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Encephalopathy with retinitis due to cat-scratch disease

R A Smith1, B Scott, D W Beverley

  • 1Department of Paediatrics, York Hospital, York, UK. robert.a.smith@york.nhs.uk

Developmental Medicine and Child Neurology
|November 28, 2007
PubMed

Insights

Cat-scratch disease, caused by Bartonella henselae, can lead to severe neurological issues like encephalopathy. Early diagnosis and azithromycin treatment led to a full recovery in a pediatric case.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Ophthalmology

Background:

  • Cat-scratch disease is caused by Bartonella henselae, a bacterium.
  • While some Bartonella infections resolve spontaneously, others can be fatal without antibiotic treatment.

Observation:

  • A 7-year-old male presented with a 2-week history of malaise and cervical lymphadenopathy.
  • Symptoms progressed to fever, headache, vomiting, confusion, and meningism.
  • Unusual retinal findings and evidence of Bartonella henselae infection were noted.

Findings:

  • Lumbar puncture showed elevated cerebrospinal fluid protein, low glucose, and increased white blood cells.
  • Antibody titers to Bartonella quintana supported the diagnosis of cat-scratch disease.
  • The patient exhibited unexplained encephalopathy and atypical retinal findings.

Implications:

  • This case highlights the potential for Bartonella henselae to cause severe neurological complications in children.
  • Prompt diagnosis and treatment with azithromycin are crucial for favorable outcomes.
  • Ophthalmological examination is important in diagnosing atypical presentations of cat-scratch disease.

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