A Man in His Forties with Recurrent Cat-Scratch Disease.

Area of Science:

• Infectious Diseases
• Bacteriology
• Zoonotic Infections

Background:

• Cat-scratch disease (CSD) is a common zoonotic infection caused by Bartonella henselae.
• It typically presents with lymphadenopathy and constitutional symptoms, usually self-limiting within eight weeks.
• Recurrence or reactivation of Bartonella henselae infections is infrequently documented.

Observation:

• A 45-year-old male with a prior CSD diagnosis presented with recurrent groin lymphadenopathy.
• The patient had a history of close feline contact, with no specific exposure incident reported.
• Diagnosis was confirmed by positive serology indicating recent infection and characteristic histopathological findings.

Findings:

• The patient's presentation mimicked primary CSD, despite a previous diagnosis.
• Serological and histopathological evidence confirmed a new Bartonella henselae infection.
• Treatment with azithromycin led to complete symptom resolution.

Implications:

• This case underscores the possibility of CSD recurrence or reactivation, even years after initial infection.
• It emphasizes the importance of considering Bartonella henselae in patients with recurrent lymphadenopathy, especially with feline exposure history.
• Prompt diagnosis and appropriate antibiotic therapy, such as azithromycin, are crucial for managing recurrent CSD.