title: Cat-scratch disease in adult hospitalized for prolonged-Fever associated with multiple lymphadenopathies and weight loss.
abstract: We report a 19-year-old patient with a Cat-scratch disease presenting three months continuous alteration of the general condition, including prolonged-fever, anorexia, asthenia, weight loss associated with adenitis and multiple thoracic-abdominal adenopathies, leukocytosis with neutrophil polynuclear predominance, and increased of C-reactive protein. The serologies of toxoplasmosis, infectious mononucleosis, human immunodeficiency virus, Brucellosis, Bartonellosis and the tuberculosis research by tuberculin reaction test and Ziehl acid-alcohol resistant bacilli direct examination were negatives. The cytomegalovirus and Epstein-Barr virus serologies were positives only for immunoglobulin-G. The Bartonella henselae diagnosis was made with the analysis of histopathological specimens. The clinical and biological symptoms regressed following eight weeks of azithromycin's treatment. According to this observation, the cat-scratch disease should be considered in differential diagnosis of patients presenting prolonged-fever associated with multiple lymphadenopathies and weight loss. The azithromycin would be an alternative therapeutic issue for this pathology in case of confirmed efficacy by studies in a large patient population.
authors.affiliation: Service de Médecine B-Hepato-Gastro-Enterologie, Centre Hospitalier de Tulle, France ; Département de Maladies Infectieuses et Tropicales, Faculté de Médecine de Libreville, Université des Sciences de la Santé, Gabon ; Service de Médecine Interne-Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire International Albert Schweitzer de Lambaréné, Université des Sciences de la Santé, Libreville, Gabon.
authors.forename: Vincent
authors.initials: V
authors.lastname: Guiyedi
authors.affiliation: Service de Chirurgie Orthopédique, Centre Hospitalier de Tulle, France.
authors.forename: Hanna
authors.initials: H
authors.lastname: Haddad
authors.affiliation: Département de Maladies Infectieuses et Tropicales, Faculté de Médecine de Libreville, Université des Sciences de la Santé, Gabon ; Service de Médecine Interne-Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire International Albert Schweitzer de Lambaréné, Université des Sciences de la Santé, Libreville, Gabon.
authors.forename: Madeleine
authors.initials: M
authors.lastname: Okome-Nkoumou
authors.affiliation: Service de Médecine B-Hepato-Gastro-Enterologie, Centre Hospitalier de Tulle, France.
authors.forename: Fabien
authors.initials: F
authors.lastname: Gire
authors.affiliation: Service de Médecine Interne-Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire International Albert Schweitzer de Lambaréné, Université des Sciences de la Santé, Libreville, Gabon.
authors.forename: Brice
authors.initials: B
authors.lastname: Ongali
authors.affiliation: Service de Médecine Interne-Rhumatologie-Neurologie, Centre Hospitalier de Tulle, France.
authors.forename: Philippes
authors.initials: P
authors.lastname: Lore
authors.affiliation: Service de Médecine B-Hepato-Gastro-Enterologie, Centre Hospitalier de Tulle, France.
authors.forename: Luis
authors.initials: L
authors.lastname: Gameiro
keywords: Azithromycin; adenopathies; cat-scratch disease; prolonged-fever.; weight loss