title: Cat scratch disease during etanercept therapy in a rheumatoid arthritis patient.
abstract: Cat scratch disease (CSD) is an infectious disorder caused by Bartonella henselae and characterized by fever and granulomatous lymphadenopathy. Immunosuppression is a risk factor for the development of atypical forms of the disease. We report the case of a 52-year-old woman who presented with fever and bilateral inguinal lymph node enlargement. She did not have apparent contact with animals. The patient was receiving etanercept therapy for rheumatoid arthritis. Lymph node biopsy demonstrated granulomatous lymphadenitis. She was successfully managed by discontinuing etanercept and by treatment with minocycline. She developed clinical remission and typical seroconversion. Infection with Bartonella should be considered in the differential diagnosis in rheumatoid arthritis patients with lymphadenopathy of unknown origin.
authors.affiliation: Servicio de Medicina Interna, Clínica San Camilo, Ciudad Autónoma de Buenos Aires, Argentina. Electronic address: aoorden@intramed.net.ar.
authors.forename: Alberto O
authors.initials: AO
authors.lastname: Orden
authors.affiliation: Servicio de Reumatología, Clínica San Camilo, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Norma N
authors.initials: NN
authors.lastname: Nardi
authors.affiliation: Servicio de Hematología, Clínica San Camilo, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Alicia B
authors.initials: AB
authors.lastname: Vilaseca
authors.affiliation: Servicio de Infectología, Clínica San Camilo, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Ana C
authors.initials: AC
authors.lastname: Colombini
authors.affiliation: Servicio de Bacteriología, Clínica San Camilo, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Nora G
authors.initials: NG
authors.lastname: Barrios
authors.affiliation: Centro de Patología y Citología (CEPACIT), Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Anahí
authors.initials: A
authors.lastname: Vijnovich Barón
mesh_terms: D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D018416:Bartonella henselae / Q000302:isolation & purification*; D002372:Cat-Scratch Disease / Q000175:diagnosis* / Q000276:immunology; D000068800:Etanercept / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008875:Middle Aged
chemical_list: D018501:Antirheumatic Agents; D000068800:Etanercept
keywords: Artritis reumatoidea; Bartonella; Cat scratch disease; Enfermedad por arañazo de gato; Etanercept; Rheumatoid arthritis