Cat scratch disease complicated with aseptic meningitis and neuroretinitis.
Cat scratch disease (CSD) is a self limited condition characterized by fever, lymph node enlargement and less often eye involvement. Central nervous system involvement by Bartonella henselae infection is possibly an important cause of morbidity; its role as an agent of aseptic meningitis is unknown. We report a case of a 40 years-old man with CSD accompanied by aseptic meningitis and neuroretinitis. Serum indirect immmunofluorescence (IFI) assays for B. henselae were positive and the cerebrospinal fluid (CSF) analysis showed mononuclear pleocytosis and increased level of protein. Serological tests for other etiologies were negative. The patient responded well to antibiotic therapy with oral doxycicline plus rifampin and in the 12th day of hospitalization evolved to total regression of the headache and partial regression of the visual loss. Clinicians should consider CSD as a differential diagnosis when assessing previously healthy patients with aseptic meningitis associated with regional lymphadenopathy and epidemiological history of feline contact.
Pinto
Vitor Laerte
VL
Evandro Chagas Clinical Research Institute, Fiocruz, Rio de Janeiro, RJ, Brazil. vitor.laerte@ipec.fiocruz.br
Curi
André Land
AL
Pinto
Adriana da Silva
Ada S
Nunes
Estevão Portela
EP
Teixeira
Maria de Lourdes Benamor
Mde L
Rozental
Tatiana
T
Favacho
Alexsandra Rodrigues
AR
Castro
Elba Lemos de
EL
Bóia
Márcio Neves
MN
D000328:Adult; D018416:Bartonella henselae; D002372:Cat-Scratch Disease / Q000150:complications*; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D008297:Male; D008582:Meningitis, Aseptic / Q000150:complications*; D012173:Retinitis / Q000150:complications*