Acute hemiplegia associated with cat-scratch disease

Abstract

Cat scratch disease (CSD) is an infectious illness caused by a Gram-negative rod namedBartonella henselae. Typical CSD is characterized by a small skin lesion at the site of a scratch or a bite, followed by regional lymphadenopathy, one to two weeks later. Atypical forms may present as ocular manifestations, neurological manifestations, hepatosplenic involvement and vertebral osteomyelitis. Among neurological complications, encephalopathy is by far the most common. Other neurological manifestations are very rare. We report a case of an 11-year-old boy, with a posterior cervical lymphadenopathy and fever. Cat scratch disease was diagnosed and treated after a positive "Whartin-Starry" stain on lymph node biopsy. Two weeks after treatment, the patient was readmitted presenting an acute episode of left hemiplegia. A brain MRI demonstrated a right subcortical fronto-parietal lesion with no contrast enhancement. Complete recovery was observed after corticosteroid treatment.

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

“…They are, in order of frequency: seizures with encephalopathy, status epilepticus and coma, neuroretinitis, aseptic meningitis, transverse myelitis, radiculitis, cerebral arteritis, acute hemiplegia, and dementia (Stevens 1952, Selby & Walker 1979, Miller & Bell 1980, Carithers 1985, Lewis & Tucker 1986, Baker et al 1995, Hadley et al 1995, Hamilton et al 1995, Noah et al 1995, Schwartzman et al 1995, Riviello & Ruoff 1998, Walter & Eppes 1998, Hmaimess et al 2004, Rocha et al 2004, Stockmeyer et al 2007, Baylor et al 2007). Overall neurological complications account for 1-2% of cases of CSD (Carithers 1985, Carithers & Margileth 1991, Noah et al 1995.…”

“…Combative behaviour follows seizures or status epilepticus, but full recovery is generally achieved (Carithers 1985, Carithers & Margileth 1991. Encephalopathy occurs more often in older children and adults (Carithers 1985, Carithers & Margileth 1991, Hadley et al 1995, Rocha et al 2004) and usually follows lymphadenopathy by 2-6 weeks.…”

Bartonellaspecies detection in captive, stranded and free-ranging cetaceans

“…In addition, the involvement of Bartonella spp. in the development of neurologic disorders in animals and people [1,22,33], suggests that the association of this genus with stranding events should be investigated in the future. Of note in this regard is the encephalitis of unknown origin identified histologically in four of the stranded animals in the current study.…”

“…Best known of these are B. quintana (trench fever), and B. henselae (cat-scratch disease). Infection with Bartonella species is known to cause lymphadenopathy [17,24,31], neurological disorders [1,22,33], bacillary angiomatosis and bacillary peliosis [9,23,37], endocarditis [4,5,22,24], hepatosplenic involvement, skin lesions, and vertebral osteomyelitis in domestic and wild animals and in humans [22,23,36].…”

Description of Lyme disease-like syndrome in Brazil: is it a new tick borne disease or Lyme disease variation?

“…There have been descriptions of the simultaneous presence of Borrelia and Chlamydia in the synovium of patients with Lyme arthritis (39). Also, concurrent infection of the central nervous system by B. burgdorferi and Bartonella henselae has been recently described, representing a novel tick-borne disease complex (40,41).…”