THE CAT SCRATCH DISEASE. / LA ENFERMEDAD POR ARAÑAZO DE GATO.

 

The Cat Scratch Disease. !!

La enfermedad por arañazo de gato. !!

 

ACTUALIZADO 2017 - 2024 

   EDITORIAL ENGLISH
===================
Hello friends of the network. DERMAGIC EXPRESS Again with a very interesting topic about pets, in this case the cute kittens. Today's topic THE CAT SCRATCH DISEASE (SCD) Transmitted Zoonotic Disease by the bite or scratches of our pets, cute kittens.

The causal agent of this disease is the Bacteria Bartonella Henselae, according to the scientists more than half of the cats are carriers of the same. The bacterium is transmitted from cat to cat by cat flea Ctenocephalides felis.

 The disease begins as a papule at the site of inoculation. Which is transformed into pustule and later a regional infadenopathy with local symptoms. The disease can heal spontaneously but can give more severe manifestations among which they stand out:

Long-Term Complications of Cat Scratch Disease

Chronic Lymphadenopathy:

In some cases, lymph nodes may remain swollen for months or even years after the initial infection. This can cause discomfort and require medical follow-up.

Disseminated Infections:

In severe cases, Bartonella henselae can spread to other organs, such as the liver, spleen, lungs, and central nervous system. This can result in more serious complications, such as hepatitis or pneumonia.

Ocular Complications:

CSD can cause eye problems, such as retinitis, which can lead to vision loss if not treated properly. This is more common in immunocompromised people. Parinaud's oculoglandular syndrome, neuroretinitis, uveitis.


Neurological Symptoms:

Rarely, the disease can affect the nervous system, causing symptoms such as confusion, seizures, or encephalitis.

Persistent Fatigue:

Some people may experience prolonged fatigue and malaise that persists long after other symptoms have disappeared.

Arthritis:

Although rare, some patients may develop arthritis or joint pain as a result of the infection.

In summary:

 GENERAL: Discomfort. Fever, anorexia, weight loss.
 SKIN: Subcutaneous nodules and abscesses.
 HIGAGO: Granulomatous hepatitis, Hepatomegaly, hepatic abscess.
 BAZO: Splenomegaly, splenic abscesses.
 BRAIN: Encephalitis, meningitis, seizures
 SPINAL CORD: transverse myelitis.
 HEART: Endocarditis.
 BLOOD: Bacteremia
 EYE: Parinaud's oculoglandular syndrome, neuroretinitis, uveitis.

The Bartonella Hanselae also produces another disease called bacillary angiomatosis, which is seen more in immunocompromised patients.

Treatment:

Treatment options for cat scratch disease are:

1.) Local Heat Application:
This measure is recommended in the affected area to relieve pain and inflammation.

2.) Analgesics: to relieve pain and inflammation.

3.) Antibiotics: The literature states that they are not always necessary, but the better way is to administer antibiotics to prevent the spread of infection, and the eligible ones are; azithromycin or doxycycline to help reduce the inflammation of the lymph nodes and shorten the duration of symptoms.

However, its use is controversial and is not considered essential in all cases.

In a study of 268 patients with this pathology, the effectiveness of 4 (four) antibiotics was demonstrated: they were rifampicin 87%, ciprofloxacin 84%, trimethoprim-sulfamethoxazole 58%. Intramuscular gentamicin sulfate was 73% effective.

In cases where lymph node suppuration is present, intranodal injection of gentamicin has been used successfully.

In cases of ocular involvement, topical drops of 0.5% ketorolac twice a day and 0.05% difluprednate four times a day have been used for more than 6 weeks.

4.) In immunosuppressed patients(HIV/AIDS) or autoimmune diseases: treatment should be more aggressive:

Apart from the classic analgesics and local measures (heat), antibiotic therapy should be mandatory: azithromycin, doxycycline, rifampicin or gentamicin, ciprofloxacin, trimethoprim-sulfamethoxazole.

The incidence of CAT SCRATCH DISEASE disease in the United States between 2005 and 2013 in children between 5 and 9 years of age was 9.4 cases per 100,000 population. The most affected age group was 50 to 64 years. About 12.000 new cases are estimated each year, of which 500 are hospitalized.

The best preventive measure, control the flea of ​​the cat and of course avoid the biting or scratches of the cute kittens.


Through these 49 references you will know the disease, its complications and the therapeutic alternatives.
In the attachment, the cat, the child, the initial papule and the posterior lymphadenopathy.

Greetings to all.

Dr. José Lapenta

EDITORIAL ESPAÑOL
==================

Hola amigos de la red. De nuevo el DERMAGIC EXPRESS con un tema bien interesante sobre las mascotas, en este caso los lindos gatitos. El tema de hoy LA ENFERMEDAD POR ARAÑAZO DE GATO. Enfermedad Zoonótica transmitida por la mordedura o arañazos de nuestras mascotas, lindos gatitos. El agente causal de esta enfermedad es la bacteria Bartonella Henselae, según los científicos mas de la mitad de los gatos son portadoras de la misma. La bacteria es transmitida de gato a gato por la pulga del gato Ctenocephalides felis.

La enfermedad comienza como una pápula en el sitio de la inoculación. la cual se transforma en pústula y posteriormente una linfadenopatia regional con síntomas locales. La enfermedad puede sanar espontáneamente pero puede dar manifestaciones mas severas entre las que destacan:

Complicaciones a Largo Plazo de la Enfermedad por Arañazo de Gato

Linfadenopatía Crónica:

En algunos casos, los ganglios linfáticos pueden permanecer inflamados durante meses o incluso años después de la infección inicial. Esto puede causar molestias y requerir seguimiento médico.

Infecciones Diseminadas:

En casos severos, la Bartonella henselae puede diseminarse a otros órganos, como el hígado, el bazo, los pulmones y el sistema nervioso central. Esto puede resultar en complicaciones más graves, como hepatitis o neumonía.

Complicaciones Oculares:

La CSD puede causar problemas oculares, como la retinitis, que puede llevar a la pérdida de visión si no se trata adecuadamente. Esto es más común en personas inmunocomprometidas. Síndrome óculo glandular de Parinaud, neuro retinitis, uveítis.

Síntomas Neurológicos:

En raras ocasiones, la enfermedad puede afectar el sistema nervioso, causando síntomas como confusión, convulsiones o encefalitis.

Fatiga Persistente:

Algunas personas pueden experimentar fatiga prolongada y malestar general que persiste mucho después de que otros síntomas han desaparecido.

Artritis:

Aunque es poco común, algunos pacientes pueden desarrollar artritis o dolor articular como resultado de la infección.
 

Resumiendo:

GENERALES: Malestar. fiebre, anorexia, perdida de peso.
PIEL: Nódulos subcutaneos y abscesos.
HIGAGO: Hepatitis granulomatosa, Hepatomegalia, absceso hepático.
BAZO: Esplenomegalia, abscesos esplénicos.
CEREBRO: Encefalitis, meningitis, convulsiones
MÉDULA ESPINAL: mielitis transversa.
CORAZÓN: Endocarditis.
SANGRE: Bacteriemia
OJO: Síndrome óculo glandular de Parinaud, neuro retinitis, uveítis.

La Bartonella Henselae también produce otra enfermedad denominada angiomatosis bacilar, la cual se observa mas en pacientes inmunocomprometidos.

Tratamiento:

las opciones de tratamiento para la enfermedad por arañazo de gato son:    

1.) Aplicación de Calor Local:
Esta medida se recomienda en la zona afectada para aliviar el dolor y la inflamación.

2.) Analgésicos: para aliviar el dolor e inflamación.

3.) Antibióticos: La literatura refiere que no siempre son necesarios, pero lo ideal es administrar antibióticos para evitar la diseminasion de la infección, y los elegibles son; azitromicina o doxiciclina para ayudar a reducir la inflamación de los ganglios linfáticos y acortar la duración de los síntomas.
Sin embargo, su uso es controvertido y no se considera esencial en todos los casos.

En un estudio de 268 pacientes con esta patología se demostró la efectividad de 4 (cuatro) antibióticos: ellos fueron rifampicina 87%, ciprofloxacino 84%, trimetoprim-sulfametoxazol 58%. El sulfato de gentamicina intramuscular tuvo una eficacia del 73%.

En los casos donde se presenta supuración de los ganglios linfáticos se ha utilizado con éxito la inyección intra-nodal de gentamicina.

En casos de afección ocular se ha utilizado gotas tópicas de ketorolaco al 0,5 % dos veces al día y difluprednato al 0,05 % cuatro veces al día durante más de 6 semanas.

4.) En pacientes inmunodeprimidos (VIH/SIDA) o enfermedades autoinmunes el tratamiento debe ser mas agresivo:

Aparte de los clásicos analgésicos y medidas locales (calor), la antibiótico terapia debe ser obligatoria: azitromicina, doxiciclina, rifampicina o gentamicina, ciprofloxacino, trimetoprim-sulfametoxazol.

La incidencia de la enfermedad por ARAÑAZO DE GATO EN los Estados Unidos entre 2.005 y 2.013 en niños entre 5 y 9 años de edad fue de 9,4 casos por 100.000 habitantes. El grupo etario mas afectados fue de 50 a 64 años. Se estiman unos 12.000 casos nuevos al año, de los cuales 500 son hospitalizados.
 
la mejor medida preventiva, controlar la pulga del gato y por supuesto evitar la mordedura o arañazos de los lindos gatitos.

A través de estas 49 referencias conocerás la enfermedad, sus complicaciones y las alternativas terapéuticas.

En el adjunto, el gato, el niño, la pápula inicial y la posterior linfadenopatia.

Saludos a todos,,,

 Dr. José Lapenta R.,,,
 

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REFERENCIAS BIBLIOGRÁFICAS / BIBLIOGRAPHICAL REFERENCES
======================================================================
1.) The Cat-Scratch Disease.
2.) Cat scratch disease: detection of Bartonella henselae DNA in archival
biopsies from patients with clinically, serologically, and histologically
defined disease.
3.) [A case of cat scratch disease identified by an elevated Bartonella
henselae antibody level using enzyme immunoassay]
4.) Will the real agent of cat-scratch disease please stand up?
5.) [Cat scratch disease caused by Bartonella henselae]
6.) Hypercalcemia due to endogenous overproduction of active vitamin D in
identical twins with cat-scratch disease.
7.) Cat-scratch disease caused by Bartonella henselae: the first case
report in Taiwan.
8.) [Cat-scratch disease and other infections caused by Bartonella species]
9.) Bartonella spp. as emerging human pathogens.
10.) [Bartonella henselae infection in immunocompetent patients: cat
scratch disease]
11.) Cat-scratch disease and related clinical syndromes.
12.) Cat-scratch disease and bacillary angiomatosis.
13.) Detection of antibodies to Bartonella henselae in clinically diagnosed
cat scratch disease.
14.) The expanding spectrum of Bartonella infections: II. Cat-scratch disease.
15.) Evaluation of serological response to Bartonella henselae, Bartonella
quintana and
Afipia felis antigens in 64 patients with suspected cat-scratch disease.
16.) [Cat scratch disease and associated infections]
17.) Cat-scratch disease simulating Histiocytosis X.
18.) [Atypical cat-scratch disease: a case report of splenic granulomatosis]
19.) [2 patients with atypical manifestations of cat-scratch disease]
20.) [Visceral localizations of cat-scratch disease in an immunocompetent
patient]
21.) Serous retinal detachment of the macula associated with cat scratch
disease.
22.) Cat scratch disease in Greece.
23.) Cat-scratch disease--an overlooked disease in Denmark?]
24.) Prolonged Bartonella bacteremia in cats associated with cat-scratch
disease patients.
25.) Application of polymerase chain reaction assay in the diagnosis of
orbital granuloma complicating atypical oculoglandular cat scratch disease.
26.) Systemic cat scratch disease: hepatic and splenic involvement about 3
pediatric cases.
27.) Bartonella clarridgeiae, a newly recognized zoonotic pathogen causing
inoculation papules, fever, and lymphadenopathy (cat scratch disease).
28.) Coinfection with Bartonella clarridgeiae and Bartonella henselae and
with different Bartonella henselae strains in domestic cats.
29.) [Cat-scratch disease: historical, clinical, phylogenetic and taxonomic
aspects]
30.) Molecular diagnosis of cat scratch disease: a two-step approach.
31.) Antibiotic therapy for cat-scratch disease: clinical study of
therapeutic outcome in 268 patients and a review of the literature.
32.) Successful treatment of cat-scratch disease with ciprofloxacin [see
comment 33.) Diverse Clinical Signs of Ocular Involvement in Cat Scratch Disease.
34.) Cat Scratch Disease: Expanded Spectrum.
35.) Dynamics of Co-Infection with Bartonella henselae Genotypes I and II in Naturally Infected Cats: Implications for Feline Vaccine Development.
36.)Bacillary angiomatosis with bone invasion.
37.) Molecular epidemiology of bartonella infections in patients with bacillary angiomatosis-peliosis.
38.) Corticosteroid Treatment for Prolonged Fever in Hepatosplenic Cat-Scratch Disease.
39.) Final Diagnosis in Patients Referred with a Diagnosis of Neuroretinitis.
40.) Disseminated cat-scratch disease: case report and review of the literature.
41.) Multiple Renal and Splenic Lesions in Cat Scratch Disease.
42.) Cat-Scratch Disease in the United States, 2005-2013. 43.) Cat fleas (Ctenocephalides felis) from cats and dogs in New Zealand: Molecular characterisation, presence of Rickettsia felis and Bartonella clarridgeiae and comparison with Australia.

44.) Effectiveness of Antibiotic Therapy in Pediatric Patients With Cat Scratch Disease.
45.) Cat-Scratch Disease.
46.) Antibiotic Therapy for Cat-Scratch Disease: Clinical Study of Therapeutic Outcome in 268 Patients and a Review of the Literature.
47.) Hepatosplenic Cat-Scratch Disease in Children: Selected Clinical Features and Treatment.
48.) Intra-Nodal Injection of Gentamicin for the Treatment of Suppurated Cat Scratch Disease's Lymphadenitis.
49) Case Report: Treatment of Severe Neuroretinitis and Other Sequelae Associated With Cat Scratch Disease.

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1.) The Cat-Scratch Disease
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Source: Harrison's 14
DEFINITION AND ETIOLOGY
Typical CSD is manifested by painful regional lymphadenopathy persisting
for several weeks or months after a cat scratch. Occasionally, infection
may disseminate and produce more generalized lymphadenopathy and systemic
manifestations, which may be confused with the manifestations of lymphoma.
B. henselae is the causative agent of CSD. There is no evidence that B.
quintana or Afipia felis (originally proposed as the agent of CSD) can
cause this disease, nor are those two species carried by cats.
EPIDEMIOLOGY
Approximately 60 percent of cases of CSD in the United States occur in
children. Exposure to bacteremic young cats that either are flea-infested
or have been in contact with another cat carrying fleas poses a significant
risk of infection. Most infections are caused by a scratch and only rare
cases by a bite or by licking. Most cases occur in the warmer months, when
fleas are active. Regions of the United States where fleas are endemic have
higher rates of infection. The flea may serve to transmit infection between
cats; it is not known whether humans can be infected through the bite of an
infected flea.
CLINICAL MANIFESTATIONS
A localized papule (Fig. 165-CD3), progressing to a pustule that often
crusts over, develops 3 to 5 days after a cat scratch. Tender regional
lymphadenopathy (Fig. 165-CD4) develops within 1 to 2 weeks after
inoculation; by this time, the papule may have healed spontaneously.
Scratches are most often sustained on the hands or face, producing
epitrochlear, axillary, pectoral, and cervical lymph node involvement. The
involved nodes occasionally become suppurative; bacterial superinfection
with staphylococci or other cutaneous pathogens may develop. Although most
patients do not have fever, systemic symptoms are frequent and include
malaise, anorexia, and weight loss. Without treatment, lymphadenopathy
persists for weeks or even months and may be confused with lymphatic
malignancy. Other manifestations in apparently immunocompetent patients
include encephalitis, seizures and coma (especially in children),
meningitis, transverse myelitis, granulomatous hepatitis and splenitis,
osteomyelitis, and disseminated infection. Conjunctival inoculation may
cause Parinaud's oculoglandular syndrome, with conjunctivitis and
preauricular lymphadenopathy.
PATHOLOGY
The histopathologic hallmark of CSD is granulomatous inflammation with
stellate necrosis but no evidence of angiogenesis. Thus, infection by B.
henselae can produce two entirely different pathologic reactions, depending
on the immune status of the host: CSD or bacillary angiomatosis.
DIAGNOSIS
CSD should be suspected if the patient has a history of exposure to cats
and develops lymphadenopathy and a skin lesion. The diagnosis can be
confirmed by pathologic examination of the involved nodes. Tiny bacilli in
clusters can sometimes be seen in biopsy samples stained with
Warthin-Starry silver. The CSD skin test, in which lymph node material
obtained from patients with CSD serves as an antigen, is no longer used for
diagnosis because of concerns about the transmission of viral agents. A
specific serologic test has been developed recently and may produce a
positive result in 70 to 90 percent of patients with intact immunity. The
identification of B. henselae 16S ribosomal RNA genes in biopsy material by
PCR amplification with specific oligonucleotide primers can also be
diagnostically useful; however, these methods are not yet commercially
available. Cultures of lymph nodes, cerebrospinal fluid, or other tissues
are rarely positive.
TREATMENT
Although CSD is generally self-limited, tender regional lymphadenopathy and
systemic symptoms may be debilitating. Patients with encephalitis or other
serious manifestations should be treated with antibiotics, even though the
efficacy of such therapy is unclear. No comparative trials of antibiotic
treatment have been performed, and no anecdotal reports of treatment
failures have appeared. Several reports suggest that aminoglycoside
treatment (e.g., intravenous gentamicin at standard doses calculated to
result in therapeutic levels) is effective in patients with encephalitis
and other systemic infections. The oral agents that appear to be useful are
those that also are most effective for the treatment of bacillary
angiomatosis; they include ciprofloxacin, doxycycline, and possibly
erythromycin (at the dosages recommended for bacillary angiomatosis). Many
patients with established CSD have no apparent response to antibiotics; the
necessary duration of therapy is variable.
=========================================================================
2.) Cat scratch disease: detection of Bartonella henselae DNA in archival
biopsies from patients with clinically, serologically, and histologically
defined disease.
=========================================================================
Author
Scott MA; McCurley TL; Vnencak-Jones CL; Hager C; McCoy JA; Anderson B;
Collins RD; Edwards KM
Address
Department of Pathology, Vanderbilt University Medical Center, Nashville,
Tennessee 37232, USA.
Source
Am J Pathol, 149(6):2161-7 1996 Dec
Abstract
Serological and epidemiological studies suggest that Bartonella henselae is
the etiological agent of cat scratch disease. We designed a study to detect
B. henselae in archival biopsies by polymerase chain reaction amplification
of the 16S rRNA gene followed by Southern blot hybridization. Forty-two
histologically defined cat scratch disease biopsies and eighteen controls
were selected for blinded analysis. After testing, charts were reviewed for
clinical, immunological, and microbial evidence of infection. Results were
correlated with duration of illness and antimicrobial therapy. B. henselae
DNA was identified in 27 of 42 (64%) histologically defined patients and 23
of 34 (68%) patients defined both clinically and histologically. There were
no false positives (0 of 18). A small subset (n = 14) had cat scratch
disease serological tests performed. B. henselae was identified in 8 of 10
serologically positive patients. Polymerase chain reaction detected 50% of
our DNA-positive cases (most of these early in the clinical course).
Southern blotting of amplicons both doubled sensitivity (detecting patients
> 4 weeks into illness) and confirmed B. henselae as the causative species.
Our study strongly associates B. henselae with cat scratch disease,
suggesting that it may be the most likely etiological agent in the majority
of patients with cat scratch disease.
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3.) [A case of cat scratch disease identified by an elevated Bartonella
henselae antibody level using enzyme immunoassay]
=========================================================================
Author
Kusaba N; Nakamura H; Yoshimoto K; Ogata H; Sata M; Tanikawa K; Kusaba A;
Yoshida H
Address
Second Department of Medicine, Kurume University School of Medicine.
Source
Kansenshogaku Zasshi, 71(10):1075-9 1997 Oct
Abstract
A 68-year-old male was admitted to our hospital because of fever and a
2-week history of inguinal adenomegaly. Since he owned a cat, cat scratch
disease was suspected. But it was necessary to distinguish cat scratch
disease from lymphoma type adult T-cell leukemia because he showed a high
level of antibody against HTLV-1. An excisional biopsy of the inguinal node
was performed. Histopathologic examination revealed abscess-forming
granulomatous lymphadenitis compatible with cat scratch disease. A
Warthin-Starry silver stain showed pleomorphic bacilli in the lymph node.
So we confirmed a serological response to Bartonella henselae, the
causative agent of cat scratch disease, using enzyme immunoassay (EIA). The
IgG antibody level to B. henselae was positive at 42 EIA Unit before
treatment. After treatment with intravenous cefepime and oral tosufloxacin,
his physical symptoms improved and the antibody level decreased to less
than 12 EIA Unit. EIA was very useful for diagnosis of this case. Serology
to B. henselae may replace traditional diagnostic criteria for cat scratch
disease.
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4.) Will the real agent of cat-scratch disease please stand up?
=========================================================================
Author
Jerris RC; Regnery RL
Address
Emory University, Department of Pathology and Laboratory Medicine, Atlanta,
Georgia 30322, USA.
Source
Annu Rev Microbiol, 50():707-25 1996
Abstract
Cat-scratch disease has been recognized since 1889 in association with the
oculoglandular syndrome of Parinaud. The epidemiologic association with
cats was first made in 1931 and further substantiated throughout the years,
refining the interaction predominantly to kittens. Putative infectious
agents have included numerous species of bacteria, chlamydiae, and viruses.
The cultivation of Afipia spp. in the late 1980s appeared to answer the
mystery of the identity of the agent. However, even more recent analysis,
which has combined traditional microbiology, molecular methods, and
additional epidemiology, has demonstrated that Bartonella (Rochalimaea)
henselae is the definitive agent of cat-scratch disease. Our understanding
of the pathogenesis of cat-scratch disease and other diseases caused by
Bartonella species is incomplete and the spectrum of diseases continues to
emerge. We review historic and modern efforts to understand the etiology of
cat-scratch disease and related syndromes.
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5.) [Cat scratch disease caused by Bartonella henselae]
=========================================================================
Author
S¨older B; Allerberger F; Covi B; Maurer K; Scheminzky C; Kreczy A; Sch¨on
G; Dierich MP
Address
Klinik f¨ur Kinder- und Jugendheilkunde, Universit¨at Innsbruck.
Source
Immun Infekt, 23(6):228-31 1995 Dec
Abstract
Bartonella henselae is an etiologic agent of cat-scratch disease and, in
immunocompromised patients, of bacillary angiomatosis and other severe
syndromes. Cat-scratch disease usually presents as lymphadenopathy, which
resolves spontaneously within 2-4 months. The utility of antibiotic therapy
remains controversial. In Tyrol four cases of human cat-scratch disease
were diagnosed in children in 1994, yielding a prevalence of 0.7/100,000
per year. A 3-year-old boy had lymphadenitis coli since one year despite
antituberculosis therapy which was initiated because of the
histopathological picture and a positive tuberculin reaction (despite
negative mycobacteria-cultures and -PCR). Two girls, age 9 and 13 years,
had lymphadenitis at upper or lower extremities after cat-scratches from
kittens. A 13-year-old boy presented with febrile illness and right hip
pain, computer tomography revealed an osteolytic lesion; symptoms subsided
within 3 weeks. Diagnosis of cat-scratch disease is based on cat contact,
negative studies for other similar diseases, characteristic histopathologic
features (if available), and results of an indirect immunofluorescence test
(antigen: Houston-1 isolate, ATCC 49882). We believe that the availability
of this serological test will increase the number of diagnosed cases of
human Bartonella henselae infections.
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6.) Hypercalcemia due to endogenous overproduction of active vitamin D in
identical twins with cat-scratch disease.
=========================================================================
Author
Bosch X
Address
Internal Medicine Unit, Hospital Casa Maternitat, Corporaci´o Sanit`aria
Clinic, Barcelona, Spain.
Source
JAMA, 279(7):532-4 1998 Feb 18
Abstract
CONTEXT: The extrarenal synthesis of active vitamin D sterols has a central
causative role in the hypercalcemia associated with various granulomatous
diseases. OBJECTIVE: To study the calcium metabolism in patients with
cat-scratch disease who have hypercalcemia. DESIGN: Case report. SETTING:
University hospital in Barcelona, Spain. PATIENTS: Two identical twins who
developed asymptomatic hypercalcemia during the acute phase of cat-scratch
disease. MAIN OUTCOME MEASURES: Serial measures of calcium homeostasis and
metabolism over a 2-month period. RESULTS: On admission and 6 and 7 days
later, both patients were found to have increased levels of serum and
urinary calcium, serum phosphate, and serum 1,25-dihydroxyvitamin D
[1,25(OH)2D], whereas they had normal values of serum 25-hydroxyvitamin D
and urinary cyclic adenosine monophosphate and decreased serum
concentrations of intact parathyroid hormone. Sixteen and 20 days after
admission, these abnormalities had resolved without treatment. A direct
correlation was observed between the serum 1,25(OH)2D levels and both the
serum and 24-hour urinary calcium concentrations. Also, the concentrations
of calcium and 1,25(OH)2D paralleled the clinical activity of the
infectious disease over the period these parameters were measured.
CONCLUSIONS: Our cases provide evidence that cat-scratch disease can
produce hypercalcemia through the unregulated production of the metabolite
1,25(OH)2D. Cat-scratch disease should be added to the list of
granuloma-forming diseases that are responsible for 1,25(OH)2D-mediated
hypercalcemia.
=========================================================================
7.) Cat-scratch disease caused by Bartonella henselae: the first case
report in Taiwan.
=========================================================================
Author
Lee SC; Fung CP; Lee N; Shieh WB
Address
Department of Pathology, Chang Gung Memorial Hospital, Keelung, Taiwan.
Source
J Formos Med Assoc, 97(8):569-72 1998 Aug
Abstract
We report a typical case of cat-scratch disease caused by Bartonella
henselae, in Taiwan. A 20-year-old man developed right axillary
lymphadenopathy 2 weeks after being scratched on his right hand by a
kitten. The axillary lymphadenopathy resolved gradually and spontaneously
after 10 weeks without specific treatment. Serologic tests were not done
during the acute stage of the event. However, an immunofluorescent antibody
test performed during the convalescent stage was positive for B. henselae
antibodies, and the concentration dropped by fourfold 2 months later.
Histopathologic examination of a biopsy specimen from the right axillary
lymph node revealed findings characteristic of cat-scratch disease
including multiple foci of microabscesses surrounded by histiocytes and
infiltration by plasma cells and lymphocytes. This is the first reported
case of cat-scratch disease in Taiwan, with a history of contact with a
cat, a positive serologic test for B. henselae infection and characteristic
histopathologic findings of cat-scratch disease which met the criteria for
diagnosis.
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8.) [Cat-scratch disease and other infections caused by Bartonella species]
=========================================================================
Author
Schellekens JF
Address
Rijksinstituut voor Volksgezondheid en Milieu, Laboratorium voor
Bacteriologie en Antimicrobi¨ele Middelen, Bilthoven.
Source
Ned Tijdschr Geneeskd, 140(3):144-7 1996 Jan 20
Abstract
Bartonella henselae, the causative agent of cat-scratch disease, was
identified recently by DNA amplification techniques. Several other
Bartonellae (most of which were called Rochalimaea before) cause disease in
humans: B. bacilliformis (Carrion's disease), B. elizabethae (endocarditis)
and B. quintana (bacillary angiomatosis and peliosis, chronic bacteraemia
and endocarditis, trench fever). B. henselae is transmitted to humans by
scratch or bite of a bacteraemic, but asymptomatic, cat, which event may be
followed by regional lymphadenitis (classical cat-scratch disease),
bacillary angiomatosis or peliosis of liver and spleen (in immune
compromised, e.g. HIV-infected individuals) or chronic bacteraemia and
endocarditis (in elderly individuals). The incidence in the Netherlands of
cat-scratch disease is > 2/100,000/year. If a Bartonella infection is
suspected, specific immuno-assays and polymerase chain reaction assay may
be applied for diagnosis. Culture of the organism is difficult. Macrolides
and tetracyclines have been shown to be effective in treatment of
disseminated infections. The natural (self-limiting) course of regional
lymphadenitis however is not affected by antibiotic treatment.
=========================================================================
9.) Bartonella spp. as emerging human pathogens.
=========================================================================
Anderson BE; Neuman MA
Department of Medical Microbiology and Immunology, College of Medicine,
University
of South Florida, Tampa 33612, USA. banderso@com.1.med.usf.edu
Clin Microbiol Rev (UNITED STATES) Apr 1997 10 (2) p203-19 ISSN:
0893-8512
Contract/Grant No.: R29-AI38178--AI--NIAID
Language: ENGLISH
Document Type: JOURNAL ARTICLE; REVIEW; REVIEW, ACADEMIC
Journal Announcement: 9709
Subfile: INDEX MEDICUS
Members of the genus Bartonella (formerly Rochalimaea) were virtually
unknown to
modern-day clinicians and microbiologists until they were associated with
opportunistic infections in AIDS patients about 6 years ago. Since that
time,
Bartonella species have been associated with cat scratch disease, bacillary
angiomatosis, and a variety of other disease syndromes. Clinical
presentation of
infection with Bartonella ranges from a relatively mild lymphadenopathy
with few
other symptoms, seen in cat scratch disease, to life-threatening systemic
disease in
the immunocompromised patient. In some individuals, infection manifests as
lesions
that exhibit proliferation of endothelial cells and neovascularization, a
pathogenic
process unique to this genus of bacteria. As the spectrum of disease
attributed to
Bartonella is further defined, the need for reliable laboratory methods to
diagnose
infections caused by these unique organisms also increases. A brief
summary of the
clinical presentations associated with Bartonella infections is presented,
and the
current status of laboratory diagnosis and identification of these
organisms is
reviewed. (205 References)
=========================================================================
10.) [Bartonella henselae infection in immunocompetent patients: cat
scratch disease]
=========================================================================
Author
Abarca K; Vial PA; Rivera M; Garc´ia C; Odd´o D; Prado P; Ferr´es M
Address
Departamentos de pediatr´ia, de Radiolog´ia y Anatom´ia Patol´ogica,
Facultad de Medicina, Pontificia Universidad Cat´olica de Chile, Santiago,
Chile.
Source
Rev Med Chil, 124(11):1341-9 1996 Nov
Abstract
BACKGROUND: Cat scratch disease, whose etiologic agent is Bartonella
henselae, is a benign disease in immunocompetent subjects, characterized by
lymphadenopathy of prolonged course and occasional involvement of other
organs such as liver, spleen, central nervous system, eye and lung. In
immunocompromised patients, the infection is bacteremic and disseminated.
AIM: To report Chilean cases of cat scratch disease. PATIENTS AND METHODS:
Ten children (seven male, aged between 6 and 13 years old) with
histologically or serologically confirmed cat scratch disease are reported.
RESULTS: Lymphadenopathy location was pre auricular in four cases, axillary
in two, inguinal in two and epitrochlear in two. Three children had fever
over 39 degrees C and two had a parinaud syndrome. Nine children had a
history of cat scratch and one of a cat byte. Six had an erythrocyte
sedimentation rate over 40. Lymph node ultrasound examination was a useful
diagnostic tool. Two patients had splenic granulomas. Lymph node biopsies
were obtained in four cases, showing a suppurative granulomatous
lymphadenitis in all and a positive Warthin-Starry stain in two. Serology,
done in patients without histological confirmation was positive with titles
ranging from 1:64 to 1:8192. All patients had a satisfactory outcome with
regression of lymphadenopathy. CONCLUSIONS: Infections by Bartonella
hemselae occur in the Chilean population and must be considered in the
differential diagnosis of regional lymph node enlargement.
=========================================================================
11.) Cat-scratch disease and related clinical syndromes.
=========================================================================
Author
Smith DL
Address
West Jersey Family Practice Residency, Voorhees, New Jersey, USA.
Source
Am Fam Physician, 55(5):1783-9, 1793-4 1997 Apr
Abstract
Bartonella (Rochalimaea) henselae is a common cause of cat-scratch disease.
This newly identified bacterium is also the cause of several other clinical
syndromes, including bacillary angiomatosis, bacillary peliosis hepatitis
and splenitis, and acute and relapsing bacteremia. A high percentage of
young cats carry B. henselae. Fortunately, serious complications of B.
henselae infections are rare in immunocompetent patients. Cat-scratch
disease is usually a self-limited illness that does not necessarily require
antibiotic therapy. Severe or persistent cases respond well to several
antibiotics, including erythromycin and doxycycline. Cat-scratch disease
should be included in the differential diagnosis of serious neurologic
disease, particularly when regional lymphadenopathy develops suddenly in a
previously healthy patient who owns a cat. Treatment of uncomplicated
central nervous system disease is generally supportive. Antibiotic therapy
is reserved for patients with atypical or severe involvement, including
encephalopathy and retinitis. Other internal and cutaneous manifestations
of B. henselae infection have recently been described. These potentially
life-threatening infections respond well to antibiotic therapy, even in
immunocompromised patients.
=========================================================================
12.) Cat-scratch disease and bacillary angiomatosis.
=========================================================================
Author
Chomel BB
Address
Department of Population Health and Reproduction, School of Veterinary
Medicine, University of California, Davis 95616, USA.
Source
Rev Sci Tech, 15(3):1061-73 1996 Sep
Abstract
Cat-scratch disease (CSD) was first described by Debr´e in 1950, yet the
causative bacterial agent of CSD remained obscure until 1992, when
Bartonella (formerly Rochalimaea) henselae was implicated in CSD by
serological and microbiological studies. B. henselae had initially been
linked to bacillary angiomatosis (BA), a vascular proliferative disease
most commonly associated with long-standing human immunodeficiency virus
(HIV) infection or other significant immunosuppression. B. henselae has
also been associated with bacillary peliosis, relapsing bacteraemia and
endocarditis in humans. Cats are healthy carriers of B. henselae, and can
be bacteraemic for months or years. It has recently been demonstrated that
B. henselae can be transmitted from cat to cat by the cat flea, but not by
direct contact between animals. The author discusses the present state of
knowledge on the aetiology, clinical features and epidemiological
characteristics of cat-scratch disease and bacillary angiomatosis.
=========================================================================
13.) Detection of antibodies to Bartonella henselae in clinically diagnosed
cat scratch disease.
=========================================================================
Author
Flexman JP; Chen SC; Dickeson DJ; Pearman JW; Gilbert GL
Address
Department of Clinical Microbiology and Infectious Diseases, Royal Perth
Hospital, WA. jameflex@dunamis.rph.uwa.edu.au
Source
Med J Aust, 166(10):532-5 1997 May 19
Abstract
OBJECTIVE: To determine the usefulness of an indirect immunoflourescence
antibody test for antibodies to Bartonella henselae in diagnosing cat
scratch disease (CSD). DESIGN AND SETTING: Retrospective case survey of 354
patients whose sera were tested for antibodies to B. henselae at Royal
Perth Hospital, Perth, and the Institute of Clinical Pathology and Medical
Research, Sydney. In 1994; and measurement of the background prevalence of
antibodies to B. henselae. MAIN OUTCOME MEASURES: Prevalence of antibodies
to B. henselae, odds of a positive titre (> or = 64) in patients with and
without specific risk factors for CSD and clinical features of the disease;
prevalence of antibodies to B. henselae in randomly selected blood donors.
RESULTS: Demographic, clinical and cat contact data were available for 303
patients. Sixty-four (21.1%) had a positive titre, as did 53 of 98 (54%)
patients with a history of cat contact and lymphadenopathy. This proportion
increased to 62% (38 of 61 patients) in patients with a history of cat
scratch or bite and to 90.3% (28 of 31) in those with cat contact,
lymphadenopathy and histological evidence of granulomatous lymphadenitis.
Patients who developed lymphadenopathy after cat contact were significantly
more likely to have a positive titre than those without this history (odds
ratio [OR], 20.8; 95% confidence interval [95% Cl], 9.6-46; P < 0.0001).
Inclusion of a history of a cat scratch or bite significantly raised the
odds of being seropositive (OR, 13.7; 95% Cl, 6.8-28.1; P < 0.0001), and
the presence of granulomas on lymph node biopsy further increased the odds
(OR, 124.4; 95% Cl, 19.4-1073; P < 0.0001). The prevalence of antibodies to
B. henselae in random blood donors in New South Wales was about 5% (five of
102 sera samples). CONCLUSIONS: The immunofluorescence antibody test for B.
henselae can be expected to be positive in just over half the patients with
clinically suspected CSD, and it has a positive predictive value of 83%. In
a significant number of cases the diagnosis cannot be made on the basis of
the results of immunofluorescence antibody testing alone and further
investigations, including lymph node biopsy, may be required.
=========================================================================
14.) The expanding spectrum of Bartonella infections: II. Cat-scratch disease.
=========================================================================
Bass JW; Vincent JM; Person DA
Department of Pediatrics, Tripler Army Medical Center, Honolulu, HI
96859-5000,
USA. jamess.bass@ches.tamc.amedd.army.mil
Pediatr Infect Dis J (UNITED STATES) Feb 1997 16 (2) p163-79 ISSN:
0891-3668
Language: ENGLISH
Document Type: HISTORICAL ARTICLE; JOURNAL ARTICLE; REVIEW; REVIEW,
ACADEMIC
Journal Announcement: 9706
Subfile: INDEX MEDICUS
Recent advancements and developments in molecular biotechnology have
allowed more
precise reclassification of many microorganisms. With the use of these new
taxonomy
tools, several organisms previously thought to belong to other genera have
been
recently described as bartonellae. Of the 11 organisms now described as
Bartonella
spp., only four have been shown to be pathogenic for humans. Table 1 lists
the four
Bartonella human pathogens along with the their known epidemiology and the
scope and
range of disease associated with each. All are now considered to be
bacteria and can
be grown on blood-enriched agar although primary isolation in some may best
be
achieved in cell tissue culture. B. bacilliformis infection is limited to
certain
geographic regions in South America where the only human reservoir and the
sandfly
vector(s) that spreads the disease reside together. Specific antibiotic
treatment is
dramatically effective in treating the highly fatal, acute intraerythrocytic
hemolytic form of the disease, but their effectiveness in treating the
vascular
proliferative forms (verruga peruana) or the chronic asymptomatic,
bacteremic,
carrier state of the disease has not been effective. This disease should
remain
confined to its present endemic geographic areas in South American unless
asymptomatic bacteremic persons from these areas migrate to areas where
sandflies and
humans exist that are capable of establishing this infection in new endemic
areas.
B. quintana and B. henselae cause a wide range of clinical diseases in
humans, the
type and extent of which varies significantly with the immune status of the
host. In
immunocompetent hosts the pathologic response is granulomatous, suppurative,
extracellular and intracellular, generally self-limited and usually
unresponsive to
antibiotic treatment, even to those drugs to which the organism is shown to
be
sensitive in vitro. In contrast, in immunocompromised hosts the pathologic
response
is vasculoproliferative, organisms may be seen intracellularly but they are
often
seen in abundance in extracellular clumps and infection is usually
progressive and
fatal unless treated. In these patients clinical response to treatment
with drugs
that are effective in vitro against these organisms has usually been
dramatic. Of
these agents those that penetrate cells and are found in high concentrations
intracellularly, such as erythromycin, clarithromycin, azithromycin,
rifampin,
doxycycline and gentamicin, appear to be most effective. These agents not
only
appear to provide the most dramatic treatment response in patients with BA,
BP and
PRFB and other manifestations of B. henselae (and B. quintana as well) in
immunocompromised persons, they appear to be the most promising agents for
treatment
of persons with both typical and atypical CSD. Further studies will be
necessary to
more clearly elucidated the mechanisms responsible for the diverse clinical
presentations of infection with these organisms in human hosts relative to
their
immune status. In addition clarification of the epidemiology of B.
elizabethae
infections in humans may be helpful in understanding the nature of
infection with
Bartonella organisms. (215 References)
=========================================================================
15.) Evaluation of serological response to Bartonella henselae, Bartonella
quintana and
Afipia felis antigens in 64 patients with suspected cat-scratch disease.
=========================================================================
Dupon M; Savin De Larclause AM; Brouqui P; Drancourt M; Raoult D; De
Mascarel A;
Lacut JY
Service de Maladies Infectieuses et Medecine Interne, Hopital Pellegrin,
France.
Scand J Infect Dis (SWEDEN) 1996 28 (4) p361-6 ISSN: 0036-5548
Language: ENGLISH
Document Type: JOURNAL ARTICLE
Journal Announcement: 9704
Subfile: INDEX MEDICUS
The serological response to Bartonella henselae, B. quintana, and Afipia
felis was
assessed by an indirect fluorescence antibody test (IFAT) in 64 patients with
suspected cat-scratch disease (CSD) recruited from the Bordeaux area in
France.
Blood samples were collected from 57 patients with chronic lymphadenopathy
who
underwent lymph-node biopsy with suggestive histopathologic features of
CSD, and from
an additional 7 patients with suspected CSD who underwent surgical incision
and
drainage because of lymph-node tenderness. Of the patients, 31 were male
and 33
female, with a median age of 27 years (range 2-89). 69.8% reported cat
and/or dog
contact. Of the 26/64 (40.6%) patients, serum samples were positive at a
titer of
1:100 or more for immunoglobulin G (IgG) antibodies (17 only to B.
henselae, 1 only
to B. quintana, 3 only to Afipia felis, and 5 to both B. henselae and B.
quintana).
IgM or IgA antibodies were also detected in 10 patients with IgG antibodies
to B.
henselae. 11 (17.2%) of the 64 patient serum samples were positive at a
low titer of
1:50. These data suggested that serological response assessed by standard
IFAT is
not enough to confirm a CSD diagnosis.
=========================================================================
16.) [Cat scratch disease and associated infections]
=========================================================================
Author
Chomel BB; Boulouis HJ; Gurfield AN; Heller R; Pi´emont Y; Pilet C
Address
Department of Population Health and Reproduction, School of Veterinary
Medicine, University of California, Davis, USA.
Source
Bull Acad Natl Med, 181(3):441-50; discussion 451-4 1997 Mar 18
Abstract
Cat scratch disease (CSD) was first described in France by Debr´e et al. in
1950, yet the causative bacterial agent of CSD remained obscure until 1992,
when Bartonella (formerly Rochalimaea) henselae was implicated in CSD by
serological and microbiologic studies. B. henselae had been linked
initially to bacillary angiomatosis (BA), but also bacillary peliosis,
relapsing bacteremia and endocarditis. Cats are healthy carriers of B.
henselae and B. clarridgeiae, and can be bacteremic for months to years.
Cat to cat transmission of the organism involves the cat flea in absence of
direct contact transmission. Present knowledge on the etiology, clinical
features and epidemiological characteristics of cat scratch
disease/bacillary angiomatosis are presented.
=========================================================================
17.) Cat-scratch disease simulating Histiocytosis X.
=========================================================================
Author
Berg LC; Norelle A; Morgan WA; Washa DM
Address
Department of Pathology, Gunderson Clinic, Ltd, LaCrosse, WI 45601, USA.
Source
Hum Pathol, 29(6):649-51 1998 Jun
Abstract
Cat-scratch disease is a self-limited condition commonly causing a benign
chronic lymphadenopathy in children. Osteolytic lesions are a rare
complication, but have been previously reported. We report a case of a
solitary osteolytic lesion of the skull whose clinical, radiographic and
pathological features were initially interpreted as being consistent with
Histiocytosis X. Subsequently, positive serological titers for Bartonella,
a history of a cat-scratch antecedent to the onset of clinical symptoms and
review of the original histopathology confirmed the diagnosis of
cat-scratch disease. We reviewed the English language literature on
osteolytic lesions associated with cat-scratch disease and compare the
current case with those previously reported.
=========================================================================
18.) [Atypical cat-scratch disease: a case report of splenic granulomatosis]
=========================================================================
Author
Dodi I; Iughetti L; Nasi S; Rossi C; Caselli G; Malvicini R
Address
Divisione di Pediatria, Ospedale Civile di Fidenza PR, Italia.
Source
Pediatr Med Chir, 19(2):143-4 1997 Mar-Apr
Abstract
Generally cat-scratch disease is a benign inflammatory adenopathy. The
Authors describe an atypical form of this disease, characterized by
persistent fever and splenic granulomatosis requiring a diagnostic and
therapeutic prolonged effort. They point out the important role of new
immuno-fluorescent techniques to exactly identify the bacterium--Bartonella
henselae--causing cat-scratch disease and suggest to include cat-scratch
disease among the causes of unknown origin fever.
=========================================================================
19.) [2 patients with atypical manifestations of cat-scratch disease]
Twee patienten met atypische manifestaties van kattenkrabziekte.
=========================================================================
Kusumanto YH; Veenhoven RH; Bokma JA; Schellekens JF
Spaarne Ziekenhuis, afd. Kindergeneeskunde, Haarlem.
Ned Tijdschr Geneeskd (NETHERLANDS) Feb 22 1997 141 (8) p385-7 ISSN:
0028-2162
Language: DUTCH Summary Language: ENGLISH
Document Type:
JOURNAL ARTICLE English Abstract
Journal Announcement: 9707
Subfile: INDEX MEDICUS
In 2 boys aged 8 years and 10 months, respectively, uncommon
manifestations of cat
scratch disease were seen. The first patient had acute encephalopathy:
coma and
generalized tonic-clinic convulsions. The second patient was presented
with fever
and peripheral lymphadenopathy in combination with hypodense lesions in the
liver on
ultrasound. Diagnosis was established on the clinical picture and the
positive
results of serological testing of antibody titres for Bartonella henselae.
Both
patients recovered completely within 2 months.
=========================================================================
20.) [Visceral localizations of cat-scratch disease in an immunocompetent
patient]
=========================================================================
Author
Bouchard O; Bosseray A; Leclercq P; Micoud M
Address
H^opital Michallon, CHU de Grenoble.
Source
Presse Med, 25(5):199-201 1996 Feb 10
Abstract
Locoregional expression of cat scratch disease is well known, but despite
advances in microbiology over the last 10 years leading to the description
of two new bacteria (Afipia felis, Bartonella henselae) the infective agent
responsible for cat scratch syndrome remains unknown. Until the 80s, only
one systemic disease was attributed to infection with a germ in the
Bartonella genus: trench fever. With the onset of the AIDS epidemic, new
clinical syndromes caused by Bartonella bacteria have been described:
bacillary angiomatosis, hepatic peliosis, cases of recurrent septicemia,
cases of endocarditis, etc. More recently, atypical forms of cat scratch
disease including systemic diseases have been reported in immunocompetent
subjects. Although quite rare (1% of the cases), such types of expression
can raise questions as to diagnosis both in terms of clinical signs and in
terms of bacteriological findings. Clinical and experimental data do not
provide a clear direction for treatment but would suggest that prolonged
use of aminoglycosides is useful.
=========================================================================
21.) Serous retinal detachment of the macula associated with cat scratch
disease.
=========================================================================
Author
Zacchei AC; Newman NJ; Sternberg P
Address
Department of Ophthalmology, Emory University School of Medicine, New York,
New York, USA.
Source
Am J Ophthalmol, 120(6):796-7 1995 Dec
Abstract
PURPOSE: We studied an unusual ocular manifestation of cat scratch disease.
METHODS: We examined a patient who had a serous retinal detachment of the
macula with vision loss out of proportion to her retinal findings. RESULTS:
The patient was found to have cat scratch disease by antibody titers.
CONCLUSION: Cat scratch disease should be considered in patients with a
serous neurosensory retinal detachment of the macula and a history of cat
exposure or systemic signs or symptoms consistent with the disease.
=========================================================================
22.) Cat scratch disease in Greece.
=========================================================================
Author
Karpathios T; Golphinos C; Psychou P; Garoufi A; Papadimitriou A;
Nicolaidou P
Address
Second Department of Paediatrics, P and A Kyriakou Children's Hospital,
Athens, Greece.
Source
Arch Dis Child, 78(1):64-6 1998 Jan
Abstract
An indirect fluorescent antibody test for Bartonella henselae, B quintana,
and B elizabethae was performed in all 18 children who presented to our
paediatric outpatient clinic with cat scratch disease over a six year
period. Serum samples were taken on admission, after 15 days, and after six
months. Diagnosis was confirmed in 15 patients (83%) and was based on
seroconversion or a fourfold change of the antibody titre to B henselae in
12 patients and on a single high titre (> 128) in three patients.
Lymphadenopathy was present in all patients, erythema nodosum in one,
osteomyelitis in one, hepatitis in one, transverse myelitis in one, and
liver or spleen granulomata, or both, in three patients. Cat scratch
disease developed in autumn or winter in 12 patients. All had a history of
physical contact with a cat. Our study shows that our clinical suspicion
was accurate in the diagnosis of cat scratch disease in a high percentage
of patients presenting to a hospital and that indirect fluorescent antibody
testing for B henselae is a useful diagnostic tool.
=========================================================================
23.) Cat-scratch disease--an overlooked disease in Denmark?]
=========================================================================
Kattekradssygdom--en overset sygdom i Danmark?
Blomgren M; Hardt-Madsen M
Organkirurgisk afdeling K, Sygehus Fyn.
Ugeskr Laeger (DENMARK) May 5 1997 159 (19) p2876-7 ISSN: 0041-5782
Language: DANISH Summary Language: ENGLISH
Document Type:
JOURNAL ARTICLE English Abstract
Journal Announcement: 9708
Subfile: INDEX MEDICUS
Only one patient with cat-scratch disease (CSD) has been reported in
Denmark. A
case and retrospective investigation among patients admitted to the ward is
presented.
Over a period of 3.5 years, six patients were found to have suffered from
CSD. The
yearly incidence was calculated to 2.6/100,000. The patients were tested for
antibodies against Bartonella (Rochalimaea) henselae with a new test
developed at the
Danish Serum Institute. Only two of the patients with CSD had titres of
antibodies
higher than 400 (positive). Tested again with an improved test five of the
six
patients were found to have antibodies against B. henselae. It is assumed
that CSD
is found with the same incidence as the USA and Holland. It is recommended
that
examination for chronic lymphadenopathy includes questions about cat
contact and
testing for antibodies against Bartonella henselae.
=========================================================================
24.) Prolonged Bartonella bacteremia in cats associated with cat-scratch
disease patients.
=========================================================================
Author
Kordick DL; Wilson KH; Sexton DJ; Hadfield TL; Berkhoff HA; Breitschwerdt EB
Address
Department of Companion Animal and Special Species Medicine, College of
Veterinary Medicine, North Carolina State University, Raleigh 27606, USA.
Source
J Clin Microbiol, 33(12):3245-51 1995 Dec
Abstract
Recent evidence supports a causal relationship between Bartonella
(Rochalimaea) henselae, cat-scratch disease (CSD), and bacillary
angiomatosis. Cats appear to be the primary reservoir. Blood from 19 cats
owned by 14 patients diagnosed with CSD was cultured. Blood samples from
cats owned by veterinary students (n = 25) having no association with CSD
or bacillary angiomatosis were cultured as controls. Eighty-nine percent
(17 of 19) of cats associated with CSD patients and 28% (7 of 25) of
controls were bacteremic with Bartonella species (chi-square = 16.47; P <
0.001). Twenty-three isolates were characterized as B. henselae, while one
isolate from the cat of a CSD patient appeared to be a new Bartonella
species. Thirteen cats remained culture positive during the ensuing
12-month period. Our results support the conclusion that B. henselae is the
predominant species involved in CSD and is transmitted by cats. The
incidence of Bartonella bacteremia in control cats suggests that B.
henselae bacteremia is prevalent among the domestic cat population in the
United States.
=========================================================================
25.) Application of polymerase chain reaction assay in the diagnosis of
orbital granuloma complicating atypical oculoglandular cat scratch disease.
=========================================================================
Author
Dondey JC; Sullivan TJ; Robson JM; Gatto J
Address
Oculoplastics Clinic, Department of Ophthalmology, Royal Brisbane Hospital,
Herston, Australia.
Source
Ophthalmology, 104(7):1174-8 1997 Jul
Abstract
BACKGROUND: Parinaud oculoglandular syndrome is uncommon. Most cases are
caused by cat scratch disease (CSD), recently discovered to be associated
with the pathogen Bartonella henselae. Before isolation of the
micro-organism, diagnosis relied on the presence of characteristic clinical
features. However, atypical cases could cause diagnostic problems. With the
development of an indirect fluorescent antibody test and polymerase chain
reaction (PCR) assay, oculoglandular CSD can be diagnosed readily. METHODS:
The authors report a case of atypical Parinaud oculoglandular syndrome in a
51-year-old woman who presented with an inferior conjunctival forniceal
mass extending into anterior orbital tissues. Blood and operative tissue
specimens were obtained for routine screening and histopathologic analysis
but more specifically for serologic analysis, culture, and PCR assay for B.
henselae. Computed tomography was performed to delineate the mass. RESULTS:
Cultures for B. henselae were negative. Initial serologic analysis
demonstrated a low IgG response without detectable IgM, but 1 month later
had undergone a fourfold rise in IgG, again without detectable IgM.
Histopathologic analysis showed a nonspecific necrotizing granulomatous
inflammation consistent with but not diagnostic of CSD. Polymerase chain
reaction assay for B. henselae was strongly positive. Computed tomographic
scan showed a preseptal and anterior orbital inflammatory process.
CONCLUSIONS: Cat scratch disease due to B. henselae should be suspected in
patients with atypical conjunctival inflammation associated with regional
lymphadenopathy. PCR assay is extremely useful in establishing the
diagnosis. The PCR assay offers the additional advantage of early diagnosis
because the test is positive early in the disease. Antibiotic therapy
remains controversial. In this case, surgical excision hastened resolution
of the conjunctival inflammation. However, the lymphadenopathy responded
poorly to antibiotics.
=========================================================================
26.) Systemic cat scratch disease: hepatic and splenic involvement about 3
pediatric cases.
=========================================================================
Author
Destuynder O; Vanlemmans P; Mboyo A; Destuynder R; Aubert D; DeBilly B;
Colin P; Leroy J; Estavoyer JM; Viennet G
Address
Department of Pediatric Surgery, Saint-Jacques Hospital Besan¸con, France.
Source
Eur J Pediatr Surg, 5(6):365-8 1995 Dec
Abstract
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.
Language
=========================================================================
27.) Bartonella clarridgeiae, a newly recognized zoonotic pathogen causing
inoculation papules, fever, and lymphadenopathy (cat scratch disease).
=========================================================================
Author
Kordick DL; Hilyard EJ; Hadfield TL; Wilson KH; Steigerwalt AG; Brenner DJ;
Breitschwerdt EB
Address
Department of Companion Animal and Special Species Medicine, College of
Veterinary Medicine, North Carolina State University, Raleigh 27606, USA.
Source
J Clin Microbiol, 35(7):1813-8 1997 Jul
Abstract
Shortly after adopting a 6-week-old cat, a veterinarian was bitten on the
left index finger. Within 3 weeks, he developed headache, fever, and left
axillary lymphadenopathy. Initial blood cultures from the cat and
veterinarian were sterile. Repeat cultures from the cat grew
Bartonella-like organisms with lophotrichous flagella. Sera from the
veterinarian were not reactive against Bartonella henselae, B. quintana, or
B. elizabethae antigens but were seroreactive (reciprocal titer, 1,024)
against the feline isolate. Sequential serum samples from the cat were
reactive against antigens of B. henselae (titer, 1,024), B. quintana
(titer, 128), and the feline isolate (titer, 2,048). Phenotypic and
genotypic characterization of this and six additional feline isolates,
including microscopic evaluation, biochemical analysis, 16S rRNA gene
sequencing, DNA-DNA hybridization, and PCR-restriction fragment length
polymorphism of the 16S gene, 16S-23S intergenic spacer region, and citrate
synthase gene identified the isolates as B. clarridgeiae. This is the first
report of cat scratch disease associated with B. clarridgeiae.
=========================================================================
28.) Coinfection with Bartonella clarridgeiae and Bartonella henselae and
with different Bartonella henselae strains in domestic cats.
=========================================================================
Gurfield AN; Boulouis HJ; Chomel BB; Heller R; Kasten RW; Yamamoto K;
Piemont Y
Department of Population Health and Reproduction, School of Veterinary
Medicine,
University of California, Davis, 95616, USA.
J Clin Microbiol (UNITED STATES) Aug 1997 35 (8) p2120-3 ISSN: 0095-1137
Language: ENGLISH
Document Type: JOURNAL ARTICLE
Journal Announcement: 9711
Subfile: INDEX MEDICUS
Bartonella clarridgeiae and several strains of Bartonella henselae, the
agent of
cat scratch disease, with variations in the 16S rRNA gene have been found
to infect
the blood of cats. An epidemiologic study of Bartonella infection in
domestic French
cats revealed that of 436 cats sampled, 5 cats (1.1%) were coinfected with B.
henselae and B. clarridgeiae and 2 cats (0.5%) were coinfected with two
strains of B.
henselae with variations in the 16S rRNA gene, B. henselae type I and type
II. In an
indirect immunofluorescence assay, coinfected cats tested positive for both
Bartonella species at titers of > or = 128. Identification of the colonies
was
achieved by preformed enzyme analysis, PCR-restriction fragment length
polymorphism
analysis of the citrate synthase gene, and 16S rRNA gene sequencing.
Colony size
differences in mixed culture allowed differentiation of the Bartonella
species. The
coinfection of cats with two Bartonella species or variants of the same
species
raises concern about the possibility of dual infection in humans. The
development of
a polyvalent vaccine targeted against the most pathogenic or invasive
strains may be
a means of protecting cats and man from infection.
=========================================================================
29.) [Cat-scratch disease: historical, clinical, phylogenetic and taxonomic
aspects]
Katzenkratzkrankheit: historische, klinische, phylogenetische und
taxonomische
Aspekte.
=========================================================================
Muller HE
Tierarztl Prax (GERMANY) Apr 1997 25 (2) p94-9 ISSN: 0303-6286
Language: GERMAN Summary Language: ENGLISH
Document Type:
JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL English Abstract
Journal Announcement: 9708
Subfile: INDEX MEDICUS
The cat-scratch disease (CSD) is known as a nosological entity since
1950. It was
diagnosed by the clinical symptoms, epidemiologic data, and the
intracutaneous test
of Hanger and Rose. The aetiologic agent is Bartonella (formerly
Rochalimaea)
henselae occurring in thirty to fifty percent of healthy cats. The
gramnegative
alpha-2-proteobacteria cause the CSD but also fever in healthy humans.
Patients
suffering from AIDS show bacillary angiomatosis, bacillary peliosis hepatis,
endocarditis, and septicemia. There is an open question for other
aetiologic agents
causing CSD as cofactors. For example, Afipia felis is found to a certain
extent
from patients suffering from CSD. Furthermore, Rothia dentocariosa was
isolated in
lymphnodes of CSD patients, and also other grampositive rods may play an
important
role together with B. henselae in CSD. (30 References)
=========================================================================
30.) Molecular diagnosis of cat scratch disease: a two-step approach.
=========================================================================
Avidor B; Kletter Y; Abulafia S; Golan Y; Ephros M; Giladi M
The Bernard Pridan Laboratory for Molecular Biology of Infectious
Diseases, Ichilov
Hospital, Tel-Aviv Sourasky Medical Center, Israel.
J Clin Microbiol (UNITED STATES) Aug 1997 35 (8) p1924-30 ISSN:
0095-1137
Language: ENGLISH
Document Type: JOURNAL ARTICLE
Journal Announcement: 9711
Subfile: INDEX MEDICUS
Amplification of Bartonella henselae DNA has been proposed as a
diagnostic test for
cat scratch disease (CSD). The sensitivities of the following three PCR
assays were
compared. PCR/rRNA with universal primers amplifies part of the 16S rRNA
gene,
followed by hybridization with a specific B. henselae probe; PCR/CS and
PCR/HSP
amplify portions of the gltA and the htrA genes, respectively, each
followed by
restriction fragment length polymorphism analysis. The threshold of
detection of B.
henselae DNA in pus was 10(-4), 10(-3), and 10(-2) ng for PCR/rRNA, PCR/CS,
and
PCR/HSP, respectively. By these three assays, B. henselae DNA was detected
in 100,
94, and 69% of 32 pus and lymph node specimens from CSD patients,
respectively. The
similar sensitivities of the PCR/rRNA and the PCR/CS assays for detecting
B. henselae
DNA in clinical specimens are in contrast to the 10-fold difference in
sensitivities
in favor of PCR/rRNA demonstrated with purified B. henselae DNA in sterile
pus,
suggesting that in the majority of cases, the bacterial load in clinical
specimens is
large enough to be identified by the PCR/CS assay. A two-step approach is
suggested
to achieve maximal sensitivity for detecting B. henselae in clinical
specimens:
initial testing by PCR/CS (which does not require hybridization), followed by
PCR/rRNA with PCR/CS-negative specimens when CSD is strongly suspected.
=========================================================================
31.) Antibiotic therapy for cat-scratch disease: clinical study of
therapeutic outcome in 268 patients and a review of the literature.
=========================================================================
Author(s) Margileth AM
Address Department of Pediatrics, University of Virginia Health Sciences
Center, Charlottesville.
Source Pediatr Infect Dis J 1992;11:474.
Abstract
During 24 months in an uncontrolled, retrospective study of 268 patients
with cat-scratch disease (CSD), 202 were treated with 18 different
antimicrobial agents. Criteria for antibiotic effectiveness were
established. One or two antibiotics were taken separately for at least 3 to
5 days by 202 patients with CSD. Outcome was determined by follow-up
examinations and telephone. Effectiveness of antibiotic therapy was based
upon 3 or more days of therapy and clinical improvement of the patient with
absence of and/or a decrease in malaise, fatigue, fever, headache,
anorexia, lymphadenopathy and, in 90 patients, a declining or normal
sedimentation rate. Of 18 different antimicrobials prescribed, 14 commonly
used antibiotics were judged to be of little or no value in treatment of
CSD. Four antimicrobials were efficacious. Efficacy of the three oral drugs
in decreasing order was: rifampin 87%, ciprofloxacin 84%,
trimethoprim-sulfamethoxazole 58%. Gentamicin sulfate intramuscular was 73%
effective. Antibiotic therapy can be considered for patients with severe
cat scratch disease. Conservative, symptomatic treatment is recommended for
the majority of patients with mild or moderate CSD.
=========================================================================
32.) Successful treatment of cat-scratch disease with ciprofloxacin [see
comments]
=========================================================================
Author(s) Holley HP Jr
Address Division of Infectious Diseases, Medical University of South
Carolina, Charleston 29425.
Source JAMA 1991;265:1563 - 5.
Abstract
Cat-scratch disease is usually a benign, self-limited disease. Infection
may be asymptomatic but is commonly associated with painful regional
lymphadenitis. Occasionally, disease may result in systemic symptoms and
dissemination. Five adult patients, aged 24 to 57 years, were diagnosed as
having cat-scratch disease, based on a positive history of cat scratches
followed by typical symptoms including painful regional lymphadenitis,
malaise, and positive cat-scratch skin tests. Diagnostic evaluations
revealed no other cause for the lymphadenitis. Three patients had not
received prior treatment with antibiotics, and two patients had failed to
improve on other antibiotics. All five were treated with oral
ciprofloxacin, 500 mg by mouth, twice daily. All patients had dramatic
improvement in symptoms within a few days and none has relapsed during
follow-up. This is the first report of successful treatment of cat-scratch
disease with ciprofloxacin, which appears to be an effective therapy for
cat-scratch disease in adults.
=========================================================
33.) Diverse Clinical Signs of Ocular Involvement in Cat Scratch Disease.
========================================================
Turk J Ophthalmol. 2017 Jan;47(1):9-17. doi: 10.4274/tjo.28009. Epub 2017 Jan 17.
Oray M1, Önal S2, Koç Akbay A3, Tuğal Tutkun İ1.
Author information
1İstanbul University İstanbul Faculty of Medicine, Department of Ophthalmology, İstanbul, Turkey.
2Koç University Faculty of Medicine, Department of Ophthalmology; VKV American Hospital, Ophthalmology Clinic, İstanbul, Turkey.
3Koç University Faculty of Medicine, Department of Ophthalmology, İstanbul, Turkey.
Abstract
OBJECTIVES:
To describe ocular manifestations, diagnosis, and treatment of cat scratch disease.
MATERIALS AND METHODS:
Clinical records of patients with ocular cat scratch disease were reviewed.
RESULTS:
Thirteen eyes of 10 patients (7 female, 3 male) with a mean age of 26.9±18.5 years were included. Nine patients had a history of cat contact and had systemic symptoms associated with cat scratch disease 2-90 days prior to the ocular symptoms. Ocular signs were: neuroretinitis in 4 eyes (associated with serous retinal detachment in the inferior quadrant in 1 eye), optic neuropathy in 2 eyes (1 papillitis and optic disc infiltration, 1 optic neuritis), retinal infiltrates in 6 eyes, retinochoroiditis in 1 eye, branch retinal arteriolar occlusion in 3 eyes, and endophthalmitis in 1 eye. Visual acuities at presentation were 1.0 in 7 eyes, 0.3 in 1 eye, ≤0.1 in 4 eyes, and light perception in 1 eye. Bartonella henselae immunoglobulin (Ig) M and/or IgG were positive in all patients. Systemic antibiotic therapy was administered in all patients. Systemic corticosteroid treatment (15-40 mg/day) was added to the therapy in 4 patients, following 5 days of intravenous pulse methylprednisolone in 2 patients. Treatment was ongoing for 1 patient and the mean treatment duration of the other 9 patients was 47±14.5 days. Visual acuities at final visit were 1.0 in 9 eyes, 0.8 in 1 eye, 0.4 in 1 eye, and no light perception in 1 eye.
CONCLUSION:
Cat scratch disease may present with different ocular signs and should be considered in the differential diagnosis in patients with such presentations.
=============================================================================
34.) Cat Scratch Disease: Expanded Spectrum.
===============================================
Ocul Oncol Pathol. 2016 Oct;2(4):246-250. Epub 2016 Jul 1.
Aziz HA1, Plesec TP2, Sabella C3, Udayasankar UK4, Singh AD1.
Author information
1Department of Ophthalmology, Cole Eye Institute, Ohio, USA.
2Anatomic Pathology, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
3Pediatric Infectious Diseases, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
4Radiology, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Abstract
BACKGROUND:
To expand the spectrum of ophthalmic manifestations in cat scratch disease.
METHODS:
Case report.
RESULTS:
A 7-year-old male was referred for evaluation of his left optic disc after failing vision screening test at school. His visual acuity was 20/20 OD and light perception OS. Fundus examination showed a left optic disc lesion associated with an exudative retinal detachment and vitreous seeding. Ultrasonography revealed a 7 × 7.5 × 3.8 mm lesion with a possible 6.3 mm of retrolaminar extension into the substance of the optic nerve. Brain MRI did not show evidence of optic nerve involvement but revealed a 6-mm nodule of the pineal gland suggestive of a pineoblastoma. Enucleation was performed and histopathology revealed a suppurative granulomatous inflammation suggestive of Bartonella infection. Upon further questioning, the patient had recent exposure to kittens with areas of cat scratches along both of his arms. He was subsequently referred to and treated with a 2-week course of trimethoprim-sulfamethoxazole and rifampin by the pediatric infectious disease specialist. Repeat brain MRI showed interval total resolution of enlarged pineal gland. Conclusion: Optic nerve granulomas are a rare presentation of cat scratch disease and could potentially masquerade as retinoblastoma.
============================================
35.) Dynamics of Co-Infection with Bartonella henselae Genotypes I and II in Naturally Infected Cats: Implications for Feline Vaccine Development.
=======================================================
Microb Ecol. 2017 Feb 2. doi: 10.1007/s00248-017-0936-8. [Epub ahead of print]
Huwyler C1,2, Heiniger N1,2, Chomel BB3, Kim M1,2, Kasten RW3, Koehler JE4,5.
Author information
1Microbial Pathogenesis and Host Defense Program, University of California, San Francisco, San Francisco, CA, 94143-0654, USA.
2Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, 513 Parnassus Ave., Room S-380, San Francisco, CA, 94143-0654, USA.
3Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA, 95616, USA.
4Microbial Pathogenesis and Host Defense Program, University of California, San Francisco, San Francisco, CA, 94143-0654, USA. jkoehler@medicine.ucsf.edu.
5Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, 513 Parnassus Ave., Room S-380, San Francisco, CA, 94143-0654, USA. jkoehler@medicine.ucsf.edu.
Abstract
Bartonella henselae is an emerging bacterial pathogen causing cat-scratch disease and potentially fatal bacillary angiomatosis in humans. Bacteremic cats constitute a large reservoir for human infection. Although feline vaccination is a potential strategy to prevent human infection, selection of appropriate B. henselae strains is critical for successful vaccine development. Two distinct genotypes of B. henselae (type I, type II) have been identified and are known to co-infect the feline host, but very little is known about the interaction of these two genotypes during co-infection in vivo. To study the in vivo dynamics of type I and type II co-infection, we evaluated three kittens that were naturally flea-infected with both B. henselae type I and type II. Fifty individual bloodstream isolates from each of the cats over multiple time points were molecularly typed (by 16S rRNA gene sequencing), to determine the prevalence of the two genotypes over 2 years of persistent infection. We found that both B. henselae genotypes were transmitted simultaneously to each cat via natural flea infestation, resulting in mixed infection with both genotypes. Although the initial infection was predominately type I, after the first 2 months, the isolated genotype shifted to exclusively type II, which then persisted with a relapsing pattern. Understanding the parameters of protection against both genotypes of B. henselae, and the competitive dynamics in vivo between the two genotypes, will be critical in the development of a successful feline vaccine that can ultimately prevent B. henselae transmission to human contacts.
=========================================================================
36.)Bacillary angiomatosis with bone invasion.
=========================================================================
An Bras Dermatol. 2016 Nov-Dec;91(6):811-814. doi: 10.1590/abd1806-4841.20165436.
Diniz LM1, Medeiros KB1, Landeiro LG1, Lucas EA1.
Author information
1Universidade Federal do Espírito Santo (UFES) - Vitória (ES), Brazil.
Abstract
Bacillary angiomatosis is an infection determined by Bartonella henselae and B. quintana, rare and prevalent in patients with acquired immunodeficiency syndrome. We describe a case of a patient with AIDS and TCD4+ cells equal to 9/mm3, showing reddish-violet papular and nodular lesions, disseminated over the skin, most on the back of the right hand and third finger, with osteolysis of the distal phalanx observed by radiography. The findings of vascular proliferation with presence of bacilli, on the histopathological examination of the skin and bone lesions, led to the diagnosis of bacillary angiomatosis. Corroborating the literature, in the present case the infection affected a young man (29 years old) with advanced immunosuppression and clinical and histological lesions compatible with the diagnosis.
==========================================================
37.) Molecular epidemiology of bartonella infections in patients with bacillary angiomatosis-peliosis.
==========================================================
N Engl J Med. 1997 Dec 25;337(26):1876-83.
Koehler JE1, Sanchez MA, Garrido CS, Whitfeld MJ, Chen FM, Berger TG, Rodriguez-Barradas MC, LeBoit PE, Tappero JW.
Author information
1Department of Medicine, University of California, San Francisco 94143-0654, USA.
Abstract
BACKGROUND:
Bacillary angiomatosis and bacillary peliosis are vascular proliferative manifestations of infection with species of the genus bartonella that occur predominantly in patients infected with the human immunodeficiency virus. Two species, B. henselae and B. quintana, have been associated with bacillary angiomatosis, but culture and speciation are difficult, and there has been little systematic evaluation of the species-specific disease characteristics. We studied 49 patients seen over eight years who were infected with bartonella species identified by molecular techniques and who had clinical lesions consistent with bacillary angiomatosis-peliosis.
METHODS:
In this case-control study, a standardized questionnaire about exposures was administered to patients with bacillary angiomatosis-peliosis and to 96 matched controls. The infecting bartonella species were determined by molecular techniques.
RESULTS:
Of the 49 patients with bacillary angiomatosis-peliosis, 26 (53 percent) were infected with B. henselae and 23 (47 percent) with B. quintana. Subcutaneous and lytic bone lesions were strongly associated with B. quintana, whereas peliosis hepatis was associated exclusively with B. henselae. Patients with B. henselae infection were identified throughout the study period and were epidemiologically linked to cat and flea exposure (P< or =0.004), whereas those with B. quintana were clustered and were characterized by low income (P=0.003), homelessness (P = 0.004), and exposure to lice (P= 0.03). Prior treatment with macrolide antibiotics appeared to be protective against infection with either species.
CONCLUSIONS:
B. henselae and B. quintana, the organisms that cause bacillary angiomatosis-peliosis, are associated with different epidemiologic risk factors and with predilections for involvement of different organs.
=================================================================
38.) Corticosteroid Treatment for Prolonged Fever in Hepatosplenic Cat-Scratch Disease.
============================================================
Clin Pediatr (Phila). 2016 Dec 1:9922816684606. doi: 10.1177/0009922816684606. [Epub ahead of print]
Phan A1,2, Castagnini LA1,2.
Author information
11 Baylor College of Medicine, San Antonio, TX, USA.
22 The Children's Hospital of San Antonio, San Antonio, TX, USA.
Abstract
Hepatosplenic cat-scratch disease (CSD) may cause prolonged fever. We present the case of a 4-year-old boy with confirmed hepatosplenic CSD with fever lasting 3 months despite use of multiple different antimicrobial agents. The patient became afebrile soon after corticosteroid therapy was started. Our case indicates corticosteroids may be useful in patients with hepatosplenic CSD and prolonged fever.
=================================================================
39.) Final Diagnosis in Patients Referred with a Diagnosis of Neuroretinitis.
================================================================
Neuroophthalmology. 2015 Dec 14;39(6):266-270. eCollection 2015.
Kahloun R1, Khairallah-Ksiaa I1, Abroug N1, Mahmoud A1, Ben Yahia S1, Zaouali S1, Jelliti B1, Khairallah M1.
Author information
Abstract
The purpose of this study was to determine final diagnosis of patients referred with a diagnosis of neuroretinitis. A retrospective study of 40 patients with optic disc oedema with macular star (ODOMS) referred with a diagnosis of neuroretinitis was conducted. The final diagnosis was neuroretinitis in 26 patients (65%), with most of these patients (96.1%) having unilateral involvement. Main underlying aetiologies included cat scratch disease (30.8%), rickettsiosis (19.2%), and idiopathic neuroretinitis (23.1%). The remaining 14 patients (35%) had ODOMS that had been mistaken for neuroretinitis. Of these patients, 42.8% were found to have a previously unknown malignant systemic hypertension in association with bilateral ODOMS. Neuroretinitis, usually unilateral, should be differentiated from other causes of unilateral or most often bilateral ODOMS that may masquerade as neuroretinitis, mainly malignant systemic hypertension. This is essential to avoid inappropriate work-up and management and subsequent potential visual or systemic morbidity.
==========================================================================
40.) Disseminated cat-scratch disease: case report and review of the literature.
================================================================
Paediatr Int Child Health. 2016 Jan 12:1-3. [Epub ahead of print]
Chang CC1, Lee CJ2, Ou LS3, Wang CJ1, Huang YC2,4.
Author information
Abstract
Cat scratch disease (CSD) can present as a systemic disease in 5-10% of cases and lead to various disease entities. A previously healthy 16-month-old boy presented with fever for 7 days without other obvious symptoms. Abdominal computed tomography scan demonstrated enlarged right inguinal lymph nodes and multiple small round hypodensities in the spleen. Despite antibiotic treatment for 1 week, the fever persisted and the intrasplenic lesions progressed. Inguinal lymph node biopsy confirmed CSD by immunohistochemistry staining. The diagnosis of CSD was also supported by a history of contact, imaging and serological findings. The patient recovered after treatment with azithromycin for a total of 5 weeks and, in serial follow-up, the hepatosplenic micro-abscesses resolved after 4th months.
========================================================
41.) Multiple Renal and Splenic Lesions in Cat Scratch Disease.
========================================================
Jpn J Infect Dis. 2016 Sep 21;69(5):424-5. doi: 10.7883/yoken.JJID.2015.362. Epub 2015 Nov 13.
Wakiguchi H1, Okamoto Y, Matsunaga M, Kodama Y, Miyazono A, Seki S, Ikeda N, Kawano Y.
Author information
1Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences.
Abstract
Cat scratch disease (CSD) is an infectious disease caused by Bartonella henselae. Atypical clinical presentations of CSD include prolonged fever and multiple hepatosplenic lesions. Furthermore, multiple renal lesions are extremely rare in CSD. An 11-year-old Japanese girl presented at our hospital with a prolonged fever of unknown cause after being scratched and bitten by a kitten. Abdominal computed tomography (CT) revealed multiple small, round hypodense lesions in both kidneys and the spleen. Based on her history and the CT results, her diagnosis was CSD. The diagnosis was confirmed by serological tests, which indicated antibodies against B. henselae. After treatment with azithromycin, her fever immediately improved. Careful history taking and imaging are essential for the diagnosis of atypical CSD. In CT images, not only hepatosplenic lesions but also renal lesions are important features indicative of a diagnosis of atypical CSD. Subsequently, a diagnosis of CSD can be confirmed by specific serological tests. This is the first reported Japanese case of multiple renal and splenic lesions in a patient with CSD. Although difficult to diagnose, an early diagnosis atypical CSD and appropriate treatment are important to prevent complications and the need for invasive examinations.
================================================================
=====================================================
42.) Cat-Scratch Disease in the United States, 2005-2013.
======================================================
Emerg Infect Dis. 2016 Oct;22(10):1741-6. doi: 10.3201/eid2210.160115.
Nelson CA, Saha S, Mead PS.
Abstract
Cat-scratch disease (CSD) is mostly preventable. More information about the epidemiology and extent of CSD would help direct prevention efforts to those at highest risk. To gain such information, we reviewed the 2005-2013 MarketScan national health insurance claims databases and identified patients <65 years of age with an inpatient admission or outpatient visit that included a CSD code from the International Classification of Diseases, Ninth Revision, Clinical Modification. Incidence of CSD was highest among those who lived in the southern United States (6.4 cases/100,000 population) and among children 5-9 years of age (9.4 cases/100,000 population). Inpatients were significantly more likely than outpatients to be male and 50-64 years of age. We estimate that each year, 12,000 outpatients are given a CSD diagnosis and 500 inpatients are hospitalized for CSD. Prevention measures (e.g., flea control for cats) are particularly helpful in southern states and in households with children. =====================================================================
43.) Cat fleas (Ctenocephalides felis) from cats and dogs in New Zealand: Molecular characterisation, presence of Rickettsia felis and Bartonella clarridgeiae and comparison with Australia.
===============================================================
Vet Parasitol. 2017 Jan 30;234:25-30. doi: 10.1016/j.vetpar.2016.12.017. Epub 2016 Dec 28.
Chandra S1, Forsyth M2, Lawrence AL3, Emery D1, Šlapeta J4.
Author information
1School of Life and Environmental Sciences, Faculty of Veterinary Science, University of Sydney, NSW, Australia.
2Merial New Zealand, Auckland, New Zealand.
3School of Life and Environmental Sciences, Faculty of Veterinary Science, University of Sydney, NSW, Australia; Department of Medical Entomology, The University of Sydney and Pathology West, ICPMR, Westmead Hospital, Westmead, NSW, Australia.
4School of Life and Environmental Sciences, Faculty of Veterinary Science, University of Sydney, NSW, Australia. Electronic address: jan.slapeta@sydney.edu.au.
Abstract
The cat flea (Ctenocephalides felis) is the most common flea species parasitising both domestic cats and dogs globally. Fleas are known vectors of zoonotic pathogens such as vector borne Rickettsia and Bartonella. This study compared cat fleas from domestic cats and dogs in New Zealand's North and South Islands to Australian cat fleas, using the mitochondrial DNA (mtDNA) marker, cytochrome c oxidase subunit I and II (cox1, cox2). We assessed the prevalence of Rickettsia and Bartonella using genus specific multiplexed real-time PCR assays. Morphological identification confirmed that the cat flea (C. felis) is the most common flea in New Zealand. The examined fleas (n=43) at cox1 locus revealed six closely related C. felis haplotypes (inter-haplotype distance 1.1%) across New Zealand. The New Zealand C. felis haplotypes were identical or near identical with haplotypes from southern Australia demonstrating common dispersal of haplotype lineage across both the geographical (Tasman Sea) and climate scale. New Zealand cat fleas carried Rickettsia felis (5.3%) and Bartonella clarridgeiae (18.4%). To understand the capability of C. felis to vector zoonotic pathogens, we determined flea cox1 and cox2 haplotype diversity with the tandem multiplexed real-time PCR and sequencing for Bartonella and Rickettsia. This enabled us to demonstrate highly similar cat fleas on cat and dog populations across Australia and New Zealand.
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