[Cat scratch disease: still current zoonosis].

Abstract

OBJECTIVES A retrospective evaluation of a group of patients which is focused on clinical picture, serological diagnosis, therapy and familial occurrence of the disease. MATERIAL AND METHODS Cat scratch disease (CSD) was considered within the scope of a differential diagnosis of lymphadenopathy. Serological diagnosis was based on detection of antibodies against Bartonella henselae by indirect immunofluorescence, where the level of IgG antibodies of at least 1 : 256 or any positive level of IgM antibodies were considered positive for CSD. If a histological examination was conducted, the suspicion of CSD was supported by finding granulomatous inflammation. Macrolides were used for treatment in both children and adults. In addition to macrolides, doxycycline was used in adults. RESULTS From 2004 to 2013, a total of 27 patients aged 7-73 years were diagnosed with CSD at the Clinic of Infectious Medicine, University Hospital in Ostrava. None of them suffered from immunodeficiency detected earlier. Diagnostic extirpation of a lymph node was performed in 5 patients diagnosed with granulomatous inflammation. Lymph node syndrome was observed in all patients, with cervical, inguinal and axillary nodes being most frequently affected. However, two patients had supraclavicular nodes affected and a 52-year-old woman had unusual swelling of lymphatic tissue in the scapular region with skin lesions. Lymph node syndrome accompanied by encephalopathy was observed in one 50-year-old patient. Positive IgM antibodies were detected in only 8 patients. There were two cases of familial occurrence affecting 2 and 3 family members. Antibiotic therapy with full resolution of clinical findings was successful in 24 patients, including the patient with encephalopathy. In spite of the antibiotic treatment, three patients developed lymph node colliquation requiring surgical intervention. CONCLUSIONS Atypical lymph node localization in 3 patients, encephalopathy in 1 patient, positive levels of IgM antibodies in 8 only patients, delayed antibodies production in 4 patients and antibiotic therapy coupled with extirpation of colliquated lymph nodes in 3 patients were found in the group of 27 patients.

Cite this paper

@article{Hozkov2014CatSD, title={[Cat scratch disease: still current zoonosis].}, author={Lubom{\'i}ra Hoz{\'a}kov{\'a} and L Ro{\vz}novsk{\'y} and H B{\'i}lkov{\'a} Fr{\'a}nkov{\'a}}, journal={Klinická mikrobiologie a infekc̆ní lékar̆ství}, year={2014}, volume={20 1}, pages={4-10} }