Cat scratch disease in children with nocturnal fever:A case report

BACKGROUND Cat scratch disease(CSD)is the most common human infection caused by Barto-nella henselae(B.henselae).The main manifestation is self-limited lymphaden-opathy that primarily affects adolescents,and typically resolves without treat-ment within 2-4 months.However,individuals with compromised immune systems or immunodeficiency require specific antibacterial therapy following diagnosis.Due to its low incidence,nonspecific clinical manifestations,and diagnostic limitations,this condition often poses challenges for clinicians in terms of missed diagnoses and misdiagnoses.CASE SUMMARY The child was ultimately diagnosed with CSD.The primary manifestations included nocturnal fever,enlargement of lymph nodes in the neck,axilla and groin,and suspected brucellosis;however,both brucellosis tests conducted during the course of the illness yielded negative results.Bone marrow cytology indicated stimulated proliferation.Lymph node biopsy indicated hyperplasia of lymphoid tissue in the cervical lymph nodes(right),with combined immunohisto-chemical findings indicating reactive hyperplasia.Immunohistochemical analysis revealed CD20 B(+),CD3 T(+),BCL-6(+),and BCL-2(-).CD21 FDC networks were present and Ki67 expression in the germinal center was~80%.Blood next-generation sequencing indicated B.henselae sequence number was 3.Serological test results demonstrated positive antibody response to B.henselae IgG(+),B.henselae IgM(+),Bartonella quintana(B.quintana)IgG(-)and B.quintana IgM(-),and the final diagnosis was CSD.CONCLUSION In patients presenting with fever at night and swollen lymph nodes of unknown origin,CSD should be considered.

Ophthalmic manifestations of cat scratch disease

Cat scratch disease(CSD)is a worldwide distributed zoonosis caused by Bartonella henselae and other Bartonella spp.The reservoirs of Bartonella are domestic animals,especially cats,and the transmission to humans is thought to occur from a cat scratch or even through the cat flea Ctenocephalides felix.With more and more pet owners,the physicians should keep in mind signs and symptoms of CSD.A widespread infection may occur in 5-14%of cases,and ocular involvement,called ocular bartonellosis,is a quite common consequence of disseminated CSD.Although the most typical manifestations of ocular Bartonellosis are Parinaud’s oculoglandular syndrome,neuroretinitis and retinochoroiditis,many other ophthalmic conditions have been reported.The diagnosis of CSD is often based on history of contact with a cat and high serum titers of immunoglobulin G antibodies against B.henselae.Polymerase chain reaction could be helpful for CSD diagnosis when serology is negative but clinical findings are suggestive for the disease.Multimodal imaging,including fundus autofluorescence,fluorescein and indocyanine green angiography,optical coherence tomography(OCT)and OCT angiography,can be used for diagnosis and monitoring of ocular Bartonellosis.Since CSD is more often a self-limited infection in immunocompetent individuals,no antibiotic treatment is usually needed.However,when a therapy is prescribed,doxycycline is the most used antibiotic.The aim of this article is to review the current literature relating to epidemiology,systemic and ocular manifestations,diagnosis,treatment and prognosis of bartonellosis,in order to give the ophthalmologists a useful tool for daily practice.

A Case Report of Bartonella henselae Infection Causing Fever of Unknown Origin: Unveiling a Stealthy Pathogen

Bartonella species are bacterial pathogens responsible for Cat Scratch Disease (CSD) with various clinical manifestations, ranging from self-limiting febrile illnesses to severe systemic infections. Diagnosis is often challenging due to its insidious nature and variable presentation based on the body’s immune status. Such a scenario emerged when a 25-year-old male presented to our hospital with nonspecific symptoms of Fever of unknown origin that were not responding to antibiotics until a timely diagnosis of Bartonella infection. This case report highlights the importance of considering Bartonella as a potential etiology in patients with prolonged Fever of unknown origin, especially in endemic regions.

Bartonellosis in transplant recipients:A retrospective single center experience

BACKGROUND Bartonellosis is a rare but challenging condition to diagnose with a spectrum of clinical presentations in the immunocompromised host.AIM To further characterize the presentation of Bartonella henselae(B.henselae)infections in solid organ and hematopoietic stem cell transplant recipients.METHODS We conducted a single-center retrospective study of all B.henselae testing for 5012 transplant recipients receiving care at a single institution between 2011 and 2018.RESULTS We identified 38 patients who underwent testing for B.henselae,and three of 38 were found to have bartonellosis.Two of the patients were renal transplant recipients who presented with visceral bartonellosis and symptoms concerning for post-transplant lymphoproliferative disorder.One autologous stem cell transplant recipient presented with cat scratch disease.We detail the clinical courses of these three cases and review the literature concerning the clinical presentations,differential diagnosis,and limitations of diagnostic tests for B.henselae infections in transplant recipients.CONCLUSION Although the incidence of B.henselae infection in transplant recipients is unknown,it merits inclusion in the differential diagnosis for fever of unknown origin in this population.