1/205. cat-scratch disease with paravertebral mass and osteomyelitis.The case of a 9-year-old girl with cat-scratch disease (CSD) complicated by development of a paravertebral mass and osteomyelitis is presented. Following multiple scratches and inguinal lymphadenopathy, she developed back pain, and imaging demonstrated a paravertebral mass with evidence of osteomyelitis involving vertebra T9. The diagnosis was made on the basis of detection of bartonella henselae by use of molecular techniques on an aspirate from the vertebral column and supportive serology for infection with B. henselae. Eleven other cases of this unusual manifestation associated with CSD have been reported in the literature and are reviewed. The patient was treated with gentamicin, followed by rifampicin and trimethoprim-sulfamethoxazole, orally and made a favorable recovery over 7 months. This is comparable with other case reports, regardless of the choice of antibiotic therapy. CSD in immunocompetent hosts is not always self-limiting, and tissues beyond the lymph nodes can be involved.- - - - - - - - - - ranking = 1keywords = disease (Clic here for more details about this article) |
2/205. Cat scratch disease diagnosed by polymerase chain reaction in a patient with suspected tuberculous lymphadenitis.We present a patient diagnosed as having tuberculous lymphadenitis after lymph node biopsy and referred for tuberculous therapy. On review, because of recent cat exposure, she was tested for cat scratch disease (CSD), but serological tests for bartonella henselae were negative. However, the diagnosis of CSD was confirmed, and tuberculosis excluded, by polymerase chain reaction techniques. This case serves as a reminder that CSD may mimic tuberculosis histologically and that sensitive molecular diagnostic tests are available.- - - - - - - - - - ranking = 1keywords = disease (Clic here for more details about this article) |
3/205. cat-scratch disease simulating a malignant process of the chest wall.cat-scratch disease is a well-known cause of regional adenopathy in immunocompetent children. Rarely, patients may present with symptoms simulating a neoplastic disease. The case of a 12-year-old boy with fever, swelling of the chest wall and hepatosplenic nodules is reported. Histological analysis of biopsy specimen obtained from the chest wall lesion and the liver revealed granulomatous reaction without malignant cells. Serological investigations were positive for Bartonella species. The symptoms and the lesions disappeared after oral antibiotic therapy (ciprofloxacin) was started. The patient remained symptom-free 12 months later. CONCLUSION: The present case emphasizes the wide spectrum of clinical manifestations associated with cat-scratch disease which should be investigated as differential diagnosis of manifestations suggesting a neoplastic disease in children.- - - - - - - - - - ranking = 1.6keywords = disease (Clic here for more details about this article) |
4/205. Presumed ocular bartonellosis.BACKGROUND: The spectrum of diseases caused by bartonella henselae continues to expand and ocular involvement during this infection is being diagnosed with increasing frequency. methods: The clinical features and visual prognosis for 13 patients with intraocular inflammatory disease and laboratory evidence of bartonellosis were investigated. There were nine patients with neuroretinitis and four with panuveitis with positive antibody titres against B henselae determined by an enzyme immunoassay (IgG exceeding 1:900 and/or IgM exceeding 1:250). RESULTS: Positive IgG levels were found for eight patients and positive IgM levels for five. Despite animal exposure of 10 patients, only two (IgG positive) cases had systemic symptoms consistent with the diagnosis of cat scratch disease. Pathological fluorescein leakage of the optic disc was observed in all affected eyes. At 6 months' follow up, 3/18 (17%) affected eyes had a visual acuity of less than 20/100, owing to optic disc atrophy and cystoid macular oedema. 12 patients (17 eyes) were treated with antibiotics; visual acuity improved two or more Snellen lines for 9/17 (53%) eyes. CONCLUSIONS: The possibility of B henselae infection should be considered in patients with neuroretinitis and panuveitis (especially in cases with associated optic nerve involvement) even in the absence of systemic symptoms typical for cat scratch disease.- - - - - - - - - - ranking = 0.8keywords = disease (Clic here for more details about this article) |
5/205. Conservative management of documented neuroretinitis in cat scratch disease associated with bartonella henselae infection.BACKGROUND: bartonella henselae has been identified as the causative agent of the neuroretinitis associated with cat scratch disease (CSD). Immunofluorescent antibody tests with good sensitivity and specificity are available to aid in diagnosis. Despite diagnostic advances, optimal management remains controversial. We present a case of documented B. henselae macular neuroretinitis managed without antibiotics and discuss antibiotic use in this condition. methods: We examined a young woman with macular neuroretinitis and established a diagnosis of CSD. Management consisted of a review of the literature, followed by educating her about the condition and close observation. We documented the course of her disease. RESULTS: We diagnosed neuroretinitis associated with B. henselae infection based on immunofluorescent antibody titres and clinical presentation. Our patient's neuroretinitis resolved promptly without antibiotic therapy. CONCLUSIONS: Macular neuroretinitis in CSD can be satisfactorily diagnosed with the use of fluorescent antibodies in the appropriate clinical setting. Optimal treatment for the disease has not been established and observation combined with patient education remains an appropriate option. The self-limited nature of the disease implies that treatment studies not using controls must be interpreted with great caution. Adverse drug reactions and other iatrogenic complications can be reduced by limiting antibiotic use in settings where a meaningful treatment benefit has not been established.- - - - - - - - - - ranking = 1.6keywords = disease (Clic here for more details about this article) |
6/205. Vertebral osteomyelitis associated with cat-scratch disease.We describe a patient with vertebral osteomyelitis and paravertebral soft-tissue collections associated with cat-scratch disease (CSD). diagnosis was established on the basis of histologic examination and serological and polymerase chain reaction (PCR) tests. Treatment consisted of administration of antibiotics, and although skeletal lesions were persistently evident on radiography the patient showed complete clinical recovery. In addition, 15 cases of documented osteomyelitis associated with CSD are reviewed.- - - - - - - - - - ranking = 1keywords = disease (Clic here for more details about this article) |
7/205. bartonella henselae associated with Parinaud's oculoglandular syndrome.bartonella henselae was recovered from the conjunctival scraping of a 38-year-old woman who presented with a 2-week history of tender preauricular lymphadenopathy and a 1-day history of a red left eye. Dry adherent colonies were observed on agar plates at 21 days of incubation, and the isolate was identified through conventional and molecular tests. polymerase chain reaction (PCR) amplification of a specific region of the 16S rRNA gene and confirmation by a separate PCR reaction with hybridization of the product with a B. henselae-specific probe confirmed the isolate as B. henselae. This is the first reported isolation of the causative agent of cat scratch disease from ocular tissue in a patient with Parinaud's oculoglandular syndrome.- - - - - - - - - - ranking = 0.2keywords = disease (Clic here for more details about this article) |
8/205. Cat scratch encephalopathy.Cat scratch disease is usually a self-limited illness associated with tender lymph nodes, fever, malaise, and fatigue. Lymphadenopathy usually resolves spontaneously within three to four months. Cat scratch disease can be atypical as indicated by the presentation of our patient.- - - - - - - - - - ranking = 0.4keywords = disease (Clic here for more details about this article) |
9/205. Cat-scratch neuroretinitis.BACKGROUND: cat-scratch disease is a subacute regional lymphadenitis, usually preceded by a history of a cat scratch or exposure to kittens. The disease is caused by bartonella henselae, and possibly bartonella quintana, pleomorphic gram-negative rods formerly known as Rochalimaea henselae and Rochalimaea quintana. Ocular involvement is rare and typically manifests as either Parinaud's oculoglandular syndrome or neuroretinitis. patients with neuroretinitis resulting from cat-scratch disease may be asymptomatic or experience mild-to-severe vision loss. The clinical features, angiographic appearance, differential diagnosis, and management of cat-scratch neuroretinitis are discussed. CASE REPORT: A 30-year-old white woman reported to the eye clinic with painless, decreased vision in the right eye. A diagnosis of cat scratch neuroretinitis was made on the basis of the history of cat scratch, clinical appearance, and angiographic findings. Treatment with oral ciprofloxacin restored vision to normal in 4 weeks. CONCLUSION: Painless vision loss associated with optic nerve swelling and macular star exudate should alert suspicion of systemic disease. Additional findings--including positive history of a cat scratch, lymphadenopathy, and flu-like symptoms--may indicate bartonella henselae or bartonella quintana infection. While treatment remains controversial, appropriate serology testing may aid in the diagnosis and management of the underlying infection.- - - - - - - - - - ranking = 0.8keywords = disease (Clic here for more details about this article) |
10/205. Unusual eruption as a presenting symptom of cat scratch disease.Cat scratch disease (CSD) is a common infectious cause of subacute regional lymphadenopathy. bartonella henselae is the principal etiologic agent. About 10% of CSD patients experience atypical manifestations, including rashes. The most common cutaneous manifestation of CSD is a papule at the inoculation site. We report a case of CSD presenting with an eruption on the upper trunk, reminiscent of Sweet's syndrome, accompanied by lymphadenopathy, arthralgia, and fever. Response to systemic corticosteroids was remarkable. Histopathologic findings refuted the diagnosis of Sweet's syndrome. Identification of anti-B henselae antibodies and B henselae dna in the affected lymph node confirmed the diagnosis of CSD. This is a first report of extensive papuloedematous eruption as a cutaneous manifestation of CSD. Accurate diagnosis is possible due to the availability of serological tests and dna amplification techniques.- - - - - - - - - - ranking = 1keywords = disease (Clic here for more details about this article) |
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