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Hepatosplenic cat-scratch disease in children: selected clinical features and treatment
E S Arisoy1, A G Correa, M L Wagner
1Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, USA.
Insights
Rifampin is effective for treating hepatosplenic cat-scratch disease, a bacterial infection. This antibiotic significantly shortens fever duration, offering a crucial treatment option for children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Hepatosplenic cat-scratch disease is a serious Bartonella henselae infection.
- Diagnosis often involves prolonged fever and abdominal pain in children.
Observation:
- A retrospective review of 19 pediatric cases was conducted.
- Patients presented with prolonged fever (mean 22 days) and abdominal pain (68%).
Findings:
- Rifampin, alone or with other antibiotics, led to rapid improvement within 1-5 days.
- The common dosage was 20 mg/kg/day every 12 hours for 14 days.
Implications:
- Rifampin should be considered for initial treatment of hepatosplenic cat-scratch disease.
- Early rifampin therapy can significantly reduce illness duration in pediatric patients.
Abstract:
We reviewed 19 cases of hepatosplenic cat-scratch disease at Texas Children's Hospital (Houston). The range of the patients' ages was 2 years 4 months to 11 years 8 months. The chief complaint was fever for all patients. The duration of fever before diagnosis was 7 to 56 days (mean, 22 days). Abdominal pain was present in 13 patients (68%). Thirteen children were treated with rifampin alone, and three received rifampin therapy plus gentamicin or trimethoprim-sulfamethoxazole. Once rifampin therapy was initiated alone or in combination, improvement was noted within 1 to 5 days (mean, 2.6 days) for patients who had had prolonged fever the duration of which before rifampin therapy averaged 3 weeks. The most common dosage and duration for our patients were 20 mg/[kg x d] every 12 hours and 14 days, respectively. Rifampin should be considered in the initial antimicrobial treatment of hepatosplenic cat-scratch disease.