CASE REPORT OF CAT SCRATCH DISEASE (BARTONELLA)

We report a case of Cat Scratch Disease (CSD) in a 39-year-old male who presented to the emergency department of an infectious diseases center with high fever, chills, myalgia, arthralgia, sweating, dry cough, nausea, weakness, right axillary lymphadenopathy, and fatigue. Initial laboratory findings showed elevated inflammatory markers consistent with bacterial infection. Imaging revealed right axillary lymphadenopathy with multiple hypovascular lesions in the liver and spleen. Patient history revealed multiple cat bites over the past 5 years. Initial treatment with ceftriaxone and azithromycin was administered. Serology and histopathology confirmed Bartonella henselae infection. Despite initial clinical improvement and discharge with antibacterial therapy (macrolides and rifampicin for 14 days), the patient returned with recurrent symptoms due to medication non-adherence. His 16-year-old son also presented with similar lymphadenopathy. Both tested positive for Bartonella henselae. Surgical removal of enlarged lymph nodes and combined antibacterial treatment resulted in complete recovery, with follow-up imaging showing resolution of hepatosplenic lesions. This case highlights the familial transmission potential of CSD and the importance of medication adherence, accurate diagnosis, and timely treatment to prevent complications and recurrence.