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American Family Physician Jan 2011Cat-scratch disease is a common infection that usually presents as tender lymphadenopathy. It should be included in the differential diagnosis of fever of unknown origin... (Review)
Review
Cat-scratch disease is a common infection that usually presents as tender lymphadenopathy. It should be included in the differential diagnosis of fever of unknown origin and any lymphadenopathy syndrome. Asymptomatic, bacteremic cats with Bartonella henselae in their saliva serve as vectors by biting and clawing the skin. Cat fleas are responsible for horizontal transmission of the disease from cat to cat, and on occasion, arthropod vectors (fleas or ticks) may transmit the disease to humans. Cat-scratch disease is commonly diagnosed in children, but adults can present with it as well. The causative microorganism, B. henselae, is difficult to culture. Diagnosis is most often arrived at by obtaining a history of exposure to cats and a serologic test with high titers (greater than 1:256) of immunoglobulin G antibody to B. henselae. Most cases of cat-scratch disease are self-limited and do not require antibiotic treatment. If an antibiotic is chosen, azithromycin has been shown in one small study to speed recovery. Infrequently, cat-scratch disease may present in a more disseminated form with hepatosplenomegaly or meningoencephalitis, or with bacillary angiomatosis in patients with AIDS.
Topics: Adult; Animals; Bartonella henselae; Cat-Scratch Disease; Cats; Child; Humans
PubMed: 21243990
DOI: No ID Found -
Journal of Clinical and Experimental... 2012In this review, representative types of granulomatous lymphadenitis (GLA) are described. GLA can be classified as noninfectious GLA and infectious GLA. Noninfectious GLA... (Review)
Review
In this review, representative types of granulomatous lymphadenitis (GLA) are described. GLA can be classified as noninfectious GLA and infectious GLA. Noninfectious GLA includes sarcoidosis and sarcoid-like reaction. The cause of sarcoidosis remains unknown, but it has good prognosis. Sarcoid-like reaction, which is considered to be a biological defense mechanism, is observed in regional lymph nodes with many underlying diseases. Infectious GLA can be classified as suppurative lymphadenitis (LA) and nonsuppurative LA. Suppurative LA generally shows follicular hyperplasia and sinus histiocytosis in the early phase. In tularemia and cat scratch disease, monocytoid B lymphocytes (MBLs) with T cells and macrophages contribute to the formation of granuloma. However, none of the epithelioid cell granulomas of Yersinia LA contains MBLs like in cat scratch disease. In addition, almost all have a central abscess in granulomas induced by Gram-negative bacteria. In terms of the lymph nodes, tularemia and cat scratch disease are apt to affect the axillary and cervical regions while Yersinia LA affects the mesenteric lymph node. Nonsuppurative LA includes tuberculosis and BCG-histiocytosis. These are induced by delayed allergic reaction of M. tuberculosis. Tuberculosis LA mainly appears in the cervical lymph node. Organisms are histologically detected by Ziehl-Neelsen staining in the necrotic area. Toxoplasmosis is also a nonsuppurative protozoan infection (Toxoplasma gondii). In toxoplasma LA, MBLs can also be seen, but round and organized, well-formed granulomas are not found in this disease. Furthermore, necrosis is not induced and there are no accompanying neutrophils, eosinophils and fibrosis. GLA described above is associated with characteristic histological findings. An accurate pathological diagnosis using the above findings can lead to precise treatment.
Topics: Animals; Cat-Scratch Disease; Gram-Negative Bacterial Infections; Granuloma; Humans; Lymph Nodes; Sarcoidosis
PubMed: 22706525
DOI: 10.3960/jslrt.52.1 -
Revue Medicale de Liege Jul 2020We present three clinical cases to show the diversity of clinical presentations of Bartonella henselae infection, from classical adenopathy to disseminated form. It is...
We present three clinical cases to show the diversity of clinical presentations of Bartonella henselae infection, from classical adenopathy to disseminated form. It is an infection that leads to diagnostic wandering, due to a lack of explicit history and the variety of clinical manifestations. Antibiotic therapy is rarely necessary because it has a spontaneously favourable evolution in the majority of cases.
Topics: Anti-Bacterial Agents; Bartonella henselae; Cat-Scratch Disease; Humans
PubMed: 32779899
DOI: No ID Found -
Acta Ophthalmologica Jun 2018To characterize cat-scratch disease (CSD) ocular manifestations and visual outcome and evaluate the effect of systemic antibiotics and corticosteroids on final visual... (Comparative Study)
Comparative Study
PURPOSE
To characterize cat-scratch disease (CSD) ocular manifestations and visual outcome and evaluate the effect of systemic antibiotics and corticosteroids on final visual acuity (VA).
METHODS
Multicentre retrospective cohort study. Medical records of 86 patients with ocular disease (107 eyes) of 3222 patients identified in a national CSD surveillance study were reviewed.
RESULTS
Mean age was 35.1 ± 14.2 years. Median follow-up was 20 weeks (range 1-806 weeks). Of 94/107 (88%) eyes with swollen disc, 60 (64%) had neuroretinitis at presentation, 14 (15%) developed neuroretinitis during follow-up, and 20 (21%) were diagnosed with inflammatory disc oedema. Optic nerve head lesion, uveitis, optic neuropathy and retinal vessel occlusion were found in 43 (40%), 38 (36%), 34 (33%) and 8 (7%) eyes, respectively. Good VA (better than 20/40), moderate vision loss (20/40-20/200) and severe vision loss (worse than 20/200) were found in 26/79 (33%), 35/79 (44%) and 18/79 (23%) eyes at baseline and in 63/79 (80%), 11/79 (14%) and 5/79 (6%) eyes at final follow-up, respectively (p < 0.001). Significant VA improvement (defined as improvement of ≥3 Snellen lines at final follow-up compared to baseline) occurred in 12/24 (50%) eyes treated with antibiotics compared with 14/16 (88%) eyes treated with antibiotics and corticosteroids (p = 0.02). Multivariate logistic regression was suggestive of the same association (odds ratio 7.0; 95% CI 1.3-37.7; p = 0.024).
CONCLUSION
Optic nerve head lesion is a common and unique manifestation of ocular CSD. Most patients improved and had final good VA. Combined antibiotics and corticosteroid treatment was associated with a better visual outcome.
Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Antibodies, Bacterial; Bartonella henselae; Cat-Scratch Disease; Child; DNA, Bacterial; Eye Infections, Bacterial; Female; Fluorescein Angiography; Fundus Oculi; Glucocorticoids; Humans; Male; Middle Aged; Retrospective Studies; Treatment Outcome; Vision Disorders; Visual Acuity; Young Adult
PubMed: 29504674
DOI: 10.1111/aos.13684 -
Turkish Journal of Ophthalmology Aug 2023To present the clinical and demographic characteristics, imaging findings, diagnosis and treatment approach in cases of cat scratch disease (CSD) with ocular involvement.
OBJECTIVES
To present the clinical and demographic characteristics, imaging findings, diagnosis and treatment approach in cases of cat scratch disease (CSD) with ocular involvement.
MATERIALS AND METHODS
The records of 19 patients followed-up and treated between 2010 and 2020, including detailed ophthalmological examinations, imaging findings, and treatment approach, were evaluated retrospectively.
RESULTS
Twenty-three eyes of 19 patients, 7 female (37%) and 12 male (63%), were included in the study. The mean age was 34.1±13.3 (range: 11-56) years, and the mean follow-up duration was 12.6±18.0 (range: 1-81) months. Unilateral involvement was observed in 15 cases (79%). Cat contact was reported in 14 cases (74%). In 6 cases (32%), flu-like symptoms were present before the ocular complaints. The mean visual acuity (VA) at presentation was 0.42±0.36 (range: 0.001-1.0). Anterior uveitis was observed in 3 eyes (13%). Posterior segment findings included neuroretinitis in 14 (61%), superficial retinal infiltrate(s) in 8 (35%), papillitis in 3 (13%), branch retinal artery occlusion in 2 (8%), and cilioretinal artery occlusion in 1 (4%) of the eyes. All cases were positive for immunglobulin (Ig)M and/or IgG. Systemic antibiotic therapy was administered to all patients. Intravenous pulse or oral corticosteroids were given, especially in cases with optic disc involvement. The mean final VA was 0.80±0.25 (range: 0.01-1.0).
CONCLUSION
CSD may present with different ocular involvement patterns. Apart from the classical neuroretinitis and macular star appearance, patients may present with isolated optic disc edema, branch retinal artery occlusion, and retinal infiltrations. In such patients, cat contact history and serology should be evaluated to differentiate CSD.
Topics: Female; Male; Humans; Cat-Scratch Disease; Retrospective Studies; Retina; Retinitis; Chorioretinitis; Retinal Artery Occlusion
PubMed: 37602640
DOI: 10.4274/tjo.galenos.2022.44692 -
Revue Scientifique Et Technique... Apr 2000Cat-scratch disease (CSD) was first described by Debré in 1950, yet the causative bacterial agent of CSD remained obscure until 1992, when Bartonella (formerly... (Review)
Review
Cat-scratch disease (CSD) was first described by Debré 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. Bartonella henselae had initially been linked to bacillary angiomatosis (BA), a vascular proliferative disease most commonly associated with long-standing human immunodeficiency virus infection or other significant immunosuppression. Bartonella 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. Cat-to-cat transmission of the organism by the cat flea, with no direct contact transmission, has been demonstrated. Two new Bartonella species have been identified in the cat reservoir, namely: B. clarridgeiae and B. koehlerae. The role of these species in the aetiology of CSD still needs to be confirmed by isolation or DNA identification from lesions in humans. The author discusses the present state of knowledge on the aetiology, clinical features and epidemiological characteristics of CSD/BA, in addition to diagnosis, treatment and prevention.
Topics: Animals; Bartonella; Cat Diseases; Cat-Scratch Disease; Cats; Dog Diseases; Dogs; Humans; Zoonoses
PubMed: 11189710
DOI: 10.20506/rst.19.1.1204 -
Revue Scientifique Et Technique... Sep 1996Cat-scratch disease (CSD) was first described by Debré in 1950, yet the causative bacterial agent of CSD remained obscure until 1992, when Bartonella (formerly... (Review)
Review
Cat-scratch disease (CSD) was first described by Debré 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.
Topics: Angiomatosis, Bacillary; Animals; Bacteremia; Bartonella henselae; Cat Diseases; Cat-Scratch Disease; Cats; Disease Reservoirs; Humans; Prevalence; United States
PubMed: 9025151
DOI: 10.20506/rst.15.3.975 -
BMC Ophthalmology Aug 2023Cat-scratch disease typically presents with various ocular manifestations such as uveitis, vitritis, retinitis, retinochoroiditis, and optic neuritis. However, fundus...
BACKGROUND
Cat-scratch disease typically presents with various ocular manifestations such as uveitis, vitritis, retinitis, retinochoroiditis, and optic neuritis. However, fundus nodular lesions was rarely reported. In our study, we reported a case of Cat-Scratch disease with binocular fundus nodular lesions.
CASE PRESENTATION
An 11-year old male presented with uveitis in the right eye and bilateral fundus nodular lesions after indirect contact with unvaccinated cats. Comprehensive ancillary examinations including wide-angle fundus photography, ultrasonography, fluorescein fundus angiography, optical coherence tomography, and orbital magnetic resonance imaging were performed to elucidate the multidimensional features of the binocular lesions. Metagenomics next-generation sequencing was utilized to confirm the diagnosis of Cat-scratch disease. The patient's condition showed improvement after a 6-month combination treatment regimen involving systemic administration of doxycycline hyclate and methylprednisolone tablets, as well as local application of mydriatic and corticosteroid eye drops.
CONCLUSIONS
We firstly reported a case of Cat-scratch disease presenting simultaneously with uveitis and fundus nodular lesions caused by Bartonella henselae infection in a child. Timely diagnosis and treatment with antibiotics and corticosteroids showed promising outcomes for the prognosis of these ocular disorders.
Topics: Male; Humans; Cat-Scratch Disease; Bartonella henselae; Fundus Oculi; Retinitis; Chorioretinitis
PubMed: 37544996
DOI: 10.1186/s12886-023-03063-4 -
Journal of Current Ophthalmology Sep 2019To review the clinical features, diagnosis, treatment modalities, and prognosis of Bartonella-associated neuroretinitis. (Review)
Review
PURPOSE
To review the clinical features, diagnosis, treatment modalities, and prognosis of Bartonella-associated neuroretinitis.
METHODS
This is a narrative review on Bartonella-associated neuroretinitis including general and ophthalmological aspects of the disease. A comprehensive literature review between January 1950 and September 2018 was conducted in PubMed database. Epidemiology, clinical features, diagnosis, treatment, and prognosis of Bartonella neuroretinitis were reviewed.
RESULTS
Cat scratch disease (CSD) is a worldwide distributed systemic infectious disease caused by a bacterium, which is usually transmitted to humans through contact with infected cats. Ocular manifestations of CSD are diverse, with neuroretinitis and superficial retinal infiltrates being the most common and typical manifestations. Neuroretinitis typically presents as optic disc edema with a partial or complete macular star in association with mild vitritis. Macular star may be absent at the initial presentation, becoming evident 1-2 weeks after the onset of optic disc edema. Diagnosis of CSD is confirmed by reliable laboratory tests. Neuroretinitis usually has a self-limited course. Antibiotic therapy is required for severe systemic disease and vision-threatening ocular involvement. The adjunctive use of oral corticosteroids may further improve the visual outcome.
CONCLUSIONS
The diagnosis of Bartonella-associated neuroretinitis is based on typical clinical findings and positive serology. The prognosis is usually favorable in immunocompetent individuals.
PubMed: 31528758
DOI: 10.1016/j.joco.2019.03.005