Cat scratch disease in a child.
We report a case of a 9-year-old girl scratched on the right side of her neck by a kitten about one month prior to admission. She was well until three weeks later when she developed enlarged right neck masses, a pustula on the scratch site, right injected conjunctiva, headache, general malaise and fever, thus fulfilling the clinical criteria for CSD. Initially, she was treated by a practicing physician but the manifestations persisted for one week. After admission, leukocytosis and a mildly elevated erythrocyte sedimentary rate were noted. The serum IgG titer to Bartonella henselae was performed by means of indirect fluorescent antibody (IFA) test at the National Institute of Preventive Medicine. The serum titer of anti-B, henselae Ig G was 1:256 and greater (> or = 1:256). The positive serum titer(negative titer being < 1:64) to B, henselae, the organism thought to be responsible for CSD, also supports this diagnosis. She was treated with a 7-day course of intravenous gentamicin and the fever subsided within 24 hours. Following this, she improved clinically and was discharged one week later. One month after discharge, she remained well with no palpable neck masses.
Hsu
C F
CF
Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C.
Wang
C C
CC
Chen
S J
SJ
Chen
Y H
YH
Chu
M L
ML
Chen
H Y
HY
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000302:isolation & purification; D018416:Bartonella henselae / Q000276:immunology*; D002372:Cat-Scratch Disease / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D002648:Child; D005260:Female; D019085:Fluorescent Antibody Technique, Direct; D005839:Gentamicins / Q000627:therapeutic use; D006801:Humans
D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D005839:Gentamicins