CASE REPORT
Cat Scratch Disease in a 1.5-year-old girl – Case report
 
More details
Hide details
1
Paediatric Orthopaedic and Rehabilitation Department, Medical University Lublin, Poland
 
2
Department of Interventional Radiology and Neuroradiology, Medical University, Lublin, Poland
 
3
Department of Livestock, Animal Health Division
 
 
Corresponding author
Łukasz Matuszewski   

Paediatric Orthopaedic and Rehabilitation Department, Medical University of Lublin, Poland, Racławickie 2, 20-950 Lublin, Poland
 
 
Ann Agric Environ Med. 2018;25(2):345-348
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
The paper is a case report presenting Cat Scratch Disease (CSD) in a 1.5-year- old girl. Bartoneloses, including CSD, are a group of infectious diseases which are rarely detected, therefore there are no statistical data concerning the aetiology, and the incidence of CSD noted in Poland is low in comparison with other European countries.

Objective:
The purpose of the paper is to discuss several problems related to CSD.

Material and Methods:
A 1.5-year-old girl who was seen in hospital for the sparing use of her left arm when crawling. X-rays showed osteolytic lesions which radiologists described as multi-ocular cyst or infection. As neither clinical examination nor laboratory investigations found pathological signs, the patient was followed-up on an ambulant basis. Repeated x-ray taken 4 weeks later showed increased periosteal proliferation accompanied by pain. The baby was admitted to the Clinic but additional investigations found no pathologies. The baby was consulted by a rheumatologist and haematologist; however, they did not facilitate a definitive diagnosis. As the baby developed, because of a thickening of the soft tissues on the dorsal side of the distal epiphisis in the forearm the doctors decided to inspect the condition operatively. Macroscopic examination found brownish granulated tissue. Suction drainage was inserted and a tissue sample was tested for aerobic and anaerobic bacteria, tuberculosis and borelliosis. The test results were negative. The baby was in good condition, was not pyrexial and suffered from less pain. The diagnostics was further expanded and the baby tested for yersinia, chlamydia, tuberculosis and bartonella, i.e. CSD. The postoperative wound healed soon and radiological bony lesions began to resolve. After a month, we received a positive bartonella test result, the baby tested positively for Bartonella henselae IgG class, which confirmed past or active infection of CSD. A repeated test for B. henselae taken 6 months later showed a lower level of antibodies.

Conclusions:
It should be remembered that CSD, which is an extremely rare infection, can be diagnosed despite mediocre clinical and radiological manifestations. Thus, in the case of infections of unexplained aetiology and mediocre manifestations diagnostics should include testing for Bartonella henselae.

 
REFERENCES (17)
1.
Boggs SR, Fisher RG. Bone Pain and Fever in an Adolescent and His Sibling. Pediat Infect Dis J. 2011; 30(1): 89, 93–94.
 
2.
Dennis AC. Treatment of cat-scratch disease. Curr Opin Pediatr. 2001; 13(1): 56–59.
 
3.
Dussera P, Eyssette-Guerreaub S, Kone´-Pauta I. Osteomyelite dans la maladie des griffes du chat: a` propos d’un caset revue de la litterature (Osteomyelitis in cat scratch disease: A case report and literature review). Archives de Pediatrie 2013; xxx: 1–5.
 
4.
Garcia-Esteban C, Gil H, Rodriguez-Vergas M, et al. Molecular Method for Bartonella Species Identification in Clinical and Environmental Samples. J Clin Microbiol. 2008; 46: 776–779.
 
5.
Hajjaji N, Hocqueloux L, Kerdraon R, Bret L. Bone infection in cat-scratch disease: a review of the literature. J Infect. 2007; 54: 417–421.
 
6.
Iannace C, Lo Conte D, Di Libero L, Varricchio A, Testa A, Vigorito R, Gagliardi G, Lepore M, Caracciolo F. Cat scratch disease presenting as breast cancer: a report of an unusual case. Case Rep Oncol Med. 2013; 2013: 507504. doi: 10.1155/2013/507504. Epub 2013 Mar 13.
 
7.
Maman E, Bickels J, Ephros M, et al. Musculoskeletal manifestations of cat scratch disease. Clin Infect Dis. 2007; 45: 1535–1540.
 
8.
Margileth AM. Cat scratch disease. Adv Pediatr Infect Dis. 1993; 8: 1–21.
 
9.
Okaro U, Addisu A, Casanas B, Anderson B. Bartonella Species, an Emerging Cause of Blood-Culture-Negative Endocarditis. Clin Microbiol Rev. 2017 Jul; 30(3): 709–746. doi: 10.1128/CMR.00013–17.
 
10.
Prutsky G, Domecq JP, Mori L, Bebko S, Matzumura M, Sabouni A, Shahrour A, Erwin PJ, Boyce TG, Montori VM, Malaga G, Murad MH. Treatment outcomes of human bartonellosis: a systematic review and meta-analysis. Int J Infect Dis. 2013 Apr 18. pii: S1201-9712(13)00107-0.
 
11.
Roubaud-Baudron C, Fortineau N, Goujard C, et al. Cat scratch disease with bone involvement: a case report and literature review [in French]. Rev Med Interne. 2009; 30: 602–608.
 
12.
Rutkowska-Daniłowicz E, Zajkowska J, Ostrowska J, Szpakowicz T. Problemy diagnostyczne choroby kociego pazura. Wiad Lek. 1992; 45(21–22): 870–872.
 
13.
Sander A, Berner R, Ruess M. Serodiagnosis of cat-scratch disease: response to Bartonellahenselae in children and a review of diagnostic methods. Eur J Clin Microbiol Infect Dis. 2001; 20: 392–401.
 
14.
Smith DL. Cat-scratch disease and related clinical syndromes. Am Fam Physician 1997; 55: 1783–1789.
 
15.
Szymański M, Siwiec H, Gołąbek W. Choroba kociego pazura ślinianki przyusznej. Wiad Lek. 2004, LVII, 11–12, 704–706.
 
16.
Mazur-Melewska K, Mania A, Kemnitz P, Figlerowicz M, Służewski W. Cat-scratch disease: a wide spectrum of clinical pictures Postepy Dermatol Alergol. 2015 Jun; 32(3): 216–220.
 
17.
Dąbrowska-Bień J, Pietniczka-Załeska M, Rowicki T. Cat scratch disease--a diagnostic problem, case report. Otolaryngol Pol. 2009 Mar-Apr;63(2):154–7. doi: 10.1016/S0030-6657(09)70097-6.
 
eISSN:1898-2263
ISSN:1232-1966
Journals System - logo
Scroll to top