CAT scratch disease.
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Cat-Scratch Disease↗
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[Problems diagnosing cat scratch disease].
The diagnosis of cat scratch disease is hampered by the fact the basic laboratory investigations fail to demonstrate characteristic changes of this disease, and the diagnosis is based usually on epidemiological history and the clinical symptom complex. The diagnosis is confirmed by the complement binging test with the antigen obtained from pathologically changed lymph nodes with values over 1.5 being pathognomonic for the disease, and by the cutaneous tests of Hanger-Rose and Mollaret. The authors present 2 cases treated for the disease stressing differences in its course.
Adult↗
[Cat-scratch disease of the parotid gland].
Cat-scratch disease is a mild disease associated with regional lymph node enlargement. We present a case of cat-scratch disease of the parotid gland in 10-year-old girl. She presented with painful parotid mass, after unsuccessful treatment with antibiotics. Computed tomography showed tumour like lesions in parotid gland. Subtotal parotidectomy with facial nerve preservation was performed as neoplastic disease was suspected. Histopathology examination of the sample revealed typical changes for cat-scratch disease. History of continuous contacts with cats was confirmed by the parents. Cat-scratch disease should be taken into account in differential diagnosis of parotid masses, especially in children.
Cat-Scratch Disease↗
Granulomatous hepatitis associated with cat scratch disease.
In three patients with cat scratch disease the liver was affected. All three had high fever (39 degrees C) for more than 3 weeks. Two of them had no peripheral adenopathy. Computed tomography of the abdomen revealed focal hepatic defects in two patients and periportal and periaortic adenopathy in the third. At laparotomy, there were nodules on the liver surfaces of all patients and histological examination revealed necrotising granulomata. The Warthin-Starry silver stain showed organisms consistent in appearance with the cat scratch bacillus in the liver and a periaortic lymph node of one patient, in the liver of the second patient, and in the axillary lymph node of the third. In all three patients the clinical findings and radiological abnormalities improved without specific therapy. A review of the surgical pathology files of Washington University revealed only two other cases of granulomatous hepatitis in children over a 6-year period. These findings indicate that cat scratch disease should now be included in the differential diagnosis of granulomatous hepatitis, at least in children. The absence of peripheral adenopathy in two of the three patients with granulomatous hepatitis suggests that the clinical spectrum of cat scratch disease may be broader than previously appreciated.
Cat-Scratch Disease↗
The current status of cat-scratch disease: an update.
Cat-scratch disease (CSD) is a benign inoculative lymphoreticulosis, first described in independent reports by Pierre Mollaret [1] and Robert Debre in 1950 [2]. The disease usually self-limited, with spontaneous resolution occurring after several weeks, appears to be related to the presence of an identified gram-negative bacteria.
Acquired Immunodeficiency Syndrome↗
[Pefloxacin and cat-scratch disease].
Three patients with cat scratch diseases were treated with pefloxacin (800 mg p.d.). Three of four criteria of the diagnosis were present. The pathogen of the disease is probably an intracellular Gram negative bacilli with a deficient wall. Improvement was obtained in one case and partial response in two other cases.
Adolescent↗
Prevalence of antibodies to Bartonella henselae in patients with suspected cat scratch disease (CSD) in Italy.
Cat scratch disease (CSD) is a relatively new diagnosed illness with clinical signs of self-limiting regional lymphadenopathy accompanied by symptoms of fever and malaise, to encephalopathy and neuropathy, occurring after a cat scratch or flea bite. Bartonella henselae is now accepted as the etiologic agent of CSD. From January 1994 to September 1998, 412 patients were evaluated for suspect CSD in Italy. Sera were tested for antibodies to B. henselae by a commercially available indirect immunofluorescent assay (IFA), based on B. henselae-infected Vero-cells as the antigen substrate. Of the 412 patients, 26 (6.3%) were considered positive having titers of immunoglobulin G (IgG) to B. henselae of 64 or higher. In these patients CSD was indeed confirmed by either histopathologic examination of lymph nodes biopsy or fourfold raise in antibody titers. Nevertheless, sera were tested by IFA for Afipia felis and one showed a double reactivity to B. henselae and A. felis. Finally, three sera, negative to B. henselae serology, were positive to A. felis. Three hundred and eighty-six patients received alternative diagnoses. One hundred and twenty-five serum samples from control subjects were negative by IFA for either B. henselae or A. felis. Moreover, a cross-reactivity with sera from patients affected by other diseases was not observed. Our study shows that the ascertained cases of CSD are etiologically determined by B. henselae, IFA assay is confirmed as a useful tool in the laboratory diagnosis and, over a 5 years period of study, the incidence of CSD in Italy has been low.
Adolescent↗
Regional lymphadenopathy in cat-scratch disease: ultrasonographic findings.
BACKGROUND: Cat-scratch disease (CSD) is considered to be an emerging disease worldwide and is caused by Bartonella henselae, a gram-negative bacterium introduced by a scratch or bite of a cat. The most common clinical manifestation is regional lymphadenopathy, but clinical recognition may be difficult, as atypical manifestations may occur. The diagnosis is confirmed with serologic testing and histology is rarely needed. This paper is based on our experience with the use of ultrasonography in the diagnosis of CSD. OBJECTIVE: The aim of this study was to describe the sonographic and color Doppler appearances of regional lymphadenopathy in CSD, as this has not widely reported in the literature. MATERIALS AND METHODS: Forty-seven patients (average 9.4 years) were included who all had serologically and/or histologically proven CSD and had been studied using US early in the clinical course. All had a positive history of exposure to cats and exhibited regional lymphadenopathy. RESULTS: US showed large hypoechoic adenopathy with some transmission enhancement and high vascularization on color-flow Doppler imaging. In 30 patients, abdominal US was also performed and splenic and/or hepatic granulomata were found in 10. CONCLUSIONS: In our experience, sonography and especially color-Doppler and power-Doppler sonography was helpful in the diagnosis of CSD. We believe it should be used in the initial study of children with regional lymphadenopathy, and serologic testing should be performed when CSD is suspected.
Adolescent↗
Cat scratch disease (CSD) in patients with stellate neuroretinitis: 3 cases.
This case series describes three patients with a similar clinical picture: unilateral abrupt visual loss, optic nerve edema, and a macular star exudate. In all cases we found significant antibody titers to Bartonella henselae, the causative agent of cat scratch disease. Cat scratch disease seems to be the most common cause of stellate neuroretinitis, formerly known as Leber's idiopathic stellate retinopathy. A review of the pertinent literature shows that serologic evidence of B. henselae is sufficient to confirm the diagnosis given the low incidence of significant titers in the general population. Cat scratch disease is usually a self limiting disorder in immunocompetent patients, but treatment with doxycycline is recommended.
Adult↗
[Cat scratch disease. Atypical forms].
First described by Robert Debré in 1950, cat scratch disease, usually observed in children and young adults (80% of the case occur in subjects under 18), is the principal cause of chronic benign lymph node enlargement. The Centers for Disease Control at Atlanta currently recognize Afipia felis and Rochalimaea henselae as the causal agents of cat scratch disease. Cats transmit the disease to humans by skin scratches or by licking open wounds. The bacilli can also be transmitted by dogs, monkeys, squirels or inert objects. The contaminating cats are usually young. There is no interhuman transmission. There are several uncommon manifestations of cat scratch disease which may misguide diagnosis. In atypical forms, the positive diagnosis of this benign disease can only be confirmed by serology or molecular biology techniques. In order to reduce the duration of the disease, antibiotic treatment is recommended in forms with systemic involvement and in atypical forms although there has been no proof of efficacy.
Cat-Scratch Disease↗
Autoimmune thyroiditis--spontaneous disease models--cat.
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Animals↗
Cat scratch disease due to Bartonella henselae serotype Marseille (Swiss cat) in a seronegative patient.
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Abscess↗
[Spontaneous paralytic disease in cats during an epidemic of poliomyelitis].
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Cat Diseases↗
[Reactive arthritis after cat bit: a rare manifestation of cat scratch disease--case report and overview].
Cat scratch disease (CSD) is a rarely recognized infectious disease in Germany. Only a few years ago the causative agent, Bartonella henselae, could be isolated. The typical clinical manifestations of CSD consist of skin changes at the inoculation site and a benign lymphadenopathy; other manifestations are rare. We report the case of a 47 year old woman, who developed a reactive spondylarthropathy with synovitis of finger joints, polyarthralgias of large- and medium-sized joints, and inflammatory spinal pain after a cat bite. The rheumatic manifestations resolved after 10 months by treatment with non-steroidal antirheumatic drugs. Only a few cases of rheumatic manifestations associated with CSD have been described in the literature. Because the prevalence of Bartonella henselae infection of cats is high in Europe, rheumatic manifestations might be more frequent. Diagnosis of CSD is now improved by the development of serological tests. We provide an overview of the clinical manifestations and the diagnostic criteria.
Animals↗
Cat scratch disease: magnetic resonance imaging findings.
Cat scratch disease is an infectious lymphadenitis frequently occurring in children and adolescents. We present the magnetic resonance imaging findings of two patients with this disease. In both cases, lymphadenopathy was characterized by extensive stranding of the surrounding soft tissues, consistent with the inflammatory nature of this condition. Magnetic resonance imaging can be diagnostic and may obviate the need for invasive means of evaluation in patients suspected of having cat scratch disease.
Adult↗
[Three children with systemic cat scratch disease].
Three girls with systemic cat scratch disease, aged 10, 13 and 9 years, were reported. They presented a prolonged fever and back pain in the early stage of the disease, and had no regional lymphadenopathy. Two of them had hepatosplenic granulomas, one with multiple 5 mm hypoechoic lesions in the liver and spleen, and the other with a single 2.5 cm hypodense lesion in the left hepatic lobe. The latter patient underwent a partial left hepatic lobectomy. All patients had elevated titers of antibodies to Bartonella henselae. Polymerase chain reaction detected B. henselae DNA in tissue specimens of the patient who underwent a hepatic lobectomy. Cat scratch disease should be recognized as a cause of fever of unknown origin because the prevalence of B henselae infection might be higher in Japan.
Adolescent↗
Recent Advances in Diagnosis and Treatment of Cat Scratch Disease.
The cause of cat scratch disease (CSD), first described in France in 1950 and in the United States in 1951, was unknown until 1983 when the bacterium in lymph nodes was detected using a Warthin-Starry silver stain. Afipia felis has been an infrequent cause of CSD since1988, when this gram-negative bacterium was first isolated from 10 patients with CSD. In 1992 Bartonella organisms were isolated from immunocompetent and immunocompromised patients. An indirect fluorescent antibody test to detect bartonella-specific serum immunoglobulins was developed in 1992. Since then multiple studies have shown that three Bartonella species may produce either CSD in humans, usually Bartonella henselae or Bartonella clarridgeiae, or bacteremia in healthy cats. Also, these two bacteria and Bartonella quintana cause bacillary angiomatosis, bacillary peliosis, or relapsing bacteremia in humans. Cats are healthy carriers of Bartonella organisms and may be bacteremic for months to years. Cat-to-cat transmission of Bartonella organisms involves the cat flea in absence of direct contact transmission. CSD is the most common cause of regional lymphadenitis in children and adolescents. Present knowledge on the etiology, clinical features, epidemiology, pathogenesis, diagnosis, and management of CSD are presented. Also, brief comments about the etiology, clinical presentation, and treatment of bacillary angiomatosis and bacillary peliosis are provided.
Journal Article↗
Submacular exudates with serous retinal detachment caused by cat scratch disease.
PURPOSE: To present submacular exudates as a manifestation of cat scratch disease. METHODS: Report of two cases. RESULTS: The first patient, a 34-year-old man, developed submacular exudates with serous retinal detachment ten days after having axillary lymphadenopathy and fever. The second patient, a 30-year-old woman, developed submacular exudates with serous retinal detachment mimicking central serous chorioretinopathy. Fluorescein angiography revealed late staining of the subretinal lesions in both cases. The lesion resolved spontaneously in the first patient, while sulfamethoxazole and trimethoprim was required for the second patient. Both patients had a positive IgG titer for Bartonella henselae. CONCLUSIONS: Submacular exudates with serous retinal detachment can occur in cat scratch disease. Cat scratch disease should be included in the differential diagnosis of submacular exudates with central serous chorioretinopathy.
Adult↗