Case report: Intracranial lesions of cat-scratch disease mimicking an atypical meningioma

Abstract

ObjectivesCat-scratch disease (CSD) is an infectious disease caused by Bartonella henselae. The most typical symptom of patients with CSD is regional lymphadenopathy, while central nervous system lesions related to CSD are rare. Here, we present a case of an aged woman with CSD involving the dura mater with a manifestation similar to that of an atypical meningioma.MethodsThe patient was followed up by our neurosurgery and radiology teams. Clinical information was recorded, and the pre- and post-operation CT results and magnetic resonance imaging (MRI) changes were collected. The paraffin-embedded tissue was sampled for the polymerase chain reaction (PCR) test.ResultsIn this study, we present the details of a 54 year-old Chinese woman admitted to our hospital with a paroxysmal headache for 2 years that had worsened in the past 3 months. Brain CT and MRI showed a meningioma-like lesion below the occipital plate. En bloc resection of the sinus junction area was performed. A pathological examination showed granulation tissue and fibrosis with acute and chronic inflammation, granuloma, and central stellate microabscess, which was suspected as the cat-scratch disease. The paraffin-embedded tissue was sampled for a polymerase chain reaction (PCR) test to amplify the corresponding pathogen gene sequence, which was Bartonella henselae.ConclusionThe case in our study underscores the fact that the incubation period of CSD may be very long. On the contrary, CSD can involve the meninges, resulting in tumor-like lesions.

A Pediatric Case of Disseminated Bartonella henselae Infection Accompanied by Multiple Intracranial Lesions

“…3 The histopathologic findings of intracranial lesions obtained from previously reported patients with disseminated B. henselae infection showed microglial nodules and central stellate microabscesses. 5,6 The present case indicated that intracranial granulomatous lesions could occur in B. henselae infection. The intracranial lesions in our patient were incidentally detected on brain MRI performed to evaluate his cutaneous head masses.…”

“…To our knowledge, 6 patients with B. henselae infection complicated with intracranial lesions, including nodules and abscesses, have been reported; 2 of these patients were children. 2,5,6,[10][11][12] Clinical symptoms and intracranial lesions in 4 adult cases were resolved using rifampicin in combination with doxycycline or sulfamethoxazole. 6,[10][11][12] One pediatric case improved spontaneously, whereas another patient who did not receive an appropriate antimicrobial therapy died before being diagnosed with B. henselae infection.…”

“…2,5,6,[10][11][12] Clinical symptoms and intracranial lesions in 4 adult cases were resolved using rifampicin in combination with doxycycline or sulfamethoxazole. 6,[10][11][12] One pediatric case improved spontaneously, whereas another patient who did not receive an appropriate antimicrobial therapy died before being diagnosed with B. henselae infection. 2,5 Our case may represent the first pediatric case with intracranial lesions in which antimicrobial agents recommended for the treatment of B. henselae infection were administered.…”

“…3 Point-of-care ultrasound (POCUS) can identify findings associated with TB in children, but this is not well studied in young malnourished African children. [4][5][6][7] This study's objectives were to, in Malawian children hospitalized with SAM, (1) characterize POCUS findings associated with TB and (2) assess the feasibility and acceptability of POCUS.…”

Хвороба Котячих Подряпин: Діагностика, Лікування

“…Атиповий перебіг захворювання буває у 5-20% пацієнтів віком 15-49 років та піком захорюванності з жовтня по січень [6]. Проявами захворювання є кон'юнктивіт Паріно (2-6%), нейроретиніт [21,22,23] та ураження центральної нервової системи (1-7%) [24,25,26].…”