title: Cat scratch disease complicated with aseptic meningitis and neuroretinitis.
abstract: 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.
authors.affiliation: Evandro Chagas Clinical Research Institute, Fiocruz, Rio de Janeiro, RJ, Brazil. vitor.laerte@ipec.fiocruz.br
authors.forename: Vitor Laerte
authors.initials: VL
authors.lastname: Pinto
authors.forename: André Land
authors.initials: AL
authors.lastname: Curi
authors.forename: Adriana da Silva
authors.initials: Ada S
authors.lastname: Pinto
authors.forename: Estevão Portela
authors.initials: EP
authors.lastname: Nunes
authors.forename: Maria de Lourdes Benamor
authors.initials: Mde L
authors.lastname: Teixeira
authors.forename: Tatiana
authors.initials: T
authors.lastname: Rozental
authors.forename: Alexsandra Rodrigues
authors.initials: AR
authors.lastname: Favacho
authors.forename: Elba Lemos de
authors.initials: EL
authors.lastname: Castro
authors.forename: Márcio Neves
authors.initials: MN
authors.lastname: Bóia
mesh_terms: 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*