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Cat Scratch Disease: The First Case Report in Republic of North Macedonia
Kostadin Poposki1, Zaklina Sopova1, Marija Dimzova1
1University Clinic for Infectious Diseases and Febrile Conditions, Faculty of Medicine "Ss. Cyril and Methodius", Skopje, Republic of North Macedonia.
Insights
Cat scratch disease (CSD), caused by Bartonella henselae, is confirmed as present in our country. This case report highlights CSD as a crucial diagnosis for fever of unknown origin with lymphadenopathy.
Area of Science:
- Infectious Diseases
- Bacteriology
- Clinical Case Reports
Background:
- Cat scratch disease (CSD) is primarily caused by Bartonella henselae in immunocompetent individuals.
- Transmission occurs from cats to humans through scratches or bites.
- CSD often presents with fever and regional lymphadenopathy.
Observation:
- A previously healthy adult female presented with a month-long history of fever and axillary lymphadenopathy.
- Extensive clinical and paraclinical investigations were conducted to identify the cause of her symptoms.
- The patient had no reported history of cat contact.
Findings:
- Serological testing revealed high titers for Bartonella henselae IgG (1:1024) and IgM (1:160), confirming the diagnosis of CSD.
- A five-day course of azithromycin led to a significant clinical improvement and complete recovery.
- This case represents the first etiologically confirmed instance of CSD in the country.
Implications:
- This report establishes the presence of Cat Scratch Disease in the country, necessitating increased medical awareness.
- Physicians, particularly infectious disease specialists, should consider CSD in the differential diagnosis of fever of unknown origin (FUO) with regional lymphadenopathy.
- Prompt diagnosis and treatment with antibiotics like azithromycin are effective for managing CSD.
Abstract:
Cat scratch disease (CSD) is the main clinical manifestation caused by Bartonella henselae in immuno-competent patients. The bacterium is transmitted to humans from cats via scratches or bites. In this case report, we are presenting to our knowledge the first etiologically confirmed case of CSD in our country. Here we describe the case of a previously healthy adult female patient presenting with fever and axillar lymphadenopathy over 1-month period. She underwent numerous clinical and paraclinical investigations for potential etiologies associated with lymphadenopathy and fever. Finally, serological testing for B.henselae was performed with titers for IgG 1:1024 and 1:160 for IgM, which confirmed the diagnosis. Five-day treatment with azithromycin resulted with good clinical response and complete recovery. We proved that CSD is a reality in our country and this report should raise awareness in medical doctors, especially infectious disease specialist. Also, CSD should be included in differential diagnosis in patients with fever of unkown origin (FUO), who are presenting with regional lymphadenopathy, with or without history of cat contact.
