Manifestations Of Cat Scratch Disease Research Articles

Lymphoadenopathies caused by Bartonella henselae

Bartonella henselae is the causative agent of cat scratch disease, the main manifestation of which is lymphadenopathy, but it can manifest as bacillary angiomatosis, injury to internal organs, joints, eyes, heart, kidneys. This disease is often encountered in the practical work of doctors, especially with an atypical form of the course, which occurs in 20% of adult patients. Often the disease is undiagnosed, mimicking lymphadenopathies caused by tumors of soft tissues and bones or other bacterial pathogens. The purpose of the work was to analyze clinical cases of cat scratch disease by the results of inpatient records data based on the leading clinical symptom – lymphadenitis, to summarize literature data related to morbidity, features of the clinical course and treatment of this disease. The description of two clinical cases of cat scratch disease in adult women aged 19 and 59 is given. The typical course of the disease in one of them at the beginning of the disease, was manifested by symptoms of general intoxication, fever, an increase in lymph nodes in the neck and axillary area, which coincided in time with the previously diagnosed bacterial angina. The diagnostic search ended with the set diagnosis and surgical operation three months after the onset of clinical manifes¬tations of the disease. In the second case, a subfebrile body temperature, a painful lymph node in the right axillary area for 3 weeks, were the reason to perform an invasive surgery twice, diagnosed as a bacterial process of unknown etiology. The reasons for late diagnosis and treatment of cat scratch disease in our patients were insufficient collection of epi¬demiological anamnesis, lack of vigilance of doctors, first of all, surgeons, regarding the clinical manifestations of the disease and late examination to find out the etiological factor of the disease. An elevated titer of IgM antibodies to Bartonella henselae 1:160 and 1:140 in two cases was the basis for confirming cat scratch disease. Based on the results of the literature analysis, an overview of typical and atypical manifestations of cat scratch disease, its diagnosis and treat¬ment is presented. Bartonella henselae infection should be considered in all cases of lymphadenitis of unknown etiology, accompanied by high temperature, intoxication syndrome and a long course. In order to prevent the development of purulent complications and to avoid unreasonable invasive procedures, it is important to make a timely diagnosis and carry out appropriate antibacterial treatment at the initial stage of the manifestation of clinical symptoms of cat scratch disease.

A clinical case of the development of a rare manifestation of cat scratch disease

Introduction. Cat scratch disease is a common infectious disease caused by intracellular microorganisms Bartonella henselae, which are widespread among wild and domestic animals. The aim of study was to demonstrate a rare clinical case of chorioretinitis against the background of a 10-year-old child’s bartonellosis. Materials and methods. A 10-year-old child received with complaints about a significant decrease of vision and lowering of the upper eyelid of the left eye. The disease began with increase in temperature to 37.5 °C, abdominal pain. Three days later, these ophthalmic complaints appeared. After examining a paediatric ophthalmologist, neurologist and conducting an additional instrumental survey, the patient was hospitalised in an ophthalmological hospital. When acuity of vision of the left eye was 0.02 n/a, the upper eyelid was lowered. On the fundus there was a pronounced extensive edema of the optic nerve disc (OND) with prominance, from OND to the macular zone there was an extensive high retinal swelling. The department conducted a standard clinical examination, blood test for chronic infections, examination of visual evoked potentials and other instrumental examinations. From the first day, local and general antibacterial and anti-inflammatory treatment was carried out. Results and Discussion. Positive dynamics has been observed since the fourth day of treatment, but the visual acuity of the left eye has not improved. On the eighth day, the patient was discharged for subsequent hospitalisation at the Federal State Budgetary Institution NMRC of Eye Diseases named after Helmholtz, in which he was examined for bartonellosis and identified IgG to Bartonella henselae 1:160. Final clinical diagnosed: Left eye neuroretinitis associated with bartonellosis. On the fourteenth day after treatment, the patient was discharged - the left eye was almost calm, visual acuity was 0.06. In this clinical case, a rare manifestation of cat scratches disease is described. Due to the late visit to an ophthalmologist and the late start of medical treatment, it was not possible to fully restore the vision of the left eye. Conclusion. In most cases, it takes a lot of time to make a diagnosis, and specific treatment begins late, in connection with which it is necessary to draw attention to this problem of doctors of different directions. It should also be remembered that any atypical manifestation of the disease serves as a reason to exclude rickettsiosis, including bartonellosis.

The Clinical Profile of Cat-Scratch Disease's Neuro-Ophthalmological Effects.

Cat-scratch disease is an illness caused by Bartonella henselae that occurs as a result of contact with an infected kitten or dog, such as a bite or scratch. It is more prevalent in children and young adults, as well as immunocompromised individuals. There are limited publications examining the features of CSD in patients. As such, the purpose of this research was to assess the clinical neuro-ophthalmological consequences of CSD reported in the literature. Among the ophthalmologic disorders caused by cat-scratch disease in humans, Parinaud oculoglandular syndrome, uveitis, vitritis, retinitis, retinochoroiditis and optic neuritis are the most prevalent. The neurological disorders caused by cat-scratch disease in humans include encephalopathy, transverse myelitis, radiculitis, and cerebellar ataxia. The current review addresses the neuro-ophthalmological clinical manifestations of cat-scratch disease, as described in papers published over the last four decades (1980–2022). All the data gathered were obtained from PubMed, Medline and Google Scholar. The current descriptive review summarizes the most-often-encountered clinical symptomatology in instances of cat-scratch disease with neurological and ocular invasion. Thus, the purpose of this review is to increase knowledge of cat-scratch disease’s neuro-ophthalmological manifestations.

Eritema nodoso: gatta ci cova

Erythema nodosum is a panniculitis that can be triggered by many different stimuli. The paper describes the case of a child who presented with erythema nodosum as the unique clinical manifestation of cat scratch disease. Bartonella henselae infection usually presents with non-tender papule in the scratch line followed by subsequent onset of regional lymphadenopathy eventually associated with systemic symptoms. It can also present with atypical manifestation, such as erythema nodosum. The heterogeneity of the clinical presentations makes the disease to be underdiagnosed, whereby it is important to recognize atypical manifestations. Therefore, it is recommended to include Bartonella henselae serology in the diagnostic evaluation of erythema nodosum.

Ophthalmic manifestations of cat scratch disease

: Cat scratch disease (CSD) is a worldwide distributed zoonosis caused by Bartonella henselae and other Bartonella spp. The reservoirs of Bartonella are domestic animals, especially cats, and the transmission to humans is thought to occur from a cat scratch or even through the cat flea Ctenocephalides felix. With more and more pet owners, the physicians should keep in mind signs and symptoms of CSD. A widespread infection may occur in 5–14% of cases, and ocular involvement, called ocular bartonellosis, is a quite common consequence of disseminated CSD. Although the most typical manifestations of ocular Bartonellosis are Parinaud’s oculoglandular syndrome, neuroretinitis and retinochoroiditis, many other ophthalmic conditions have been reported. The diagnosis of CSD is often based on history of contact with a cat and high serum titers of immunoglobulin G antibodies against B. henselae. Polymerase chain reaction could be helpful for CSD diagnosis when serology is negative but clinical findings are suggestive for the disease. Multimodal imaging, including fundus autofluorescence, fluorescein and indocyanine green angiography, optical coherence tomography (OCT) and OCT angiography, can be used for diagnosis and monitoring of ocular Bartonellosis. Since CSD is more often a self-limited infection in immunocompetent individuals, no antibiotic treatment is usually needed. However, when a therapy is prescribed, doxycycline is the most used antibiotic. The aim of this article is to review the current literature relating to epidemiology, systemic and ocular manifestations, diagnosis, treatment and prognosis of bartonellosis, in order to give the ophthalmologists a useful tool for daily practice.

Cat scratch disease

Cat scratch disease is a usually harmless infectious disease caused by Bartonella henselae bacteria. These bacteria are transmitted to humans by a cat scratch or bite. Its typical presentation is a self-limiting lymphadenitis of regional lymph nodes, mostly in the neck. The disease is especially prevalent in children and young adults. Cat scratch disease can be associated with fever, headaches, and malaise, sometimes present itself atypically and in only a few cases expand as a disseminated disease. A swelling in the neck can be caused by many different disorders. In patients with lymphadenitis in the neck and a cat scratch or bite in their recent history, the probable diagnosis cat scratch disease can be made on the basis of clinical findings. Diagnostic testing should be performed when required. For patients with a typical manifestation of cat scratch disease, a wait-and-see policy can be considered. For patients with atypical manifestations, further diagnostic testing and treatment with antibiotics are recommended.

Œil et maladie des griffes du chat : à propos de 7 cas

Cat scratch disease is a pleiomorphic condition, sometimes with isolated ophthalmic involvement. We report the clinical observations of seven cases with ophthalmologic manifestations of cat scratch disease. There were seven patients, with a median age of 52 years, of whom five were women and three had unilateral involvement. Six exhibited Leber's stellate neuroretinitis, an incomplete syndrome in two cases, and one associated with chorioretinal foci. One patient had isolated retinal infiltrates. The diagnosis of cat scratch disease was confirmed by Bartonella henselae serology, positive in all cases. All patients received treatment with doxycycline. Ocular complications (with optic atrophy and macular retinal pigment epithelial changes) were noted in five cases. Ocular bartonellosis is an atypical clinical form. It requires a directed ancillary work-up with serology or PCR, which has the peculiarity of being highly specific if not very sensitive. Treatment is above all preventive. Antibiotics may be initiated. Cat scratch disease must be excluded in the work-up of posterior uveitis.

Parinaud Oculoglandular Syndrome 2015: Review of the Literature and Update on Diagnosis and Management

Parinaud oculoglandular syndrome (POGS) is an ocular granulomatous inflammatory condition characterized by unilateral follicular bulbar or palpebral conjunctivitis. Although POGS often presents as an atypical manifestation of cat scratch disease (CSD), other infectious and autoimmune etiologies have been described. Due to the rare nature of this ocular syndrome and scarcity of literature on this topic, POGS is often missed on the initial diagnostic workup. Here, we provide a brief description of disease process, and present a review of the literature on POGS in the past two decades to understand the trends in etiology of disease. Based on the results of this review, we also suggest an algorithm for diagnosis and management of POGS.

Neuroretinitis in ocular bartonellosis: a case series.

We report a case series of neuroretinitis in ocular bartonellosis and describe the serologic verification for Bartonella henselae. This is a retrospective interventional case series of four patients who presented in the ophthalmology clinic of Hospital Universiti Sains Malaysia from June 2012 to March 2013. All four patients had a history of contact with cats and had fever prior to ocular symptoms. Each patient presented with neuroretinitis characterized by optic disc swelling with macular star. Serology analysis showed strongly positive for B. henselae in all of the patients. All patients were treated with oral azithromycin (except case 4, who was treated with oral doxycycline), and two patients (case 1 and case 3) had poor vision at initial presentation that warranted the use of oral prednisolone. All patients showed a good visual outcome except case 3. Vision-threatening ocular manifestation of cat scratch disease can be improved with systemic antibiotics and steroids.

Visceral Cat Scratch Disease with Endocarditis in an Immunocompetent Adult: A Case Report and Review of the Literature

Infective endocarditis and hepatosplenic abscesses are rare manifestations of cat scratch disease (CSD), especially among immunocompetent adults. An otherwise healthy woman who presented with fever and abdominal pain was diagnosed with multiple abscesses in the spleen and the liver, as well as a mitral valve vegetation. PCR on spleen tissue was positive for Bartonella henselae. Prolonged treatment with doxycycline and gentamicin led to complete recovery. Review of the literature revealed 18 cases of hepatosplenic CSD in immunocompetent adults; the majority presented with fever of unknown origin and abdominal pain. In most cases the causative organism was B. henselae and the pathological findings were necrotizing granulomas, similar to the pathological features in classic CSD. Concomitant endocarditis was diagnosed in one case. Because Bartonella is one of the leading pathogens of culture-negative endocarditis, we raise the question of whether a comprehensive evaluation for endocarditis is needed in cases of systemic CSD.

Central scotoma without prodromal illness caused by Bartonella henselae neuroretinitis

This case report describes Bartonella henselae neuroretinitis in a 26-year-old woman who presented to the emergency department with unilateral central scotoma and no prodromal symptoms, a unique presentation of this disease. B henselae, a gram-negative bacteria, is the cause of cat scratch disease. Cat scratch disease (CSD) is a self-limiting illness, which typically presents with regional lymphadenopathy, fever, and small skin lesions in associationwith a cat scratch or bite. The mostcommon ocular manifestations of cat scratch disease are Parinaud oculoglandular syndrome and neuroretinitis. All prior reported cases of CSD neuroretinitis presented with prodromal symptoms, not vision loss alone.

Cat Scratch Disease During Pregnancy

To describe the pregnancy outcome, including long-term follow-up of the offspring, of pregnant women with cat scratch disease. A surveillance study performed over 19 years identified eight pregnant women with cat scratch disease. A case of cat scratch disease was defined as a patient with a history of cat contact with regional lymphadenitis, other manifestations, or a combination of these consistent with the disease and one or more confirmatory laboratory tests. The clinical and laboratory manifestations and pregnancy outcome of all women diagnosed with cat scratch disease during pregnancy are described. Five of the eight pregnant women had typical disease with regional lymphadenitis; two had regional lymphadenitis with arthralgia, myalgia, and erythema nodosum; and one had neuroretinitis. Delayed diagnosis was common, although all women had a history of recent cat exposure. One woman who presented with clinical cat scratch disease during the first month of pregnancy had a spontaneous abortion. Another elected to terminate the pregnancy because of concerns related to radiation associated with abdominal computed tomography scan performed as part of an evaluation for suspected malignancy. The other six women gave birth to healthy newborns without congenital anomalies. No sequelae were recorded in mothers or children during a median follow-up of 4.5 years (range 0.5-9.5 years). With the exception of one early spontaneous abortion in which causality to cat scratch disease could not be established, neither deleterious effects of cat scratch disease on newborns nor reports of long-term sequelae were found. Physicians, especially family physicians and obstetrician-gynecologists need to be more familiar with the clinical manifestations of cat scratch disease. Close monitoring of infected women during pregnancy is advisable until more data are available to determine the optimal diagnostic and therapeutic approach.

Unusual retinal manifestations of cat scratch disease

We report on 2 patients with unusual retinal manifestations of cat scratch disease (CSD), caused by Bartonella henselae. Case 1. A 42-year-old farmer presented with a 5-day history of blurred vision in his right eye. Right visual acuity was 20/25. Fundus examination of the right eye revealed mild vitreous hemorrhage and diffuse retinal hemorrhages in the mid-peripheral retina. Fluorescein angiography showed multiple vasculitic occlusions in the same area. A blood sample taken on the day of examination revealed the presence of immunoglobulin (Ig)M and IgG to B. henselae. Oral azithromycin was given for 8 days. One month later, right visual acuity was 20/20, the vitreous and retinal hemorrhages resolved, and arteriolar attenuation and sclerosis was observed in the peripheral temporal retina. Case 2. A 66-year-old craftsman with systemic hypertension and hypercholesterolemia complained of sudden visual loss (light perception) in his left eye. Fundus evaluation and fluorescein angiography revealed central retinal artery occlusion (CRAO) in the affected eye. About 2 weeks earlier, he had been bitten and scratched on his right hand by a stray cat. Serologic testing detected the presence of IgM to B. henselae. Oral azithromycin was given for 6 days. One month later, left visual acuity was hand motion. Ophthalmologists should be aware that unusual ocular complications associated with CSD include vitreous hemorrhage with retinal vasculitis and isolated CRAO. Vitreous hemorrhage and retinal vasculitis may be the only clinical manifestation of CSD.

Serous labyrinthitis as a manifestation of cat scratch disease: a case report

IntroductionCat scratch disease is an infectious disease transmitted by young cats, in which the principal causative factor is Bartonella henselae. The typical course of cat scratch disease is usually benign and self-limited and requires only supportive therapy. However, cases lasting up to 2 years have been reported, and more serious complications may occur. Many manifestations of the disease have been reported by different medical disciplines.Case presentationA case of cat scratch disease in a 71-year-old Greek woman with an unusual clinical course is presented here. Serous otitis media was combined with rotational vertigo due to labyrinthitis. The invaded ear was ipsilateral to the inoculation site.ConclusionCervicofacial lymphadenopathy has been demonstrated as the most common otolaryngologic manifestation of cat scratch disease. Manifestation in the middle and inner ear has, to the best of our knowledge, not been reported before. Our report presents a patient with cat scratch disease with clinical signs and symptoms in the middle and inner ear.

Atypical Bartonella hensalae Chorioretinitis in an Immunocompromised Patient

Purpose: To report an atypical case of chorioretinopathy in a patient with bilateral renal transplantations. Methods: A 55-year-old female was referred for management of birdshot chorioretinopathy. Ophthalmologic examination revealed bilateral yellowish, chorioretinal lesions with adjacent hemorrhages. Results: Angiography demonstrated lesions with hyperfluorescence, leakage, and diffuse macular edema. OCT showed intraretinal edema. Laboratory evaluation revealed IgG antibodies for Bartonella hensalae. Treatment with oral ciprofloxacin led to regression of lesions, resolution of macular edema, and improvement in visual acuity. Conclusion: Multifocal chorioretinal lesions associated with B. hensalae can be atypical ophthalmic manifestations of cat-scratch disease (CSD), which may occur in immunosuppressed patients. Recognition of underlying disease and appropriate therapy can lead to improved outcomes.

Bartonella henselae Infection Presenting as a Unilateral Acute Maculopathy

The purpose of this article is to report an unusual ocular manifestation of cat scratch disease (CSD) presenting as a unilateral acute maculopathy (UAM). We describe and review the clinical, laboratory, fluorescein angiography (FA), indocyanine green angiography (ICG) and optical coherence tomography (OCT) records of a patient with CSD. A 30-year-old Chinese woman presented with a painless progressive visual loss affecting her left eye. Fundus examination of the left eye disclosed rare vitreous cells and a deep-creamy choroidal macular lesion with satellite foci of choroiditis. FA revealed an early hypofluorescence of the lesion, becoming progressively hyperfluorescent with a leakage on the late phase. The ICG disclosed an early hypofluorescence of the macular lesion with a mild staining of its periphery on the late frames. Hypofluorescent satellite lesions were visible both on the early and late frames. The OCT disclosed a serous retinal detachment at the level of the whitish lesion. Serologies for Bartonella henselae (BH) became positive (IgG 1: 512, IgM < 1:20) confirming an active or recent infection. Ocular manifestations of CSD can appear as a UAM with satellite lesions. CSD should be ruled out in patients manifesting such clinical features.

Desprendimiento seroso de mácula como manifestación atípica en la enfermedad del arañazo del gato

A 58-year-old woman presented with 0.1 visual acuity in the left eye associated with a serous retinal detachment of the macula as the only ocular manifestation of cat scratch disease. This diagnosis was made by serum antibody titers and the clinical course. Although uncommon, cat scratch disease should be considered in patients with a serous detachment in the macula region of the retina.

Isolated Hepatic Involvement of Cat Scratch Disease in Immunocompetent Adults

Visceral involvement in absence of lymphadenopathy is a rare manifestation in cat scratch disease; hepatic granulomas are rare, representing 0.3% of systemic manifestations of cat scratch disease, and gallbladder extension is a singular case. The present article refers to 2 rare cases of visceral cat scratch disease in immunocompetent adults with hepatic granulomatous inflammation, caused by Bartonella henselae infection, with gallbladder involvement in 1 case and no lymphadenopathy. Histological features demonstrated the presence of inflammatory necrotizing granulomatous nonneoplastic process. Molecular studies (polymerase chain reaction) were performed to confirm the infectious etiology.

Multifocal osteomyelitis in a child: a rare manifestation of cat scratch disease

We present a case of a 9-year-old immunocompetent girl who presented with pain in her left elbow and a painful swelling at her left clavicle. She had no lymphadenopathy or fever. Four hot spots were seen at her left clavicle, proximal and distal left humerus and lumbo-sacral spine on a bone scan. A magnetic resonance imaging showed an inflammatory process with bone destruction at her clavicle. Serological testing and polymerase chain reaction performed on a bone biopsy identified a Bartonella henselae infection. She was treated with rifampin and trimethoprim-sulphamethoxazole. After a relapse half a year later, the patient recovered fully. Multifocal osteomyelitis is a rare manifestation of cat scratch disease in children.

Analysis of data in 30 patients with cat scratch disease without lymphadenopathy

The prominent clinical manifestation of cat scratch disease is regional lymphadenopathy at the site of the cat scratch or bite, associated with fever or general symptoms. A serological study of 540 patients with either lymphadenopathy, persistent fever, or pet ownership disclosed that 30 (16.1%) of the 186 patients with a serological diagnosis of cat scratch disease had no regional lymphadenopathy, and in these 30 patients, the absence of lymphadenopathy was closely related to the presence of persistent fever, fever of unknown origin, or systemic complications. Physicians should be alert to cat scratch disease that is not associated with lymphadenopathy to enable prompt diagnosis and treatment.