Cat Scratch Disease-associated Encephalitis Followed by Parkinsonism: A Case Report

Cat scratch disease (CSD) is a zoonotic infection caused by Bartonella henselae typically resulting in self-limited regional lymphadenopathy. Encephalitis is a complication with a supposedly benign prognosis, but we encountered an exceptional case. A 19-year-old Japanese woman presented with status...

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Bibliographic Details
Published in:Internal Medicine 2022, pp.9047-21
Main Authors: Nakamura, Masakazu, Ura, Shigehisa, Yabe, Ichiro, Otsuki, Mika, Soma, Hiroyuki, Ogata, Akihiko
Format: Article
Language:English
Subjects:
Bartonella henselae
cat scratch disease-associated encephalitis
dopamine transporter single-photon emission computed tomography
neuromelanin-related magnetic resonance imaging
nigrostriatal degeneration
post-encephalitic parkinsonism
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Summary:Cat scratch disease (CSD) is a zoonotic infection caused by Bartonella henselae typically resulting in self-limited regional lymphadenopathy. Encephalitis is a complication with a supposedly benign prognosis, but we encountered an exceptional case. A 19-year-old Japanese woman presented with status epilepticus. She was diagnosed with CSD-associated encephalitis based on her history of contact with a kitten and a high titre of serum IgG to B. henselae. Multimodal treatment ameliorated her encephalitis, but neurological sequelae including spastic paraparesis, persisted. After several months, she developed age-disproportionate parkinsonism inconsistent with a neurodegenerative disease. In conclusion, CSD-associated encephalitis can result in severe neurological sequelae and post-encephalitic parkinsonism.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.9047-21