Cat scratch disease- a case report

Abstract

We are reporting a case of a 10 year old boy admitted in Dhaka Shishu (Children) hospital with the complaints of -swelling of both side of inguinal region for 2 months, tenderness of the same area for 1 month and low grade fever for 2 months. With the history and physical examination of the patients our differential diagnosis was Tuberculosis/Lymphoma/Cat scratch disease (CSD). He had only a history of contact with a kitten for 1 week 3 months back but no history of cat scratch or bite. Lymph node biopsy revealed that it was a case of Cat scratch disease. Introduction Cat scratch disease (CSD) also known as "Cat scratch fever" or "Subacute regional lymphadenitis" 1 is a usually benign infectious disease caused by the intracellular bacterium Bartonella henselae. It is most commonly found in children following a scratch or bite of a cat by about one to two weeks. It was first discovered in 1889 by Henri Parinaud.2 It oc curs worldwide with no racial or sex predilection.Kittens are more likely to carry the bacteria in their blood, and may therefore be more likely to transmit the disease than are adult cats. However, the results of experimental studies showed that fleas serve as a vector for transmission of B. henselae among cats. 3Although this disorder is strongly associated with cats, other animals have also been implicated. Reports also be found of transmission by dogs, rabbits, and monkeys. A few anecdotal cases have also been described involving transmission by porcupine quills and fish bones. Transmission occurs by scratching, biting or possibly even licking. Kittens seem to be particularly common as vectors. Case HistoryA 10 year old previously healthy boy from a slam area admitted in Dhaka Shishu (Children) hospital with the complaints of -swelling of both side of inguinal region for 2 m onths, tenderness of the same area for 1 month and low grade fever for 2 months.Two months back he first noticed bilateral swelling of his both ingunal region and initialy it was hard and nontender. He also complaints of low grade intermittent fever for the same duration. Ultimately the size of swelling increased and its consistency changed to soft and it became tender as an abcess for the last 1 month. He did not get any treatment for these problems. The boy was fully immunized and BCG m a rk was present. There was no history of contact with TB patient, gradual weight loss, night sweating; no abdominal pain and abdominal fullness.He did not notice similar swelling anywhere of his body and recalled a history of contact with a kitten 3 months back. At that time he was circumcized and cofined to home for 7 days and used to play with a kitten on his bed. But there is no history of cat scratch or bite on his lower limbs. After that, he never went to any contact with any cat or kitten. On physical examinationThe boy was cachetic (anthropometric measurements were-hight-120 cm, weight-17 kg, OFC-48 cm) and febrile. He was mildly pale and vital signs were within normal limit. Abdomen was soft and nontender without organomeg...

Felinosis: the elusive-cat scratch disease

“…6,7 Children are more frequently affected following a scratch or bite of a cat. 2 Regional lymphadenopathy is considered as the hallmark of CSD. 8 Axillary lymph nodes followed by cervical, pre-auricular and submandibular lymph nodes are the most common sites of involvement.…”

“…1 Cat scratch disease (CSD) also known as felinosis or subacute regional lymphadenitis is a benign infectious disease caused by an intracellular bacterium, Bartonella henselae. 2 Children are more frequently affected following a scratch or bite of a cat. 2 Axillary lymph nodes followed by cervical, pre-auricular and submandibular lymph nodes are the most common sites of involvement.…”

“…2 Children are more frequently affected following a scratch or bite of a cat. 2 Axillary lymph nodes followed by cervical, pre-auricular and submandibular lymph nodes are the most common sites of involvement. 1 Most patients develop regional lymphadenopathy, preceded by an erythematous papule at the site of inoculation.…”