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Amin O, Rostad CA, Gonzalez M, Rostad BS, Caltharp S, Quincer E, Betke BA, Gottdenker NL, Wilson JJ, Shane AL, Elmontser M, Camacho-Gonzalez A, Senior T, Smith O, Anderson EJ, Yildirim I. Cat Scratch Disease: 9 Years of Experience at a Pediatric Center. Open Forum Infect Dis 2022; 9:ofac426. [PMID: 36072697 PMCID: PMC9439574 DOI: 10.1093/ofid/ofac426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/18/2022] [Indexed: 11/14/2022] Open
Abstract
Background A more complete understanding of the epidemiology, risk factors, and clinical features of cat scratch disease (CSD) in children could help guide patient care. Methods We conducted a retrospective analysis of children presenting to a tertiary pediatric hospital system in Atlanta, Georgia between January 1, 2010 and December 31, 2018 who had serology, polymerase chain reaction, and/or cytopathological results consistent with a Bartonella henselae infection. We also retrospectively reviewed veterinary diagnostic results performed at the University of Georgia from 2018 to 2020 to ascertain the burden of bartonellosis in companion animals within the state. Results We identified 304 children with CSD over 9 years with the largest proportion of diagnoses made during August (41 of 304, 13.5%) and September (47 of 304, 15.5%). The median age of child cases was 8.1 years (interquartile range [IQR], 5.4-12.1); 156 (51.3%) were female; 242 of 262 (92.4%) reported feline exposure; and 55 of 250 (22%) reported canine exposure of those with exposure histories documented in the medical record. Although lymphadenopathy was present on physical examination in the majority of cases (78.8%), atypical presentations lacking lymphadenopathy were also common (63 of 304, 20.7%). Among children with radiographic imaging, 20 of 55 (36.4%) had splenomegaly and 21 of 55 (38.1%) had splenic and/or hepatic microabscesses. Among veterinary data, Bartonella seroprevalence was 12 of 146 (8.2%), all among canines, with a geographic distribution that spanned the state of Georgia. Conclusions Distinguishing clinical features of CSD included subacute regional lymphadenopathy in school-aged children in the late summer, almost all of whom had cat exposure. Atypical clinical manifestations of CSD were also commonly identified.
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Affiliation(s)
- Omayma Amin
- Department of Pediatrics, Emory University School of Medicine and Children’s Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Christina A Rostad
- Department of Pediatrics, Emory University School of Medicine and Children’s Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Mark Gonzalez
- Department of Clinical Microbiology, Children’s Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Bradley S Rostad
- Division of Pediatric Radiology, Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Shelley Caltharp
- Department of Pathology and Laboratory Medicine, Children’s Healthcare of Atlanta, Atlanta, Georgia, USA
- Department of Pathology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Elizabeth Quincer
- Department of Pediatrics, Emory University School of Medicine and Children’s Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Briana A Betke
- Department of Veterinary Pathology, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Nicole L Gottdenker
- Department of Veterinary Pathology, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Jonathan J Wilson
- Department of Veterinary Pathology, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Andi L Shane
- Department of Pediatrics, Emory University School of Medicine and Children’s Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Mohnd Elmontser
- Department of Pediatrics, Emory University School of Medicine and Children’s Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Andres Camacho-Gonzalez
- Department of Pediatrics, Emory University School of Medicine and Children’s Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Tal Senior
- Department of Advanced Analytics, Children’s Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Oliver Smith
- Department of Pediatrics, Emory University School of Medicine and Children’s Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Evan J Anderson
- Department of Pediatrics, Emory University School of Medicine and Children’s Healthcare of Atlanta, Atlanta, Georgia, USA
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Inci Yildirim
- Department of Pediatrics, Emory University School of Medicine and Children’s Healthcare of Atlanta, Atlanta, Georgia, USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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Pischel L, Radcliffe C, Vilchez GA, Charifa A, Zhang XC, Grant M. Bartonellosis in transplant recipients: A retrospective single center experience. World J Transplant 2021; 11:244-253. [PMID: 34164299 PMCID: PMC8218350 DOI: 10.5500/wjt.v11.i6.244] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/12/2021] [Accepted: 06/01/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Bartonellosis is a rare but challenging condition to diagnose with a spectrum of clinical presentations in the immunocompromised host. AIM To further characterize the presentation of Bartonella henselae (B. henselae) infections in solid organ and hematopoietic stem cell transplant recipients. METHODS We conducted a single-center retrospective study of all B. henselae testing for 5012 transplant recipients receiving care at a single institution between 2011 and 2018. RESULTS We identified 38 patients who underwent testing for B. henselae, and three of 38 were found to have bartonellosis. Two of the patients were renal transplant recipients who presented with visceral bartonellosis and symptoms concerning for post-transplant lymphoproliferative disorder. One autologous stem cell transplant recipient presented with cat scratch disease. We detail the clinical courses of these three cases and review the literature concerning the clinical presentations, differential diagnosis, and limitations of diagnostic tests for B. henselae infections in transplant recipients. CONCLUSION Although the incidence of B. henselae infection in transplant recipients is unknown, it merits inclusion in the differential diagnosis for fever of unknown origin in this population.
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Affiliation(s)
- Lauren Pischel
- Section of Infectious Diseases, Department of Medicine, Yale University School of Medicine, New Haven, CT 06510, United States
| | - Christopher Radcliffe
- Section of Infectious Diseases, Department of Medicine, Yale University School of Medicine, New Haven, CT 06510, United States
| | - Gabriel A Vilchez
- Department of Infectious Diseases, University of Kentucky, Lexington, KY 40536, United States
| | - Ahmad Charifa
- Department of Pathology, University of California, Irvine, CA 92868, United States
| | - Xu-Chen Zhang
- Department of Pathology, Yale University School of Medicine, New Haven, CT 06510, United States
| | - Matthew Grant
- Section of Infectious Diseases, Department of Medicine, Yale University School of Medicine, New Haven, CT 06510, United States
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Tay SY, Freeman K, Baird R. Clinical Manifestations Associated with Bartonella henselae Infection in a Tropical Region. Am J Trop Med Hyg 2021; 104:198-206. [PMID: 33021197 DOI: 10.4269/ajtmh.20-0088] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Bartonella henselae is a zoonotic Gram-negative Bacillus associated with self-limited regional lymphadenopathy. In recent decades, an expanding spectrum of clinical manifestations has been described, in part, due to improved diagnostics. However, updated epidemiological data are sparse. We retrospectively reviewed the clinical features of 31 patients with B. henselae infection over 15 years from 2005 to 2019, in the tropical Top End of Australia. Our annual disease incidence of 1.3 cases per 100,000 population is lower than that in the national database surveillances in the United States, but the hospitalization incidence of 0.9 per 100,000 population in our region is higher than those reported in the literature, with an average length of stay of 9 days. Patients were more commonly male, aboriginal, and aged less than 14 years (median age: 7 years), living in a rural setting with presentation during our monsoon season. The disease spectrum included lymph node disease (74%), organ peliosis, endocarditis, cutaneous lesions, parapharyngeal abscess, parotitis, and neurologic and ocular syndromes. Lymph node disease was far commoner in children than the more serious systemic B. henselae infections associated with adults (P = 0.074). Although no deaths were reported, significant morbidities were observed. Two endocarditis cases presented with glomerulonephritis, and hematological and neurological features mimicking vasculitis, and consequently received immunosuppressants. One case was only diagnosed after representation with serial embolic strokes. Given the heterogeneity of disease manifestations with nonspecific symptoms and significant consequences, a timely and accurate diagnosis is needed to avoid unnecessary treatments or interventions.
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Teles-Silva C, Reis-Melo A, Rodrigues Araújo J, Sampaio M, Tavares M. Visual Diagnosis: Sudden-Onset Decreased Vision in a Healthy Teenage Boy. Pediatr Rev 2020; 41:e12-e15. [PMID: 32238554 DOI: 10.1542/pir.2018-0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Seo JW, Kim CM, Yun NR, Kim DM, Kim SS, Choi S, Chu H. Scalp eschar and neck lymphadenopathy after tick bite (SENLAT) caused by Bartonella henselae in Korea: a case report. BMC Infect Dis 2020; 20:216. [PMID: 32164559 PMCID: PMC7066777 DOI: 10.1186/s12879-020-4940-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 03/01/2020] [Indexed: 11/20/2022] Open
Abstract
Background Tick-borne lymphadenopathy (TIBOLA) is an infectious disease, mainly caused by species from the spotted fever group rickettsiae and is characterized by enlarged lymph nodes following a tick bite. Among cases of TIBOLA, a case of scalp eschar and neck lymphadenopathy after tick bite (SENLAT) is diagnosed when an eschar is present on the scalp, accompanied by peripheral lymphadenopathy (LAP). Only a few cases of SENLAT caused by Bartonella henselae have been reported. Case presentation A 58-year-old male sought medical advice while suffering from high fever and diarrhea. Three weeks before the visit, he had been hunting a water deer, and upon bringing the deer home discovered a tick on his scalp area. Symptoms occurred one week after hunting, and a lump was palpated on the right neck area 6 days after the onset of symptoms. Physical examination upon presentation confirmed an eschar-like lesion on the right scalp area, and cervical palpation revealed that the lymph nodes on the right side were non-painful and enlarged at 2.5 × 1.5 cm. Fine needle aspiration of the enlarged lymph nodes was performed, and results of nested PCR for the Bartonella internal transcribed spacer (ITS) confirmed B. henselae as the causative agent. Conclusion With an isolated case of SENLAT and a confirmation of B. henselae in Korea, it is pertinent to raise awareness to physicians in other Asian countries that B. henselae could be a causative agent for SENLAT.
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Affiliation(s)
- Jun-Won Seo
- Department of Internal Medicine, College of Medicine, Chosun University, 588 Seosuk-dong, Dong-gu, Gwangju, 61453, Republic of Korea
| | - Choon-Mee Kim
- Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Na Ra Yun
- Department of Internal Medicine, College of Medicine, Chosun University, 588 Seosuk-dong, Dong-gu, Gwangju, 61453, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, College of Medicine, Chosun University, 588 Seosuk-dong, Dong-gu, Gwangju, 61453, Republic of Korea.
| | - Sung Soon Kim
- Division of Bacterial Disease Research, Center for Infectious Disease Research, Korea National Institute of Health, Chungcheongbuk-do, Korea
| | - Sangho Choi
- Division of Bacterial Disease Research, Center for Infectious Disease Research, Korea National Institute of Health, Chungcheongbuk-do, Korea
| | - Hyuk Chu
- Division of Bacterial Disease Research, Center for Infectious Disease Research, Korea National Institute of Health, Chungcheongbuk-do, Korea
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Yanagihara M, Tsuneoka H, Tanimoto A, Otsuyama KI, Nishikawa J, Matsui T, Nojima J, Ichihara K. Bartonella henselae DNA in Seronegative Patients with Cat-Scratch Disease. Emerg Infect Dis 2019; 24:924-925. [PMID: 29664374 PMCID: PMC5938771 DOI: 10.3201/eid2405.152033] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We used real-time PCR to detect Bartonella henselae DNA in 7.9% (5/63) of blood specimens from seronegative patients in Japan suspected of having cat-scratch disease. The combined use of serologic tests and real-time PCR to analyze blood specimens is recommended for the prompt, noninvasive laboratory diagnosis of cat-scratch disease.
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Allizond V, Costa C, Sidoti F, Scutera S, Bianco G, Sparti R, Banche G, Dalmasso P, Cuffini AM, Cavallo R, Musso T. Serological and molecular detection of Bartonella henselae in specimens from patients with suspected cat scratch disease in Italy: A comparative study. PLoS One 2019; 14:e0211945. [PMID: 30735549 PMCID: PMC6368319 DOI: 10.1371/journal.pone.0211945] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 01/24/2019] [Indexed: 02/02/2023] Open
Abstract
Cat scratch disease (CSD) is an infectious disease caused by Bartonella henselae, usually characterized by self-limiting regional lymphadenopathy and fever. Given the low clinical diagnostic sensitivity and specificity of conventional anti-B. henselae indirect immunofluorescence assays (IFAs), real-time polymerase chain reaction (PCR)-based detection of B. henselae is now being proposed as a more sensitive tool to diagnose CSD. Thus, here we have assessed the efficacy of real-time PCR in detecting B. henselae in different specimens from patients with suspected CSD and compared it to that of IFA. From March 2011 to May 2016, at the Microbiology and Virology Unit, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin, Italy, 115 clinical specimens (56 aspirated pus, 39 fresh lymph node biopsies, and 20 whole blood samples) and 99 sera from 115 patients with suspected CSD (62 females and 53 males between the ages of 3 months and 68 years) were analyzed by both real-time PCR, used in a qualitative way, and IFA (IgM and IgG) for the presence of B. henselae. For 16 patients, serological results were not available due to a clinical decision not to request the test. B. henselae DNA positivity was detected by real-time PCR in 37.39% of patients, while 62.61% of them were negative. Thus, patients were divided into two groups: real-time PCR+ (n = 43) and real-time PCR- (n = 72). Real-time PCR screening of whole blood, biopsies, and aspirated pus revealed B. henselae positivity in 40%, 38.46%, and 35.71% of patients, respectively. When we analyzed samples by IFA, we found the presence of B. henselae in 28 out of 99 (28.28%) patients, of which 11 (11.11%) belonged to the real-time PCR+ group and 17 (17.17%) to the real-time PCR- group. Among the 71 seronegative subjects, 16 (16.16%) were found positive for B. henselae by real-time PCR. Thus, by combining the results of both assays, we were able to increase the percentage of B. henselae positive specimens from 27.27% (real-time PCR) or 28.28% (IFA) to 44.44% (real-time PCR+IFA). Altogether, these findings indicate that the early detection of B. henselae in patients with suspicious CSD through combined real-time PCR and serological analyses can lead to a more accurate diagnosis of CSD, thereby allowing prompt and appropriate disease management.
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Affiliation(s)
- Valeria Allizond
- Microbiology section, Department of Public Health and Pediatrics, University of Torino, Turin, Italy
| | - Cristina Costa
- Microbiology and Virology Unit, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Francesca Sidoti
- Microbiology and Virology Unit, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Sara Scutera
- Microbiology section, Department of Public Health and Pediatrics, University of Torino, Turin, Italy
| | - Gabriele Bianco
- Microbiology and Virology Unit, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Rosaria Sparti
- Microbiology section, Department of Public Health and Pediatrics, University of Torino, Turin, Italy
| | - Giuliana Banche
- Microbiology section, Department of Public Health and Pediatrics, University of Torino, Turin, Italy
- * E-mail:
| | - Paola Dalmasso
- Statistics section, Department of Public Health and Pediatrics, University of Torino, Turin, Italy
| | - Anna Maria Cuffini
- Microbiology section, Department of Public Health and Pediatrics, University of Torino, Turin, Italy
| | - Rossana Cavallo
- Microbiology and Virology Unit, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Tiziana Musso
- Microbiology section, Department of Public Health and Pediatrics, University of Torino, Turin, Italy
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Mantis J, Ali Y, Junejo SZ. Cat-Scratch Disease in an AIDS Patient Presenting with Generalized Lymphadenopathy: An Unusual Presentation with Delayed Diagnosis. AMERICAN JOURNAL OF CASE REPORTS 2018; 19:906-911. [PMID: 30068900 PMCID: PMC6083936 DOI: 10.12659/ajcr.909325] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Patient: Female, 44 Final Diagnosis: Cat-scratch disease Symptoms: Lymfadenopathy Medication: — Clinical Procedure: Lymph node biopsy Specialty: Infectious Diseases
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Affiliation(s)
- Jazila Mantis
- Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,NYC Health + Hospital/Queens, Jamaica, NY, USA
| | - Yasir Ali
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,NYC Health + Hospital/Queens, Jamaica, NY, USA
| | - Shoaib Zahoor Junejo
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,NYC Health + Hospital/Queens, Jamaica, NY, USA
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Lindeboom JA, Schreuder WH. Similar presentation of cervical lymphadenitis of different etiology in two siblings. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122:e51-4. [PMID: 27422429 DOI: 10.1016/j.oooo.2016.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 04/13/2016] [Accepted: 04/18/2016] [Indexed: 12/20/2022]
Abstract
Here, we report chronic suppurating submandibular swelling occurring in two siblings, with one case caused by nontuberculous mycobacteria and the other caused by Bartonella henselae. These two infections share a similar clinical presentation, but the treatment modalities differed.
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Affiliation(s)
- Jerome A Lindeboom
- Department of Oral and Maxillofacial Surgery, Amstelland Hospital, Amstelveen, The Netherlands.
| | - Willem H Schreuder
- Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands
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Lindeboom JA. Pediatric cervicofacial lymphadenitis caused by Bartonella henselae. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:469-73. [DOI: 10.1016/j.oooo.2015.06.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 06/07/2015] [Accepted: 06/22/2015] [Indexed: 01/20/2023]
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Mazur-Melewska K, Jończyk-Potoczna K, Mania A, Kemnitz P, Szydłowski J, Służewski W, Figlerowicz M. The significance of Bartonella henselae bacterias for oncological diagnosis in children. Infect Agent Cancer 2015; 10:30. [PMID: 26379764 PMCID: PMC4568588 DOI: 10.1186/s13027-015-0025-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 08/19/2015] [Indexed: 12/30/2022] Open
Abstract
Background Cat-scratch disease (CSD) is a common infection in children; however, the wide spectrum of its clinical picture may lead to delayed diagnosis. An unusual presentation of CSD includes in the differential diagnosis malignant diseases, Epstein-Barr and cytomegalovirus infections, tuberculosis, and mycobacterioses. The diagnostic procedure is difficult, and it is important to consider CSD as the etiology of untypical lesion. Patients and method We present the analysis of 22 immunocompetent children treated with the clinical diagnosis of CSD in our hospital. Their ages were 2 to 16 years (mean 9.15 ± 2.2 years). Four of them presented classical papulas at admission time. Asymmetric, local lymphadenopathy was present in 16 patients. Five children, who presented an untypical course of CSD mimicking the oncological process, were analysed carefully. There were 3 patients with skull osteomyelitis, 1 with inflammation of the parotid gland, and 1 with an extra peripharyngeal mass. The diagnosis in these children was based on epidemiological, radiological, serological, and histological factors. Results About 25 % of children with bartonellosis present an untypical spectrum of symptoms, including the lack of documented cat contact, primary lesions, or peripheral lymphadenopathy. Radiological methods like USG, CT, MRI present the unspecific masses, but they are not enough to distinguish the Bartonella inflammatory and oncological process. The final diagnosis was based on a histological method with additional polymerase chain reaction test. Conclusion CSD should be considered in differential diagnosis of any patient with untypical lesions located on the head, neck, and upper extremities.
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Affiliation(s)
- Katarzyna Mazur-Melewska
- Department of Infectious Diseases and Child Neurology Karol Marcinkowski University of Medical Sciences, Szpitalna Street 27/33, 60-578 Poznań, Poland
| | - Katarzyna Jończyk-Potoczna
- Pediatric Radiology Department Chair of Radiology Karol Marcinkowski University of Medical Sciences, Szpitalna Street 27/33, 60-578 Poznań, Poland
| | - Anna Mania
- Department of Infectious Diseases and Child Neurology Karol Marcinkowski University of Medical Sciences, Szpitalna Street 27/33, 60-578 Poznań, Poland
| | - Paweł Kemnitz
- Department of Infectious Diseases and Child Neurology Karol Marcinkowski University of Medical Sciences, Szpitalna Street 27/33, 60-578 Poznań, Poland
| | - Jarosław Szydłowski
- Pediatric ENT Department, Karol Marcinkowski Poznan University of Medical Sciences, Szpitalna Street 27/33, 60-578 Poznań, Poland
| | - Wojciech Służewski
- Department of Infectious Diseases and Child Neurology Karol Marcinkowski University of Medical Sciences, Szpitalna Street 27/33, 60-578 Poznań, Poland
| | - Magdalena Figlerowicz
- Department of Infectious Diseases and Child Neurology Karol Marcinkowski University of Medical Sciences, Szpitalna Street 27/33, 60-578 Poznań, Poland
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Kimura S, Hasegawa S, Yanagihara M, Inoue H, Matsushige T, Tsuneoka H, Ichiyama T, Ohga S. Cat-scratch disease with severe pleuritis in a 6-year-old girl. Pediatr Int 2015; 57:501-3. [PMID: 26113319 DOI: 10.1111/ped.12680] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 03/16/2015] [Accepted: 04/16/2015] [Indexed: 11/30/2022]
Abstract
We present the case of a 6-year-old girl with cat-scratch disease (CSD), who developed severe pleuritis without lymphadenitis. Bartonella henselae DNA was detected on real-time polymerase chain reaction (PCR) analysis of whole blood. This is the first report of CSD diagnosed on real-time PCR using whole blood.
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Affiliation(s)
| | | | - Masashi Yanagihara
- Departments of Basic Laboratory Science, Yamaguchi University Graduate School of Medicine
| | | | | | - Hidehiro Tsuneoka
- Departments of Basic Laboratory Science, Yamaguchi University Graduate School of Medicine
| | - Takashi Ichiyama
- Departments of Pediatrics.,Department of Pediatrics, Tsudumigaura Medical Center for Children with Disabilities, Yamaguchi, Japan
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Macías A, Aguirre C, Bustamante A, Garcés C, Echeverri V, Díaz A. Cat scratch disease in Medellín, Colombia. Oxf Med Case Reports 2015; 2014:43-5. [PMID: 25988023 PMCID: PMC4369997 DOI: 10.1093/omcr/omu018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 04/27/2014] [Accepted: 05/01/2014] [Indexed: 01/26/2023] Open
Abstract
Cat scratch disease (CSD) is the most common zoonosis transmitted by household animals. There is limited data on the epidemiology and clinical presentation of this disease in Colombia. The typical presentation includes subacute or chronic lymph node infection following inoculation of Bartonella henselae bacilli through a cat scratch. Cats have a B. henselae seroprevalence as high as 90%. Here, we report the case of a preschool boy from a rural area of Antioquia, Colombia, who presented with chronic lymphadenopathy in the right axilla. Other important infectious etiologies were ruled out, and confirmation was made with the Warthin Starry stain of a lymph node biopsy. We also discuss the most important aspects of the diagnosis, treatment and prevention of the disease.
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Affiliation(s)
| | - Carlos Aguirre
- Pediatrics Department, School of Medicine , Universidad de Antioquia , Medellín , Colombia
| | - Alberto Bustamante
- Pediatrics Department, School of Medicine , Universidad de Antioquia , Medellín , Colombia
| | - Carlos Garcés
- Pediatrics Department, School of Medicine , Universidad de Antioquia , Medellín , Colombia
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Kawasato KH, de Oliveira LC, Velho PENF, Yamamoto L, Del Negro GMB, Okay TS. Detection of Bartonella henselae DNA in clinical samples including peripheral blood of immune competent and immune compromised patients by three nested amplifications. Rev Inst Med Trop Sao Paulo 2013; 55:1-6. [PMID: 23328718 DOI: 10.1590/s0036-46652013000100001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Accepted: 08/20/2012] [Indexed: 11/22/2022] Open
Abstract
Bacteria of the genus Bartonella are emerging pathogens detected in lymph node biopsies and aspirates probably caused by increased concentration of bacteria. Twenty-three samples of 18 patients with clinical, laboratory and/or epidemiological data suggesting bartonellosis were subjected to three nested amplifications targeting a fragment of the 60-kDa heat shock protein (HSP), the internal transcribed spacer 16S-23S rRNA (ITS) and the cell division (FtsZ) of Bartonella henselae, in order to improve detection in clinical samples. In the first amplification 01, 04 and 05 samples, were positive by HSP (4.3%), FtsZ (17.4%) and ITS (21.7%), respectively. After the second round six positive samples were identified by nested-HSP (26%), eight by nested-ITS (34.8%) and 18 by nested-FtsZ (78.2%), corresponding to 10 peripheral blood samples, five lymph node biopsies, two skin biopsies and one lymph node aspirate. The nested-FtsZ was more sensitive than nested-HSP and nested-ITS (p < 0.0001), enabling the detection of Bartonella henselae DNA in 15 of 18 patients (83.3%). In this study, three nested-PCR that should be specific for Bartonella henselae amplification were developed, but only the nested-FtsZ did not amplify DNA from Bartonella quintana. We conclude that nested amplifications increased detection of B. henselae DNA, and that the nested-FtsZ was the most sensitive and the only specific to B. henselae in different biological samples. As all samples detected by nested-HSP and nested-ITS, were also by nested-FtsZ, we infer that in our series infections were caused by Bartonella henselae. The high number of positive blood samples draws attention to the use of this biological material in the investigation of bartonellosis, regardless of the immune status of patients. This fact is important in the case of critically ill patients and young children to avoid more invasive procedures such as lymph nodes biopsies and aspirates.
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Affiliation(s)
- Karina Hatamoto Kawasato
- Children's Institute, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
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Psarros G, Riddell J, Gandhi T, Kauffman CA, Cinti SK. Bartonella henselae infections in solid organ transplant recipients: report of 5 cases and review of the literature. Medicine (Baltimore) 2012; 91:111-121. [PMID: 22391473 DOI: 10.1097/md.0b013e31824dc07a] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Bartonella henselae is the causative agent of cat scratch disease and bacillary angiomatosis-peliosis. The spectrum of disease, diagnosis, and management of B. henselae infection in solid organ transplant recipients has not been well characterized. We identified 29 cases of solid organ transplant recipients who had Bartonella infection, 24 by a review of the English-language literature and 5 from our institution. Localized cat scratch disease was found in 8 patients (28%), and disseminated infection was found in 21 patients (72%). The mean time after transplantation to development of Bartonella infection among those with cat scratch disease was 5.6 ± 5.3 years, and among those with disseminated infection was 2.7 ± 2.4 years. Prominent clinical features included cat exposure in 26 patients (90%), fever in 27 patients (93%), lymphadenopathy in 12 patients (41%), and skin lesions in 7 patients (24%). Methods used in establishing the diagnosis of Bartonella infection included culture, polymerase chain reaction (PCR) assay, serologic assays, and histopathologic examination. Culture was positive in 2 of only 4 patients in whom this was performed, and PCR was positive in 12 of 14 patients (86%) in whom this test was performed. Serologic assays were positive in all 23 patients who were tested. Histopathologic examination of tissues in all 8 patients who had cat scratch disease revealed granulomatous inflammation in 4 (50%) and bacillary angiomatosis-peliosis in 2 (25%). Among the 15 patients who had disseminated infection and who had tissue examined, 8 (53%) had only granulomatous inflammation, 4 had only bacillary angiomatosis-peliosis (27%), and 2 had both granulomas and bacillary angiomatosis-peliosis (13%). A positive Warthin-Starry or Steiner stain was noted in 12 of 19 patients (63%) who had 1 of these stains performed. All 8 patients with cat scratch disease and 19 of 21 patients with disseminated bartonellosis were cured with antimicrobial therapy. Two patients, both of whom had endocarditis, died. Among solid organ transplant recipients, infection with B. henselae is uncommon and has diverse disease manifestations including disseminated disease. Persistent fevers or lymphadenopathy in a transplant recipient who has been exposed to cats should prompt clinicians to maintain a high index of suspicion for B. henselae infection. Identifying B. henselae as the causative organism often requires multiple diagnostic studies. Once the diagnosis is established, most solid organ transplant recipients respond appropriately to antimicrobial treatment.
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Affiliation(s)
- Georgios Psarros
- From the Division of Infectious Diseases, Department of Internal Medicine, University of Michigan Health System, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan
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Yamashita H, Ubano M, Uesaka Y, Kunimoto M. [A 34-year-old woman with cat scratch disease who developed encephalopathy]. Rinsho Shinkeigaku 2012; 52:576-580. [PMID: 22975857 DOI: 10.5692/clinicalneurol.52.576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
We experienced a patient with cat-scratch disease (CSD) who developed encephalopathy. The subject was a 34-year-old female who had been aware of a low-grade fever and swollen inguinal lymph nodes for 1 month. The subject's consciousness became impaired after a headache developed, accompanied by fever, nausea, and vomiting, and she subsequently sought medical consultation. No major abnormalities were observed in the cerebrospinal fluid and cranial magnetic resonance imaging (MRI) was normal. However, necrotizing lymphadenitis was observed on contrast enhanced computed tomography (CT) of the pelvis and granulomatous changes were observed in a surgical lymph node biopsy. As the subject lived with a pet cat, PCR testing for Bartonella henselae (the CSD pathogen) was performed using a tissue biopsy. This was positive and the subject was diagnosed with CSD encephalopathy. There are very few domestic reports of CSD encephalopathy and care must be taken not to overlook this disease.
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Affiliation(s)
- Hiroyuki Yamashita
- Division of Rheumatic Diseases, National Center for Global Health and Medicine
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Liberto MC, Lamberti AG, Marascio N, Matera G, Quirino A, Barreca GS, Baudi F, Focà A. Molecular identification of Bartonella quintana infection using species-specific real-time PCR targeting transcriptional regulatory protein (bqtR) gene. Mol Cell Probes 2011; 25:238-42. [DOI: 10.1016/j.mcp.2011.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Revised: 07/13/2011] [Accepted: 07/15/2011] [Indexed: 11/28/2022]
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Lin JW, Chen CM, Chang CC. Unknown fever and back pain caused by Bartonella henselae in a veterinarian after a needle puncture: a case report and literature review. Vector Borne Zoonotic Dis 2010; 11:589-91. [PMID: 20569013 DOI: 10.1089/vbz.2009.0217] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Bartonella henselae, the etiologic agent of cat-scratch disease, rarely causes back pain and is considered to be transmitted through animal scratches and bites. Here we report a cat-scratch disease case possibly with an unusual route of transmission. The patient was a 32-year-old man, and he was working as a veterinarian in a private veterinary clinic. He sought for clinical help because of unknown fever and persistent back pain for at least a month after an accidental needle puncture. Through serological testing and molecular identifications, this clinical case was confirmed to be caused by B. henselae.
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Affiliation(s)
- Jen-Wei Lin
- Department of Veterinary Medicine, College of Veterinary Medicine, National Chung Hsing University, Taichung, Taiwan
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Scott C, Azwa A, Cohen C, McIntyre M, Desmond N. Cat scratch disease: a diagnostic conundrum. Int J STD AIDS 2009; 20:585-6. [PMID: 19625597 DOI: 10.1258/ijsa.2008.008350] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We report the case of a patient who presented to a clinic for evaluation of inguinal lymphadenopathy. Histology of the lymph nodes revealed micoabscess formation suggesting infection with Lymphogranuloma venereum (LGV) or Bartonella henselae--the causative agent in cat scratch disease (CSD). The patient recalled no preceding animal exposure. Clinical and serological findings initially suggested early LGV but convalescent serology supported CSD. This serves as an important reminder that B. henselae infection should be considered a cause of regional lymphadenopathy in individuals suspected of having LGV.
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Affiliation(s)
- C Scott
- Department of Sexual Health & HIV Medicine, St Stephens Centre, Chelsea & Westminster Hospital, 369 Fulham Road, London, UK.
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