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Cat-scratch disease: Experience in a tertiary care children's hospital
María I Deregibus1, Eliana I Bagnara1, Ana Buchovsky2
1Low Risk Sector; Hospital de Pediatría S.A.M.I.C. Prof. Dr. Juan P. Garrahan, City of Buenos Aires, Argentina.
Insights
Cat-scratch disease, caused by Bartonella henselae, commonly presents as solitary lymphadenopathy in children. Diagnosis relies on clinical signs, history, and serology, with abdominal ultrasound useful for feverish children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Bartonella henselae causes cat-scratch disease, a condition with a broad clinical spectrum.
- The most frequent presentation is solitary lymphadenopathy, primarily affecting children and young adults.
Purpose of the Study:
- To analyze the epidemiology, clinical features, and disease course of cat-scratch disease.
- To investigate the diagnostic and treatment patterns in a tertiary care pediatric hospital in Argentina.
Main Methods:
- Retrospective, descriptive, and observational study.
- Inclusion criteria: children aged 0-16 years with compatible symptoms and positive serology.
- Data collected from January 2019 to June 2021.
Main Results:
- 150 patients included; mean age 7.9 years. 68.7% reported cat contact.
- Solitary lymphadenopathy (head/neck) was the most common presentation (84.7%).
- 88% had positive IgM/IgG serology; 44% received antibiotics (azithromycin most common).
Conclusions:
- Diagnosis hinges on clinical suspicion, epidemiological history, and serological testing.
- Typical presentation involves solitary lymphadenopathy; abdominal ultrasound is recommended for febrile children due to potential hepatosplenic involvement.
Abstract:
Introduction. Bartonella henselae is the etiologic agent in cat-scratch disease. It affects children and young adults. The clinical spectrum is wide; the most common clinical presentation is a solitary lymphadenopathy. The objective of this study was to analyze the epidemiology, clinical features, and course of this disease in a tertiary care hospital in Argentina. Population and methods. Retrospective, descriptive, and observational study conducted at a tertiary care pediatric hospital from January 1st , 2019 to June 30th, 2021. Children aged 0 to 16 years with compatible clinical signs and symptoms and positive serology were included. Results. A total of 150 patients were included; their mean age was 7.9 years ± 3.68. Of them, 68.7% reported having contact with cats. The most common reason for consultation was the presence of solitary lymphadenopathies (84.7%) in the head and neck. Febrile syndrome without source was the reason for consultation in 15.5% of cases, with a pathological abdominal ultrasound scan in 85.7%. IgM and IgG were positive in 88%. With the result of a positive serology test, 44% received antibiotic treatment. Protracted lymphadenopathy was the main reason for antibiotic treatment; the agent most commonly used was azithromycin (42.4%). Fourteen percent (n = 21) required hospitalization. Conclusions. Diagnosis is based on clinical suspicion, epidemiological history, and complementary testing. Its typical presentation is a solitary enlarged lymph node in the head and neck. Due to the high frequency of hepatosplenic involvement, an abdominal ultrasound scan would be indicated in children with fever.
