Cat-Scratch Disease Associated with Pleural Effusions and Encephalopathy in a Child

Abstract

Cat-scratch disease has been associated with a variety of systemic manifestations. We present a case of cat-scratch disease associated with bilateral pleural effusions and encephalopathy in a child. The particular combination of findings reported here may be more ubiquitous than formerly suspected and widen the clinical description of this condition.

Human bartonellosis: seroepidemiological and clinical features with an emphasis on data from Brazil - A review

“…Bartonella infections that deserve detailed discussion based on their increasing number of reports include blood culture negative infective endocarditis and fever of unknown origin. In addition, for several decades atypical manifestations of CSD such as meningoencephalitis, retinitis, dissemination with hepatosplenic abscesses and osteomyelitis have been reported, and it is likely that many such manifestations still go unrecognized (Stevens 1952, Adams & Hindman 1954, Selby & Walker 1979, Miller & Bell 1980, Johnson et al 1985, Wear et al 1985, Katner et al 1986, Greenbaum et al 1986, Lewis & Tucker 1986, Margileth et al 1987, Chrousous et al 1990, Apalsch et al 1993, Golden 1993, Tappero et al 1993, Bernini et al 1994, Waldwogel et al 1994, Hadley et al 1995, Whitman & Krafte-Jacobs 1995, Riviello & Ruoff 1998, Walter & Eppes 1998, Arisoy et al 1999, Hulzebos et al 1999, Robson et al 1999, Azevedo et al 2000, Krause et al 2000, Hmaimess et al 2004, Baylor et al 2007, Stockmeyer et al 2007). The onset of signs and symptoms of bartonellosis generally occur about one to two weeks after exposure, but this delay can range from 1-4 weeks, depending on the syndrome presented, and may last several months (Carithers 1985).…”

“…Cats had a seropositivity of 62% and bacteremia was detected in 22%. Cases with unusual associations, such as pleural effusions, have also been described (Whitman & Krafte-Jacobs 1995).…”

Pulmonary Nodules in an Immunocompetent Child With Cat Scratch Disease

“…[2][3][4][5][6][7][8][9][11][12][13][14][15][16][17] The first case was reported in 1957 and the most recent in 2010. 15,16 Demographics of the patients are shown in Table 1.…”

“…1 Pulmonary manifestations are rare but have been described in adults and children, especially in immunocompromised hosts. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] The usual pulmonary manifestations are pleural effusions and pneumonia. Pulmonary nodules are mostly seen in patients with bacillary angiomatosis.…”

Optic Neuropathy From Bacteria

“…Neurologic manifestations include meningitis, encephalitis, radiculitis, and myelitis. 4,5 Optic neuropathy associated with CSD usually has the appearance of neuroretinitis. 4,6,7 Papillitis with or without peripapillary serous retinal detachment may occur.…”