[Bartonella henselae infection in immunocompetent patients: cat scratch disease].
BACKGROUND
Cat scratch disease, whose etiologic agent is Bartonella henselae, is a benign disease in immunocompetent subjects, characterized by lymphadenopathy of prolonged course and occasional involvement of other organs such as liver, spleen, central nervous system, eye and lung. In immunocompromised patients, the infection is bacteremic and disseminated.


OBJECTIVE
To report Chilean cases of cat scratch disease.


METHODS
Ten children (seven male, aged between 6 and 13 years old) with histologically or serologically confirmed cat scratch disease are reported.


RESULTS
Lymphadenopathy location was pre auricular in four cases, axillary in two, inguinal in two and epitrochlear in two. Three children had fever over 39 degrees C and two had a parinaud syndrome. Nine children had a history of cat scratch and one of a cat byte. Six had an erythrocyte sedimentation rate over 40. Lymph node ultrasound examination was a useful diagnostic tool. Two patients had splenic granulomas. Lymph node biopsies were obtained in four cases, showing a suppurative granulomatous lymphadenitis in all and a positive Warthin-Starry stain in two. Serology, done in patients without histological confirmation was positive with titles ranging from 1:64 to 1:8192. All patients had a satisfactory outcome with regression of lymphadenopathy.


CONCLUSIONS
Infections by Bartonella hemselae occur in the Chilean population and must be considered in the differential diagnosis of regional lymph node enlargement.
Abarca
K
K
Departamentos de pediatría, de Radiología y Anatomía Patológica, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Vial
P A
PA
Rivera
M
M
García
C
C
Oddó
D
D
Prado
P
P
Ferrés
M
M
D000293:Adolescent; D018416:Bartonella henselae; D002372:Cat-Scratch Disease / Q000175:diagnosis* / Q000276:immunology; D002648:Child; D003234:Conjunctivitis, Bacterial / Q000175:diagnosis; D005260:Female; D006801:Humans; D007121:Immunocompetence; D008206:Lymphatic Diseases / Q000175:diagnosis; D008297:Male