Unsuspected Extralymphocutaneous Dissemination in Febrile Cat Scratch Disease

Cat scratch disease (CSD) commonly manifests as regional self-limited lymphadenitis. However, dissemination of the infection to distant multiple sites may occur even in immunocompetent patients. We report a series of 11 children with fever and extralymphocutaneous manifestations of CSD, in order to...

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Bibliographic Details
Published in:Scandinavian journal of infectious diseases 2001, Vol.33 (8), p.599-603
Main Author: Andrew Fretzayas, Nikolaos G. Papadopoulos, Maria Moustaki, Apostolos Bossios, Peter Koukoutsakis, Themistocles Karpathios
Format: Article
Language:English
Subjects:
Adolescent
Bacterial diseases
Bartonella henselae
Bartonella henselae - isolation & purification
Bartonellosis
Biological and medical sciences
Cat-Scratch Disease - complications
Cat-Scratch Disease - diagnosis
Cat-Scratch Disease - microbiology
Child
Diagnosis, Differential
Female
Fever - microbiology
Human bacterial diseases
Humans
Infectious diseases
Male
Medical sciences
Severity of Illness Index
Tropical bacterial diseases
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Summary:Cat scratch disease (CSD) commonly manifests as regional self-limited lymphadenitis. However, dissemination of the infection to distant multiple sites may occur even in immunocompetent patients. We report a series of 11 children with fever and extralymphocutaneous manifestations of CSD, in order to highlight potential multiorgan involvement in patients with febrile CSD. To be eligible for enrolment, patients had to present with involvement of sites other than regional lymph nodes. The diagnosis was based on suggestive clinical criteria, histological findings and positive serology. The utilization of ultrasound imaging revealed hepatic lesions in 3 children and splenic lesions in 8 children, whereas osteolytic lesions were observed in 4 children by bone scan. Hepatic or splenic involvement was not suggested by clinical signs or biochemical investigation in 2/3 and 6/8 children, respectively. Bone involvement was supported either by relative symptoms or signs. Our findings indicate that, in the presence of fever, extralymphocutaneous manifestations have to be anticipated in patients with clinically suspected CSD. The systematic use of imaging modalities in patients with serologically documented Bartonella henselae infection could contribute to a better understanding of the clinical spectrum of CSD.
ISSN:0036-5548
1651-1980
DOI:10.1080/00365540110026791