A case of Bartonellosis mimicking systemic lupus erythematosus

Abstract

Background and aim Cat-scratch disease (CSD) is a systemic bacterial infection caused by Bartonella henselae. The disease is typically characterized by regional lymphadenopathy developing after scratches from domestic or feral cats. Rarely, systemic involvement may be observed. The co-occurrence with glomerulonephritis and positive antinuclear antibody (ANA) tests have been reported before. In these cases, the disease can be misdiagnosed as systemic lupus erythematosus. Ocular involvement occurs in 5%–10% of the cases with CSD, and neuroretinitis is among the common manifestations. Administration of corticosteroids (CSs) in addition to antibiotics has been shown to improve prognosis in neuroretinitis cases. However, the optimal dose and duration, remain ill-defined. Case report In this article, we present an 11-year-old girl with CSD and neuroretinitis with a positive ANA test and hematuria, who benefited from high-dose methyl-prednisolone and antibiotics. Conclusion Further research is warranted in order to determine the dose and duration of CSs in the treatment of Bartonella neuroretinitis.

Atypical Cat Scratch Disease With Splenic Lesion Mimicking Kawasaki Disease in a Healthy 5-Year-old Girl

“…Other etiologies include metastatic tumors, 15 Epstein-Barr virus infection, 16 and autoimmune diseases. 17 Kara et al reported a suspected case of CSD neuroretinitis, which was eventually diagnosed as systemic lupus erythematosus based on a positive result for antinuclear antibody. 17 Atypical CSD often presents with organ-specific symptoms, such as micro-abscesses in the liver and spleen, and culture-negative endocarditis; therefore, detecting the signs in affected organs may lead to an early diagnosis.…”

“…17 Kara et al reported a suspected case of CSD neuroretinitis, which was eventually diagnosed as systemic lupus erythematosus based on a positive result for antinuclear antibody. 17 Atypical CSD often presents with organ-specific symptoms, such as micro-abscesses in the liver and spleen, and culture-negative endocarditis; therefore, detecting the signs in affected organs may lead to an early diagnosis. Comprehensive and provisional investigation of organs related to atypical CSD would be helpful to avoid unnecessary assessment or treatment of other diseases, such as KD and lymphoma, particularly in cases with a history of cat contact.…”