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A case of fatal disseminated Bartonella henselae infection (cat-scratch disease) with encephalitis

Brandy Fouch1, Susan Coventry

  • 1Department of Pediatrics, University of Louisville School of Medicine, Louisville, KY, USA.

Archives of Pathology & Laboratory Medicine
|October 10, 2007
PubMed

Insights

Cat-scratch disease, usually mild, can be fatal. This case highlights severe Bartonella henselae infection with fatal encephalitis and unique brain pathology in a child.

Area of Science:

  • Pediatric Infectious Diseases
  • Neuropathology
  • Bacteriology

Background:

  • Cat-scratch disease (CSD) is typically caused by Bartonella henselae.
  • In immunocompetent children, CSD is usually self-limiting and benign.
  • Neurologic involvement in CSD is rare and rarely fatal.

Observation:

  • A previously healthy 6-year-old boy presented with severe CSD.
  • The child experienced systemic dissemination and encephalitis.
  • The patient ultimately succumbed to the infection.

Findings:

  • Autopsy revealed perivascular lymphocytic infiltrates and microglial nodules in the brain.
  • These specific neuropathologic findings have not been previously reported in Bartonella henselae infections.
  • This suggests a potential, previously unrecognized histopathological manifestation of severe CSD.

Implications:

  • This case demonstrates the extreme end of the CSD clinical spectrum.
  • It provides crucial neuropathological evidence of Bartonella henselae's potential to cause fatal encephalitis.
  • Highlights the importance of considering CSD in unexplained pediatric encephalitis, even in severe presentations.

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