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.,,,
================================================================
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
comments].
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.
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.
===============================================================
================================================================
1.)
The Cat-Scratch Disease
=========================================================================
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.
=========================================================================
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.
=========================================================================
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.
=========================================================================
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.
=========================================================================
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.
=========================================================================
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.
=========================================================================
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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