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H A Carithers

Publications and source records attributed to H A Carithers.

11 recordsLinked to original sources
PubMed1991

Cat-scratch disease. Acute encephalopathy and other neurologic manifestations.

Seventy-six patients with neurologic complications of cat-scratch disease are discussed. Encephalopathy occurred in 61, while 15 had either cranial or peripheral nerve involvement. The average age of the patients with encephalopathy was 10.6 years (range, 1 to 66 years), and almost twice as many males as females were affected in contrast to patients with uncomplicated cat-scratch disease, in which the ratio was almost equal. Fever was not documented in 50% of patients with encephalopathy and only 26% had temperatures higher than 39 degrees C. Convulsions occurred in 46% and combative behavior in 40%. Lethargy with or without coma was accompanied by variable neurologic signs. Results of laboratory studies, including imaging of the central nervous system, were inconsistent and nondiagnostic. Biopsy tissue from 14 patients showed histopathologic findings compatible with cat-scratch disease. The "English-Wear bacillus" was demonstrated by the Warthin-Starry stain in 10 of 14 skin or lymph node specimens. Of the 15 patients without encephalopathy, two children with facial nerve paresis displayed cranial nerve symptoms and/or signs, 10 patients had cat-scratch disease neuroretinitis, and three women had peripheral neuritis. All 76 patients recovered within 12 months; 78% recovered within 1 to 12 weeks. There were no neurologic sequelae. Treatment consisted of control of convulsions and supportive measures. Commonly used antibiotics administered to more than half of the patients were apparently ineffective.

Adolescent↗
PubMed1985

Cat-scratch disease. An overview based on a study of 1,200 patients.

This study by one individual of 1,200 patients with cat-scratch disease provides a heretofore unavailable realistic evaluation of a common infectious disease. All patients had lymphadenopathy, a prerequisite for diagnosis. Suppuration occurred in 11.8% of patients. Cat contact was established for 99.1%, and the cat was immature in the vast majority. An inoculation site, the most neglected feature in the study of the patients, was detected in 92.6%. The results of a skin test, considered as specific as the standard tuberculin test and to be safe but not standardized, was positive in 99%. The 12 patients with negative skin tests probably were tested too early in the course of the disease to have developed reactivity. Skin tests of 578 family members of patients, who served as controls, gave positive results in 18.5%. Of 60 patients with unusual manifestations, 48 had the oculoglandular syndrome of Parinaud. Other manifestations included erythema nodosum, encephalopathy, osteolytic lesions, thrombocytopenic purpura, and erythema marginatum. Most patients in this series had received antibiotics of many types during the course of the disease. None appeared beneficial. The disease is benign in character in a majority of patients. Surgical removal of involved lymph nodes or biopsy of lymph nodes or inoculation sites is not necessary for diagnosis or management. A survey of hospitals in the United States discharging more than 750 pediatric patients annually indicates that cat-scratch disease is a problem in all sections of the country.

Adolescent↗
PubMed1983

Cat-scratch disease associated with an osteolytic lesion.

Lytic bone involvement accompanying cat-scratch disease has been described previously in three patients. I observed a fourth patient with this pathologic condition and noted variations among the four patients. To my knowledge, this patient is the first in whom extension from an involved lymph node to a bone was direct.

Bone Resorption↗
PubMed1978

Oculoglandular disease of parinaud. A manifestation of cat-scratch disease.

Among patients with cat-scratch disease, the oculoglandular form is the most common unusual manifestation. This condition, seen in 14 of 585 patients with the infection encountered in a private pediatric practice over a span of 23 years, belongs in the syndrome of the oculoglandular disease of Parinaud. Most of the 14 patients described were only mildly ill and had but little discomfort. All patients recovered without residuals. Diagnosis is based on four criteria: exposure to a cat, usually an immature one; the presence of a localized granuloma of the eye; the presence of preauricular lymphadenopathy; and a positive skin test to cat-scratch antigen of known potency. Several unusual features, never before described, of oculoglandular disease due to cat-scratch disease are submitted.

Adolescent↗