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The authors present a clinical case of cat's scratch disease, with lymphadenitis and inoculation pustule. A series of observations are made on the importance of anamnesis, histopathologic examination, elimination of other clinical entities with lymphadenopathic manifestations, for determining the diagnosis. The recent investigations are aimed at identifying the etiologic agent. The treatment of the disease is symptomatic.
Authors report a Pasteurella Multocida corneal abscess after a scratch from a cat. The evolution was torpid and needed a transfixiant keratoplasty. They recall bacterial tanks, infestation ways, clinical manifestations and bacteriological identification. They note the low occurrence of ophthalmological manifestations and the sensibility of Pasteurella to various antibiotics, especially Beta lactams, phenicol and cyclins.
A 67-year-old woman to our hospital because of the swelling of lymph nodes in the right inguinal region. Eighteen months before, right lower lobectomy was performed for primary lung cancer (papillary adenocarcinoma). In September 1986, she noticed the swelling of lymph no does in the right inguinal region and low grade fever. At first she was suspected to have a metastasis of the lung cancer. Lymph node biopsy was performed. The pathological examination revealed purulent lymphadenitis with granulomatous change, and Gram-negative Warthin Starry stain positive rods were found. In addition, she admitted a history of keeping cats fourteen years. Therefore the diagnosis of cat scratch disease was made. Six months later, she became free of the associated symptoms. We feel pathological confirmation of suspicious lymph nodes is important in the treatment of patients with history of malignancy.
Three patients with cat scratch diseases were treated with pefloxacin (800 mg p.d.). Three of four criteria of the diagnosis were present. The pathogen of the disease is probably an intracellular Gram negative bacilli with a deficient wall. Improvement was obtained in one case and partial response in two other cases.
The usual presentation of cat-scratch disease (CSD) is a subacute regional lymphadenitis following cutaneous inoculation. We present the case of a 10-yr-old white female with a 4-wk history of abdominal pain and fever, without associated lymphadenopathy. A 67Ga scintigram showed inhomogenous uptake by the liver. An abdominal computed tomographic (CT) scan revealed multiple low density lesions in the liver and the spleen, that were confirmed at laparotomy. Stellate microabscesses were seen on a wedge biopsy of the liver and a CSD antigen skin test was positive. CSD should be considered in the differential diagnosis of liver lesions, even in the absence of lymphadenopathy. This case emphasizes the importance of inhomogeneous 67Ga uptake by the liver.
We report a case of cat-scratch disease. The histological findings of the primary cutaneous lesion were characterized by the presence of necrotic areas surrounded by epithelioid cells in a palisade arrangement and an infiltrate composed of lymphoid cells, plasma cells and giant cells foreign body type.
This infection usually results from transmission to humans by the scratch of a cat, but may also follow spine stings or cuts from fresh bones of various animals, this explaining the ubiquity of the causative agent and its resistance to various physical agents. The primary lesion develops in the skin at the inoculation site, to be followed by the appearance of one or several satellite adenopathies, of regional distribution and evolving towards suppuration. Apart from some rare nervous manifestations the prognosis is usually good, but regression of the adenopathy is a slow process. Histology shows tumefaction of massed reticular cells with central necrosis, leucocyte diapedesis and ultimate abscess formation. Diagnosis is by evidence of allergy to a specific antigen formed of the pus from infected glands after sterilization. The responsibility of a gram-positive bacterium of the genus Rothia has just been demonstrated.
The cytologic features of cat scratch disease diagnosed by fine needle aspiration cytology of a right inguinal lymph node in a 23-year-old woman are reported. Characteristic granulomas, with peripherally palisading epithelioid histiocytes and centrally located neutrophils, and an associated polymorphic cell population were observed. The cytologic pattern closely parallels the expected histopathologic findings and therefore can suggest the diagnosis in unsuspected cases or can confirm the clinical impression. The cytologic differential diagnosis and a discussion of other granulomatous lymphadenitis are presented.
Authors present a 7-year-old patient with cat-scratch disease during which he developed a "grand mal" convulsive status with severe intracranial hypertension requiring epidural monitoring and energetic treatment. Outcome was favourable, without neurologic sequelae. Review etiology and diagnostic criteria of this disease pointing out atypical forms of presentation is made.
A case of cat-scratch syndrome is described. The dermatological features and skin reactions reported in this illness (erythema nodosum, erythema multiforma) as well as the diagnostical criteria are reviewed. The hypothetical nature of the etiologic agent of this syndrome is discussed.
An unusual case of cat scratch disease was reported. A pharyngeal form of the disease, with a primary site of inoculation in the nasopharynx was observed. The histology showing pseudo-tubercular follicules was misleading the diagnosis finally made by a strongly positive Hanger Rose reaction. From this case we are reviewing the main caracteristics of this disease and especially forms with mucosal inoculation.
Cat-scratch disease is usually a self-limiting illness but it can initially present as a tumor. A case of a lesion of the arm is described, with CT and MR findings. The radiologic appearance is not characteristic but the diagnosis can be suggested in a predisposing clinical setting.
OBJECTIVE: To assess the serologic response to Afipia and Bartonella, previously named Rochalimaea, in patients with cat scratch disease (CSD) and a healthy control group. DESIGN: Prospective, controlled trial. SETTING: Referral clinic and hospitalized patients in a university medical center. PARTICIPANTS: Eighty patients with CSD and 57 healthy control subjects of similar age. MAIN OUTCOME MEASURES: The immune responses to Afipia felis and Bartonella henselae were evaluated by a newly developed enzyme-linked immunosorbent assay (ELISA) in patients with CSD and healthy control subjects. Responses to B henselae were also measured by indirect fluorescent antibody (IFA) tests. Antibody levels to Bartonella quintana were measured by ELISA and IFA in a limited number of patients and control subjects. RESULTS: Of the 80 patients with clinical CSD, 56 had positive results of CSD skin tests. ELISA antibody levels to A felis did not differ between patients and control subjects, but immunoglobulin M (IgM) and IgG ELISA antibodies to B henselae and B quintana were significantly higher in patients than in control subjects. IFA responses to B henselae and B quintana were also significantly higher in patients than in control subjects. CONCLUSION: Patients with CSD had significant serologic responses to B henselae and B quintana but not to A felis, suggesting that the causative agent of CSD is antigenically related to the Bartonella genus and not to Afipia. The Bartonella IgM ELISA and IFA assay were both sensitive and specific and may be used to establish the diagnosis of CSD.
The results of studies on the serologic responses to Afipia felis and Rochalimaea henselae in suspected patients for Cat Scratch Disease (CSD) are illustrated. This preliminary study performed using Indirect Immunofluorescence Assay, proved negative for A. felis and R. henselae in some patients and positive in others; in a few instances the test was positive for both organisms. Additional microbiological and serological studies are needed to clarify the exact role of these microorganisms in causing CSD.
On August 14, 1994, the Broward County Public Health Unit of the Florida Department of Health and Rehabilitative Services was notified of three children from Pompano Beach who were hospitalized with encephalitis attributed to cat scratch disease (CSD). All three children (aged 5, 6, and 11 years) were previously healthy and had no histories of seizure disorders or diagnoses of CSD. This report summarizes the investigation of these cases.
The case of a 24 year old female student who developed typical cat scratch disease following an insect sting invited to review the literature. Over the last two years, Rocalimaea henselae could be identified and is now considered to be responsible for the majority of infected cases. It is related to Rochalimaea quintana that provokes trench fever and to Bartonella bacilliformis, known as the inciting agent of the verruca peruana and of Oroya fever. Recently, it has been proposed to integrate Rochalimaea and Bartonella into the family of Bartonellaceae. The diverse and fascinating array of clinical syndromes caused by R. henselae as well as their treatment are described. Capability to affect organs other than skin and lymph nodes is primarily but not exclusively associated with immunodeficiencies. In countries like Switzerland little information on these clinical pictures is available. However, it is important to recognize the typical symptoms and signs in order to initiate the appropriate and necessary examinations.
The first Danish case of Parinaud's oculoglandular syndrome, a manifestation of cat-scratch disease, is reported in a 35-year-old man presenting with an enlarged preauricular lymph node and an ipsilateral conjunctival granuloma. Surgical removal of the granulomatous lesion was followed by rapid healing. The diagnosis was verified by demonstrating a high antibody tire against Rochalimaea (Bartonella) henselae. On subsequent questioning the man gave a history of acquiring a kitten six weeks before his illness. The importance of eye examination in patients presenting with preauricular lymphadenopathy is emphasized.
The recent characterisation of a new species of the genus Rochalimaea is the culmination of a ten year search for the identity of the agent of bacillary angiomatosis, a condition that is increasingly recognised in association with AIDS. This work has also implicated Rochalimaea henselae in the aetiology of cat scratch disease contact with cats is a risk factor for both conditions. This report describes both diseases and reviews progress toward understanding their microbiology. R. quintana is also implicated as an agent of bacillary angiomatosis and was recognised much earlier as the cause of trench fever.