 month prior to admission, typically complaining of low-grade fever and regional lymphadenopathy. The two most common sites of lymph node involvement were the axilla (54%) and the neck (46%). Although there is, at this time, no specifically recommended treatment, 80% of patients received antibiotics and 70% underwent a surgical procedure--usually total nodal excision. Nodal excision was followed by rapid resolution of symptoms. Because cat-scratch disease is benign, surgery should be reserved for severe cases with signs of significant suppuration. Generally, symptomatic relief can be afforded by warm soaks and analgesics and recovery over the course of several weeks is uneventful.

Adolescent↗
PubMed1996

Imaging manifestations of cat-scratch disease.

Cat-scratch disease affects an estimated 22,000 people in the United States each year, more than half of whom are children or adolescents [1]. It is caused by Bartonella henselae, a gram-negative bacillus usually introduced by the scratch of a cat [2]. In the past, diagnosis was made if three of the following four criteria were met: (1) history of cat exposure with inoculation, (2) positive skin test: (3) absent laboratory and histopathologic evidence of other diseases, and (4) biopsy findings of granulomatous inflammation [3]. Recent identification of the causative organism has led to new diagnostic tests, including serum assays for B. henselae antibodies [4]. Although response of the disease to antibiotics is poor, spontaneous recovery generally occurs within months to years [3].

Adolescent↗
PubMed1998

Two different genotypes of Bartonella henselae in children with cat-scratch disease and their pet cats.

Two genotypes (I and II) of Bartonella henselae are involved in cat-scratch disease (CSD). Lymph node biopsies were taken from 3 children suffering from CSD, and blood cultures were obtained from their pet cats. Cat-scratch disease was confirmed serologically, histologically and by detection of B. henselae DNA in all 3 lymph nodes by PCR. Bartonella henselae grew in all cats' blood cultures. The first 2 children were siblings. Both children and their pet cats were infected with B. henselae genotype II, and the third patient and her cat were infected with B. henselae genotype I. In all cases, there were no essential differences in the clinical manifestations of the infection caused by these 2 genotypes of B. henselae.

Adolescent↗
PubMed2000

Neuroretinitis: a clinical syndrome of cat-scratch disease.

Cat-scratch disease is usually a benign self-limited illness, characterized by regional lymphadenopathy lasting between 3 and 6 weeks. The causative organism is Bartonella henselae, a small gram-negative rod. Between 1 and 2% of patients who contract the illness experience blurred vision, metamorphopsia and scotomas as a result of neuroretinitis, an associated clinical syndrome. The classical clinical findings in cat-scratch neuroretinitis include disc edema and a stellate pattern of exudates in the macula. However, a myriad of other signs has been documented, suggesting a much wider spectrum of intra-ocular disease. The following case report presents a young patient with neuroretinitis, and a history of lymphadenopathy secondary to cat-scratch disease.

Journal Article↗
PubMed1976

Continuing search for the etiology of cat scratch disease.

Fifty cat scratch disease patients were tested for antibodies against candidate etiological agents, with inconclusive results. Future research should emphasize new viral isolation methods to discover the elusive agent.

Antibodies, Bacterial↗
PubMed1991

[Cat-scratch disease].

Cat-scratch disease is usually a self-limited illness characterized by regional lymphadenopathy and a skin inoculation lesion. These findings generally resolve spontaneously over a period of several weeks or months. The discovery of the causative organism, an intracellular gram-negative rod and the recognition of severe systemic courses in immuno-compromised patients have renewed the interest in this disease. We report a prolonged clinical course with lymph node suppuration in an immunocompetent patient. The diagnosis was confirmed by the detection of the organism in Warthin-Starry silver stained lymph node biopsy.

Adult↗
PubMed1991

Cat-scratch disease.

Cat-scratch disease is a relatively common disorder that is the result of infection with a recently identified gram-negative bacillus. Although it is overwhelmingly a benign, self-limited illness requiring only supportive care, serious complications can occur and the disease may be life-threatening on occasion. Although randomized clinical trials of antibiotic therapy for CSD do not exist, CSD has demonstrated in vitro susceptibility to several antibiotics, and gentamicin has been reported beneficial in a few patients with systemic manifestations of the illness. Therefore, pending clinical trials, gentamicin may be worthy of consideration in CSD patients with serious manifestations of this illness. CSD is one of the most common causes of adenopathy and should be considered in all patients who present with unilateral or regional lymphadenopathy.

Cat-Scratch Disease↗
PubMed1998

[Cat-scratch disease].

Cat-scratch disease is a subacute, regional lymphadenitis syndrome that occurs mainly in children. The causative agent is Bartonella henselae. After an incubation period ranging usually between 1 and 2 weeks, red papules develop at the site of cutaneous inoculation and persist until the development of lymphadenopathy with some malaise. Cases with complications have been observed including Parinaud oculoglandular syndrome, encephalopathy, a variety of exanthems and granumatous hepatitis. Diagnosis is based on serologic tests and, when necessary, antimicrobial treatment can be considered. Incision and drainage should not be done.

Amoxicillin-Potassium Clavulanate Combination↗
PubMed1996

Prevalence of Bartonella henselae bacteremia, the causative agent of cat scratch disease, in an Australian cat population.

In order to determine the prevalence of Bartonella henselae becteremia in an Australian cat population we examined blood cultures on a group of Sydney cats. Cats referred to the Concord Animal Hospital for euthanasia were selected randomly for blood culture and serum sampling. Blood samples were lysed and centrifuged and then cultured for up to five weeks. Suspicious colonies were identified biochemically as probable B. henselae. Selected isolates were confirmed as B. henselae using the polymerase chain reaction. Of the cats accrued throughout Sydney, 27/77 (35%) were culture positive for B. henselae, of these 24/59 (40%) were feral cats and 3/18 (16%) were domestic. Most cats in the study were younger than one year (mean 9.9 months). Our study demonstrates that bacteremia with B. henselae is common in the metropolitan cat population and suggests that it is particularly prevalent among feral animals. By contrast Cat Scratch Disease (CSD) is a relatively uncommon clinical diagnosis in the Australian population. Explanations for this discrepancy may include poor transmission, low bacterial virulence and underdiagnosis. It is possible that feral animals are a greater potential risk source for this infection than domestic cats.

Animals↗
PubMed1986

Pleural effusion and anicteric hepatitis associated with cat-scratch disease. Documentation by cat-scratch bacillus.

Prior to the discovery of the coccobacillus in the lymph nodes of patients with cat-scratch disease by Wear and associates, the diagnosis was based on clinical findings and a nonstandardized skin test. Atypical cases either remained an enigma or were questioned as to accuracy of diagnosis. We present here a case of cat-scratch disease associated with pleural effusion, anicteric hepatitis, and other systemic manifestations confirmed by identification of the coccobacillus. It is the first association with a pleural effusion. With the Warthin-Starry stain, we anticipate a redefinition of this disease. The confirmation of atypical cases will help broaden the clinical spectrum, as well as guide us to consider this diagnosis where its classic manifestations may be absent.

Adult↗
PubMed2006

Somatostatin receptor scintigraphy in patients with cat-scratch disease.

AIM: Somatostatin receptor scintigraphy images various neoplastic, granulomatous, and auto-immune diseases. Cat-scratch disease in an infectious granulomatous disease usually affecting the lymphnodes. It is not known whether cat-scratch disease provides positive somatostatin receptor scintigrams. PATIENTS, METHODS: Twelve patients with lymphadenitis and suspected cat-scratch disease were investigated by immunofluorescence antibody testing and somatostatin receptor scintigraphy. Suppurated lymphnodes were extracted or drained and Bartonella henselae specific PCR was then performed. RESULTS: Eleven of 12 patients showed IgG antibodies against B. henselae. SRS showed positive scintigraphic results in 6 of 11 patients with CSD. B. henselae DNA was detected in tissue of lymphnodes from 4 of 5 patients with lymphnode extraction or lymphnode drainage. SRS demonstrated positive scintigrams in all patients with a positive PCR. In one patient with suspected CSD SRS was negative as well as antibody testing. CONCLUSION: Somatostatin receptor scintigraphy correlated with positive Bartonella henselae specific PCR tests and positive Bartonella henselae specific antibody tests in patients with CSD.

Animals↗
PubMed2006

[Cat scratch disease--course, diagnosis].

Cat scratch disease is an infection which often causes regional lymphadenopathy. Bartenolloses present a growing health problem both in human and veterinary medicine. They may be etiological fevers of unknown etiology, endocarditis, pneumonia, meningitis. The mildest clinical form is the cat scratch disease which proceeds as a mild regional lymphadenopathy. It is caused by Bartonellosis henselae. Animals, especially cats, are the sourse of infections. Lymphadenitis may remain for many weeks and requires differentiation from other causes of regional lymphadenopathy. Three typical cases of the disease are presented. All sick persons had contact with cats. In none case a primary change was observed. In the case no 1 the possibility of occurrence of the disease was not considered and it was diagnosed only after histopathological examination of lymphnodes. In the two other cases diagnoses were established on the basis of serological examination after a few days of admittance for hospital treatment. Cat scratch disease is rarely diagnosed in Poland probably due to insufficient knowledge of the clinical form of this disease. Swollen lymph nodes together with patient contact with a cat or other animals established during a detailed interviewing, raise suspicion of CSD. Denial by a patient of the primary change does not rule out diagnosis. When regional lymphadenopathy of cat scratch disease is taken into consideration in differential diagnosis and serological tests are carried out, it may be possible in many cases to eliminate any further diagnostics burdening a sick person.

Adolescent↗
PubMed2006

An unusual outcome in a child with hepatosplenic cat-scratch disease.

Typical cat-scratch disease (Bartonella henselae infection) in an immunocompetent child is usually associated with a history of scratch, bite or intimate contact with a cat. Most patients develop a non-tender papule in the scratch line after three to ten days. This may persist for only a few days or as long as two to three weeks. During the next two weeks or more, regional lymph nodes that drain the area gradually enlarge and then slowly resolve in more than 10% of patients. The nodes develop overlying erythema and may suppurate. Atypical forms of cat-scratch disease occur in a minority of cases and are characterized by ocular or neurological manifestations, hepatosplenic involvement, vertebral osteomyelitis, endocarditis etc. Immunocompromised individuals with B. henselae infection may develop bacillary angiomatosis, bacillary peliosis, and relapsing bacteremia. There have been several reports of hepatosplenic granulomas caused by B. henselae in immunocompetent children. We report a case of a 6-year-old boy with the hepatosplenic form of cat-scratch disease. Despite early diagnosis and long-term antimicrobial treatment, splenectomy could not be avoided.

Anti-Bacterial Agents↗
PubMed1995

Systemic cat scratch disease: hepatic and splenic involvement about 3 pediatric cases.

Numerous diseases can lead to multinodular lesions of liver and spleen; surgical biopsy can be required for the etiologic diagnosis. Among these diseases, systemic cat scratch disease has been recently described. Macroscopical appearance of the lesions is evocative and must be known by surgeons. Three children with systemic cat scratch disease involving liver and spleen are reported.

Biopsy, Needle↗