Lymphadenopathies associated with Cat-Scratch Disease in Turkiye

Abstract

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.