Cat scratch disease presenting as acute encephalopathy

Area of Science:

• Neurology
• Infectious Diseases
• Pediatrics

Background:

• Bartonella henselae infection, commonly known as cat scratch disease, can present with diverse neurological manifestations.
• Meningo-encephalitis is a rare but serious complication, particularly in pediatric cases.

Observation:

• A 9-year-old boy presented with primary meningo-encephalitis followed by partial complex seizures.
• The condition was attributed to cerebral Bartonella henselae infection.

Findings:

• The patient experienced a clinical relapse of seizures after initial treatment and subsequent carbamazepine withdrawal.
• Recurrence of absence seizures and EEG abnormalities were noted six months after discontinuing carbamazepine.
• Reintroduction of carbamazepine led to symptom improvement and seizure control.

Implications:

• This case underscores the potential for recurrent neurological symptoms in Bartonella henselae infections.
• Prolonged anticonvulsant therapy may be necessary for managing seizure disorders secondary to cerebral Bartonella henselae.
• Early diagnosis and appropriate management are crucial for preventing long-term neurological sequelae in children.